the past few days have been sheer hell. I was on call, so I was at the hospital for 15 hours. Which on medicine, that feels like forever. Especially because most of the time, you're just standing there wondering when you'll be able to go. Our intern asked if we wanted to admit another patient from the ER or go eat, and I was like, can I really go eat? I felt like a slacker because she gave me the choice of work vs. eat, and she was working over eating, but it was 9:00 PM, and I knew that admitting a patient takes forever. I tend to do things a lot quicker on my own clock. Not sure why, I just work fast. So I get so bored and antsy when I'm just watching someone else work, SLOWLY. Especially when it's past dinner time.

I am beyond burned out. And beyond frustrated as well. The only rotation I could envision myself doing was ob/gyn, and I just refuse to have those hours for the rest of my life. I really enjoy the OR, but I don't want to sacrifice my life. I want to have kids before I'm thirty- I want to be able to work part-time. And call me lazy, but I want to do a residency that is as little overnight call as possible. I just don't have the will to do much more of this.

I really wish I could just start practicing without doing a residency. Or do a part-time residency and take the pay cut. I can't envision working this hard for five more years. I am getting fat, I drink too much, I can't get a decent night's sleep, I have no sex drive, I'm putting off having kids, putting off paying my debt, putting of going home to see my mom and sister and grandparents and rest of family, putting off my ENTIRE LIFE. And for what?

Really, for what? So I can someday have a six figure salary? Bc at this point that is the only reason to come up with to choose medicine over nursing or pharmacist or physical therapy. In fact, I wish my scope was more limited and I had less responsibility. Everyday, I fantasize about how much better it would be if I were a teacher or a professor. I remember my anatomy professor asked me why I was going to med school and tried to convince me to teach. Too bad I was too stubborn to listen, I had to take the road of greatest resistance.

So here I am. With no plan.

I am crossing medicine off the list. This is my lowest low of my M3 year. Sometimes I feel like I can't even make it the next eight weeks. At least I've done four already. At least. And maybe hours on VA will be better. Right now they are as bad as OB- which is crazy.

well my arms are tired. that's how lazy I feel.

coffeeandtea

well, it's time.

it's time to start translating all of my emotions into action.

I've been thinking. Oh wow, my shift button just broke. but oh well. It is not going to sway me! This post is about positivity! Onward...

1. most importantly- no more negative talk. I was paying attention to my thoughts today- and an overwhelming number of them are negative. I constantly beat myself down. I'm not presenting well enough. I don't know my patients well enough. I hate drugs- hate med school- hate what i'm doing. hate getting up in the morning. and on and on and on. no wonder i'm not in a good mood and emotionally worn out at the end of every day. soo, i'm going to watch my thoughts. i'm really going to try to turn it around.

2. i made my first appointment for grief counseling on october 8th at 8:30 am. even though i have school, i'll just have to figure it out. because school is not as important as my own mental health. and i owe it to myself to work through my own grief.

3. i'm going to start taking care of myself. no more self destructive behavior, no more binging, drinking too much/often, and making excuses about going to the gym. no more "i'm too tired". i realized today that i spend probably 10 min out of every hour worrying and kicking myself for getting this out of shape and this heavy. it's not fair to myself to look in the mirror every day and be disgusted by my body. i've gained fifteen to twenty pounds since starting medical school. med school shouldn't take my health and my body away from me. my weight affects everything- the way i feel in my clothes, which clothes i can where, how often i dress up, how i feel every day getting dressed, how i feel about sex, how i feel about my lack of will power.

i feel like i'm incapable of accomplishing anything when i run to a fast food restaurant to "fix" my bad day. i feel like a complete failure when i suck down a milkshake as a pick-me-up. and i feel like a complete failure when i step on the scale and dread the numbers.

so, i just think it's time to start really trying- really putting some will power- into thinking that i'm important enough to take care of myself.

4. call my family and friends more often. actually pick up my phone. this one is cyclical. i feel antisocial so i don't answer my phone or call people. then i feel even more antisocial because i isolate myself. yes, depression makes you not want to talk to people. i feel like the most boring, unispiring/inspired person on earth. i feel like no one understands me and there is absolutely no point in even trying. i feel like making friends and maintaining friendships is not worth the monumental amount of work- and bottom line- i feel like i'm not worthy of having friends.

it really goes back to being so down on myself. if i don't feel good enough to put myself out there, it's just like medical school and losing weight. it's not going to improve as long as i'm being so self-defeating about it.

i can blame it on my place in life- no children, i work at med school all the time, i lost my brother and it's unfair, my husband doesn't understand, i hate living away from my family, etc. etc. but bottom line is it is entirely up to me to change.

i am in control of my own destiny!

... too bad i'm not in control of my shift button!

sorry for all the lower case i's. that is actually something that drives me nuts. but oh well.

good night everyone.

coffeeandtea

i just wanted to cut and paste a very inspirational and honest post by lauraMD about being a physician... because i'm mulling over these issues myself as a third year medical student, and because i too love delivering babies but don't think i could tolerate the lifestyle...

lauraMD thanks!
Just for balance, I'd like to say that I love my job. There were certainly times in med school and residency when I doubted myself and my career choice. But now that those years are over, I'm really very happy as an attending physician. It takes guts and tenacity to make it through, no doubt.. and it was definitely hard on my family.

I did really love my first two years of med school. Though I have to say, as I now precept 1st and 2nd year students in my office.. I am not paid AT ALL for this, and certainly not to purposefully 'inspire enthuiasm and over-the-top excitement for the clinical years." I am very (brutally) honest with my students about what year three is like. (And BTW--I'd like to know what school pays their year one/two preceptors. I might need to move there.. [scratchchin] or at least bring it up with my school. [Wink]

Definitely, year three (year four was a breeze) and intern year were merciless. I was definitely clinically depressed during my MS3 surgery rotation and again during IM rotation as a PGY1. [Tired] But as I got on to more interesting and fun sections of my education, I was able to refocus.

My advice is to follow your heart.. becoming a doctor is not easy.. but I do think one can be happy in this career. I think spending time talking to your family and being honest about your expectations is important. I suspect one reason I'm happy is that my lawyer and I worked our tails off negotiating a very nice contract with my hospital, which allows me lots of time with my family. So think about your lifestyle choices all along the way. --For example, I adore delivering, but could NOT see myself living the 'OB lifestyle.' So, I opted for FP where I can still deliever babies from time to time, but am not required to be on call all the time.

Also, a quick note on mid-levels.. I work with several PAs, some of whom will tell you that they do the same work as me (well.. not exactly.. [Roll Eyes] but I digress..) for half the pay and are sick of always having to apologize for themselves. (You know, they walk into the room and the patient says, "Oh, You mean I'm not going to see the DOCTOR??" In a snobby, disappproving voice.) I don't think I could handle that, personally. Would drive me nuts. And any time the pt does not agree with the practitioner, they demand to see the DOCTOR. Ughh.. it irritates me, I can only imagine how my PAs feel.

Ultimately, only you and your family can decide the right course. Hang in there and good luck with your decisions!!

Thoughts about my future career- ob/gyn?

wow, i am done with house medicine. well, i still have to do VA but school house month is done. and i couldn't be more relieved. i just felt like it stomped out my soul. even just one month of wards. i think it's mostly only having one day off the entire month. i simply cherish my weekend away from the hospital. i hated all of the down-time, just looking outside at how beautiful the day was, and feeling like i was just sitting at the hospital accomplishing absolutely nothing.

i don't think i'm the thinking type, honestly. i don't get excited going through the history and physical, and then coming up with a differential diagnosis and then talking about meds and labs and treatment plan.... i just feel really understimulated. and the patient's depress me, really make me feel sad and hopeless. i used to think i wanted to work with the elderly, and i'm realizing now that it's not in the cards for me. i just don't have the personality to enjoy that kind of work.

i remember doing ob/gyn, and i never felt worthless. i always felt like i was accomplishing something just as long as i was doing things. i recently took the virginia specialty inventory test, and i consistently get surg specialties over medicine, probably because i choose doing over thinking. they ask, are you a doer or a thinker?

i can't imagine being more depressed on surgery than i am on medicine. i know the hours are harder, but i think i will enjoy the work so much more. if i do enjoy surgery, that will seal the deal for me, i'm going into ob/gyn. if i somehow change my mind and end up hating surgery and feeling bored in the or, than it's back to square one. i just remember really, really enjoying both vaginal deliveries and the opportunity to scrub in on ob/gyn. i truly miss it. and i like the straight-forwardness of the specialty. i like, here's the problem, fix it mentality. it's gratifying to me.

i struggle with choosing to do something that has known terrible hours. i feel guilty and conflicted since i desperately want a work/life balance and also want a larger family. but, i'm realizing that if i had to wake up and be an internist everyday, i'd be miserable. i'm miserable after just a month of it. imagine an entire career? i'm sure i'd make the best of it, but it's never "fun" the way ob/gyn was.

also, i've been thinking, it really is up to me to have the lifestyle that i want. i can handle the residency. truly, i'd rather do long hours during the week with more weekends off, night float as opposed to q4 call. after one month of wards, i realize it's not like medicine is a walk in the park at all. and i'd rather be in ob/gyn clinic where people need a procedure done as opposed to still having to think about new admits and what the plan is.

but really, and maybe this is blindly optimistic, post-residency could be virtually anything i want to make it. considering the field demographic is changing and is now around 80% female in residency,
1. i would think job share positions will become more available in five years when i would finish residency. surely some other woman would like to stay home more with her children vs. make the extra money.
2. even if i went into a full-time position, many practices with 8+ doctors are making call and the hours much more tolerable, so it might be possible to work something out that i'm happy with.
3. if i'm run ragged and sick of the terrible hours, i could always drop ob and just do gyn and women's health. i'd be happier doing that than medicine bc i'd still get OR time and procedures.
4. if i'm completely sick of adults, i could always focus on adolescent gyn and preventative med/ counseling stuff.
5. after one year of ob/gyn residency, i could always re-evaluate and if the hours aren't worth it in terms of satisfaction and fulfillment, that's when i could pick up and switch to a more lifestyle friendly residency. i know this is a cop-out, but after doing a year i might think, i love this! but if i don't, there's always er...

have a good night everyone,
coffeeandtea

well.

i'm confused today. i started my onc rotation that is lasting for two weeks. i went in at 10 and left by 2:30. it was the shortest, easiest day i've had in a month. but for some reason, i still feel just.... down.

i was horribly nervous pretty much the entire day. my attending is known for being a great doctor and person, but he has a very strong personality, and lately i have just been cowering when i'm put on the spot. i hate having to perform. i just clam up. then i start analyzing my performance and i hate every second of it.

it's just so tough to work through all of these emotions. am i unhappy with med school bc of all of these negative feelings (since that's a temporary thing), or am i uninterested because my heart isn't in it?

i was thinking about how i don't like working with adults and miss the kiddos on peds, but then i thought to myself, "if i'm not enjoying adults on medicine, what makes me think that women's health/obgyn is going to be any different? if i don't like working with adults, then maybe i really should give a long look at peds.

plus the peds people sincerely liked me. and i sincerely liked them. and i sincerely like kids. i think that they're cute and i don't mind when they're sick and i don't get nearly as clammy and nervous and flustered with the kids.

so i'm just confused, as usual. and utterly out of any and all motivation to study for my test tomorrow. like, it's really, really bad. i have my mid-term in medicine tomorrow and i have yet to study AT ALL. it covers rheum, nephrology, pulm, and cardio, and trust me, i don't know it. but here i am, i've been sitting at home for four hours, and i haven't even attempted to study.

i guess i feel like it's just too late. i started medicine on wards and have been doing q4 call for the entire month. i didn't have any downtime to study. our residents kept us late, expected us to be there earlier than the other teams, and never let us off the hook to go read. so i'm going to bomb the test tomorrow- and there's not a whole lot i can do about it. i did go to class. plus, i just can't get motivated to read on medicine. after being at the hospital all day, the last thing i want to do is come home and read Step up to medicine. ugh.

but then at the same time, i am still in medical school. just bc i passed step 1 doesn't mean i can stop studying now. i actually need to be working HARDER considering my hubbie's insanely good step scores that i have to live up to. since we can't couples match and all :rolleyes:

well, i guess it's time to crack a book.

wish me luck tomorrow- i'm going to need it.

coffeeandtea

i want to start one of these in my state. lord knows we're in dire need. we have the highest infant mortality rate in the country. this video brought tears to my eyes and is so inspirational. what an amazing project and ministry.

http://www.homelessprenatal.org/video.htm

i'm sick. and now not only do i not have a shift button, i don't have a s button. so i have to push my finger down into the little hole to hit the s and it takes longer and is annoying.

plus i'm sick.

i have chills, a headache, and just feel like crap, but for some reason the thermometer reads 97.2. it's annoying, because i really do feel terrible.

and of course this falls right on top of our vacation this weekend. me and hubbie finally got a weekend off together.... it's been months.... and of course i'm sick for it! we have a hotel, we're celebrating my birthday, i'm going to get to go to a fancy restaurant- TOO BAD I CAN'T TASTE ANYTHING AND HAVE NO APPETITE! grrr :banghead:

but it could be worse. i could be sick on wards. at least i'm sick on amulatory so my hours are more bearable.

did i mention my keyboard is falling apart?

plus i found myself day-dreaming about ob/gyn once again. i might just end up doing it, terrible hours, crabby residents, and all. lord help me!

well that's all, just feel like whining. i absolutely hate being sick. it's the worst.

I went to my first counseling session for grief therapy, and walked away with a lot of insight. I really love my counselor. some of her spectacular points:

After listening to me for a while, she made the observation that I'm trying to be, or be like, my husband. easy to do, since we're both in medical school and he's a year ahead of me, plus I admire him... anyway, she pointed this out and it really hit me. because frankly, me and hubbie are very different. I do believe we compliment each other most of the time, but there is really no way that the job that works for him would also work for me. Nor should I look at what he wants out of a job, and think that it should apply to myself.

She made the great point that what attracted him to me in the first place was my independence. So this is no different. I have to carve out my own path. I can't use his as a template. I've tried to do that the past few months, and it's just made me dissatisfied with school and everything else.

she told me that I need to tell the Lord everyday that I want him to show me a place and make a place for me to serve. and that he will provide and he will lead me to that place. she said in the meantime to focus on the present and taking care of myself, and trust that he will take care of it.

she also really tried to convince me to consider child psychiatry- which apparently has a major shortage of doctors. I think it may be telling that the only people that have offered career advice have really pushed me to go into pediatrics of some sort. maybe that's God trying to tell me something, right there.

Anyway. what else? all in all, it was really great. I realized that one of the major reasons I'm so distraught it because I feel like in order to be happy and to make medical school seem worthwhile is to pursue a surgical field/procedure based field and work 80 hours a week. I have no idea why I feel like this- probably goes back to what she said about trying to be like hubbie.

anyway, while talking to her, it became glaringly obvious (once again), that what I really want in life is a big, loud family, a happy, bustling home, and the freedom to enjoy living, being a mom and wife, cooking, running the home, in addition to doing a job that is emotionally and intellectually fulfilling. She pointed out that I don't have to choose one or the other.

So I'm planning on sticking with the counseling, and hopefully it will continue to have such a strong impression on me. She also said I should go talk to my school MD, also a women married to another doctor.

ah well, also, can't name specifics, but mine and hubbie's plans have a rift in them, presently. We'll see how it pans out.

hope everyone is enjoying the cool fall weather.

coffeeandtea

ps. my keyboard is falling apart...

"By your own soul learn to live.
If some men thwart you, take no heed.
If some men hate you, have no care.
Sing your song, dream your dream.
Hope your hope and pray your prayer."
Pakenham Beatty

Sorry I haven't updated in a while.

I've been really struggling with a lot of issues lately, plus being out of town and having my birthday. I went home, as in where my entire family lives, for the weekend. It was the first time I've been home in a month and a half. I have a feeling that if we go far away for residency, I'm going to find myself very homesick. Not saying that we shouldn't go away- just that I can already predict that that will be one of the hardships.

Lately, I've been bouncing back and forth between hating medical school/being okay with it, thinking it is taking me away from my family, stealing my identity, forcing me to wait to have children, etc and being okay with everything and thinking, "this isn't so bad". I didn't have such violent mood swings about it since my brother died. After his death all it seems I want to do is move home, start having babies, and living some semblance of a normal life. I do realize that if I did ob/gyn, that will never really happen. Normal life for me means an adaptable job with the option to do part-time work (i.e. 20 hours/week), with little to no call, no weekends, and at home by 5 pm. I know that this is a lot to demand of medicine, but I am married to a future surgeon, I want four children, and although I don't think I want to stay at home full-time, I don't see myself wanting to work full-time when I have kids at home. Which, if all works out, and we have three or four children, that is going to be over a decade.

So my next thought is, I should plan my career to suit my personal life, because I do feel strongly about it and know what I want in terms of my personal life. Not the other way around. I have no clue what I want in a career. I'm hoping that as long as it involves patient care, and I can have control over my life, I'll be happy. I'm the type who misses having lots of hobbies- I miss being involved in a church, I miss writing and having the time and energy to read books, I miss taking random classes in the arts. I miss humanities so much. My favorite classes in college were my creative writing, history, and english classes. I did love evolutionary biology even more than my med school classes. But I'm just never using the creative part of my brain anymore, and my personality just needs that stimulation.

I guess what I'm saying is that for me, medicine can't be everything.

So I'm considering family medicine, and then going back to do a fellowship later in life when my kids are older. I've thought about palliative care or women's health. I did love ob/gyn and most of all, the delivering babies part, but the surgery (though fun) is too taxing for me long term. A lot of people, including my husband, think that family med physicians shouldn't deliver babies, that you should just do ob/gyn if you want to do that. The thing is, ob/gyn is demanding from the get-go. Family med could be family frienly, or I could do a fellowship and have the option to have a worse schedule and deliver babies. plus, my opinions on labor and delivery are a lot more crunchy-granola than ob/gyn in general, so I'd probably end up working at some alternative birthing center anyway with a bunch of midwives or something. Really, I have no idea if I'd even pursue it. But family medicine at least has that avenue. (unlike EM or internal med).

Anyway, so as you can see, my future is stressing me out.

Even moreso, I am really worried about my sister. I'm ready to get home in november to do my family medicine rotation. It start nov 18 and I'll be home until January. Which is perfect timing, because my sister needs me. She was a senior in high school last year when my brother died, and it just kind of destroyed her plans for college. Then her and her bf of two years broke up. Now she's understimulated and unhappy at a community college in a very rural area, and she's hanging out with people that I don't really approve of. We talked, she cried, and we decided that she needs a U-turn. So I need to be home to help her, because U-turns are never fun and require a lot of un-doing and a lot of determination. It's basically the path of most resistance. We're wanting to get her in a four year university, she's got her eyes on my hubbie's alma mater, so we just need to figure out the money.

anyway, I need to be doing a U-turn myself. I have been drinking way too much, and it's got to stop. Last night I had six beers and an shot, which is way more than I used to drink, ever. I used to have three, max. Now I just slam them down without even thinking about it. I have drank almost everyday this week. Which, we got some really bad news, hubbie failed his CS, but that is no excuse to excessively drink.

In addition to that, I'm still smoking the cancer sticks.

And I'm not making church a priority at all. Not making it to Bible study, not going on sunday or on wednesday. I got so tired of looking for the right church that I just gave up on going. Even though my faith is what keeps me going, and when I'm not practicing my faith I fall into pitfalls like the ones listed above. plus, with my brother's death and all of the stressors in my life, I need to depend on God everyday in my actions, not just in theory.

So here's to making a U-turn.

I'll keep everyone updated.

coffeeandtea