Hi everyone.

I've been a quiet observer on this website off and on for some time... Lately, as I feel like I'm reaching lower and lower points.. I felt compelled to reach out and share my story and hopefully feel I am part of a community who can relate.

I was talking to my husband (non-doctor) the other day about residency and my decision to become a doctor.. and how my priorities have really changed since we had our son almost a year and a half ago. I feel like I really regret my decisions.
I thought the most important thing to me was to feel like I'm helping other people and challenging myself, and now that I have my son it all just feels so silly. How can I feel positive about spending so much time helping others when I only see my son for 30 min or less/day? when i don't get to feed him his meals or teach him song or new words? what about his right to have a mommy who gives him all the wonderful things a mommy should.
I'll try to make this long story short.
I'm an anesthesia resident. Just started my first year of anesthesia. Got married summer between 1st and 2nd year of med school. Had my son during 4th year of medical school. Interviewed for residency while I was 5-6 months pregnant. I spent my intern year in internal medicine near my parents and in-laws and relied on them 100% to care for my son when I was at work.
For my anesthesia program we moved about 1 hr away and now have our son in daycare.
(if anyone has more questions about the above mentioned topics-- feel free to message me.. i know i scoured this website for opinions when i was 6 months pregnant and looking for advice on how to handle residency interviews in a maternity suit :)).
anyway.. i suffered through last year as a pre-lim in hopes that this year would be better, but now that I'm here I'm absolutely miserable.
I used to think I wanted to be in critical care -- now the reality of that stress and the effects of its encroachment on my family life are really starting to get to me. I don't think i have the nerves i used to. The thought of spending 2 more months in the ICU this year is making me feel absolutely ill.
after a particularly stressful day in the o.r. recently (unexpected death during elective procedure), that i just can't seem to shake, my whole perception of the field of anesthesia has changed and just got me thinking if this field is really for me in the long term.
I know it's soon to already thinking about changing residencies (not even 2 months in), I'm beginning to feel desperate about getting out. Maybe this unfortunely stressful event happened to me so early for a reason.. maybe i'm not cut out for anesthesia or even for medicine.
I've already started to thinking about switching to another field like pathology, PM&R, psych (less so).. just anything that requires less patient contact and/or less life or death situations. with all the stress of residency, debt, long work hours, and having very little time for me-- i just feel like this field may be adding too much additional stress.
I just feel totally overwhelmed and truly *desperate right now... i've become very depressed and wheels of residency just keep churning and it feels like there's no time to stop and think about how to make things better. and it also really feels like there's no one to talk to -- leaving me feeling really isolated and alone. i try to explain to my husband but it just seems like he can't truly relate (though he tries and i love him for that).
so.. anyone have any similar stories? any advice on how to change residency programs? thoughts on what i've said?
would be greatly appreciated!
and if anyone has any questions about my experience feel free to contact me.
i hope i can sort through this and somehow find a career that doesn't make me wish i'd get into a car accident every day (maybe not every day, but frequently) . it's just no way to live.
thanks so much for any input!

An unexpected death at the beginning of first year is a very difficult situation. It is something that really needs to be worked through, not just the emotional impact but also the medical details. Unfortunately, due to our medicolegal environment, you are very restricted in the people you can talk to about this case. (And this may be obvious, but do not give any more details here or anywhere else on the internet.) Just know that death in the O.R. is a huge stressor. Add to that the stress of being a first-year anesthesia resident and the stress of not being able to raise your child the way you think you should, and it is no wonder you feel the way you do.

I did see your smiley, but if you truly feel like harming yourself, get help. Do it in as anonymous a way as possible...not through your state medical board! Some of the things you are going through right now are temporary and you will feel better about them as time goes on. Maybe there are things you can do to help that process along, such as talking about your case in a protected setting (with the attending on the case?), changing your childcare situation if you are not comfortable with that, and/or getting more help at home so that you will have time to take care of yourself.

There are lots of residents on MomMD who have children and can definitely relate to that situation. I had my child later on, but I definitely know all about anesthesia, and there are a few other MomMD members in that field as well. This is a very supportive place.

Hang in there!

IamMe,

I have two kids, a 15 month old daughter and a nearly 6 year old son. They are the light of my life. I have taken nearly 10 years of taking classes on and off so I can be with them. In hindsight I don't know I would have done it again. I am starting college again full time and working really hard to improve my GPA from a million years ago, and get to where you are today. I know its hard now, and I have spent a LOT of time wondering if I'm doing the right thing even considering this, but I do think that down the road your kids will be proud of you. You will have more time to spend with them after your residency is over, although you'll still be busy. You could go for a simpler speciality that doesn't take as much time. (I'm not there yet so I don't know too much, forgive my ignorance)

My mother who spent her life caring for us, and never finished her college degree wanted her children to go to school. She's thrilled and supportive of me and offered this piece of advice.
"Even if you only have 5 minutes a day to spend with your children, make it the best 5 minutes of your day and their day. Focus completely on them and enjoy it. They will get the message that you love them, and that is what they will keep during all the time you can't be with them. It will be enough to keep your special relationship alive and growing until you can spend more time together."

Finally, I thank you. I appreciated the work of the anesthesiologists who attended my births, and my husbands surgery. It is a challenging field and I salute your dedication. It will get better, and in the meantime focus on that 30 minutes, and you can find ways to be more and more involved with your family. (notes, text messages, ask your husband to make home video recordings, and make some videos of your own for your children to watch.)

We're all rooting for you!

I can completely understand your thoughts. I felt that way for all of intern year, and it got worse with each rotation. I hated leaving my 3 kids everyday to be cared by someone else. I felt like I was a terrible wife, terrible resident, and terrible mom. I wanted to quit residency everyday, and was trying very hard to figure a way out of the trap I created for myself. I regreted medicine so much, and I wondered how I could spend so much time doing something that made me feel so miserable. I cried regularly because I was so sad I could not be with my kids at home. Then I started thinking that I might be happier if I change residencies or quit medicine all together.

Then I started an antidepressant (zoloft). Although I did not meet clinical criteria for depression, my internal medicine doctor suggested it and recommended I get psychiatrist as a second opinion (since he was unsure as I did not meet clinical criteria). I spoke with her and explained everything. She completely understood (she is a mom too), but did think that an antidepressant would help reduce the intense emotions I was struggling with. It would clear my perspective to make it easier to make a decision. I started it, and it has made a world of difference for me. I still feel like I want to be home with my kids, but I don't feel so awful about it anymore. I don't ruminate about what-if's and I am able to recognize the temporary misery that residency is. I don't feel so bad about what I am not able to get done in a day, whether it is make it to my child's ball game or study another textbook chapter. I amble to get though each day feeling much better about myself and make decisions without so much emotional baggage overriding.

It sounds like you are struggling with a lot of different thoughts, and I think you should consider talking to your doctor about starting an antidepressant. It doesn't change the situation, or how you feel about it. It just changes the intensity of your emotions and how you react and handle those emotions. I feel so much better on a daily basis and my energy is better to.

At first I thought my doctor was crazy, but now I am happy I gave it a chance. Do not fill the prescription through your insurance though, pay cash for it at a pharmacy you have never been to.

Good luck. You are in a tough spot like me, but give it some thought and you will be okay, whatever decision you end up making.

My first thought while reading your post was of some advice given to me: "Don't quit on your worst day." You have a lot of factors contributing to this being a difficult period. The unexpected death of a patient really can be difficult and a good reason for reflection on many levels. It sounds like you are really struggling. Do you have a mentor you trust and can talk to? I would also encourage you to be seen by your PCP or another provider who can help you determine what you may need in terms of medications and/or therapy.



I am concerned about this advice. Physicians should not avoid seeking help for mental health issues or try to hide health issues that may impact their ability to practice medicine. Physicians should get the help they need to be healthy people and doctors. I completely agree with maintaining privacy. However, any physician would be at risk for losing her license if she is not truthful or continues to practice when not able to care for patients appropriately due to her own health problems.

Depression is common and many physicians are treated for depression and continue to appropriately practice medicine without any issues with the medical board or otherwise.

As stated in LICENSING AND PHYSICIAN MENTAL HEALTH: PROBLEMS AND
POSSIBILITIES, physicians are at increased risk of suicide compared to the general population and are often untreated. I found the article interesting.

Please get the help you need and hang in there.

Hard to see the forest for the trees in residency, particularly after just finishing intern year. I'm an R2 also, so I can relate. Sounds like you're doing some soul-searching about your career choice (medicine and anesthesiology), something I think a lot of us have done on occasion. Don't forget you still have a lot of options within your chosen field (even if you stay in anesthesia).

I like the advice not to quit on your worst day, and I'd like to add to try to celebrate your best day (ok, best minute/hour/shift/day off). I, too, thank you for the committment you have made to my medicine patients present and future.

I recently ran across my AMCAS personal statement. I found an old frame and put it on the wall in my bedroom for the times I need a little extra in the (dark) mornings.

I'm working on being more present for the kids (and the husband) when I am home, hard to do but it helps I think.

And, when it's all said and done you WILL have more control over your life, hours, etc. I hope you find some peace with the unexpected loss, heaven knows most of us have been there. PCP's are a great resource to talk through things if you don't have a mentor you're close with. Is there anyone in your residency program you feel like you can talk to?

Keep us posted, we're here and listening.

I just found this site and am glad to know that there are others I can relate to.

I've always known that becoming a physician for me was to serve others and I find great joy in doing so. But didn't anticipate the extra challenges when becoming a mom MD.

Had a 33wk preemie daughter 3 months before residency and felt very guilty the first 2 yrs not being able to spend as much time as I wanted to. THe 1st yr of residency being the worst. I was even jealous of my husband because of the time he could commit to her while I had to get through my crazy hectic internship schedule, work from home, and still be a mom. Cried alot and felt horrible to even feel jealous but that resolved as the schedule lightened up(in my 3rd yr) and I was able to spend more time.

We relied alot on family members to help out but with differing views of childcare, we only asked when we needed help and placed alot of rules. That probably added to the challenge but better safer than sorry(esp with family members who relies on cultural traditions that dont' apply to preemie babies(over/underfeeding, believing in rituals that involve less than ideal hygiene,etc).
It's been manageable and we do our best to stagger our calls so that neither of us were on call the same day if we could help it. Worked for the most part.

I chose to sacrifice areas of work and time with colleagues/staff(i.e. presenting topics/research,gatherings,etc) to spend time with daughter and hubby even if it meant 30min-2hrs a night. I probably just scraped by residency with my attendings always expecting more of me. Although they were supportive,don't feel they every truly fully appreciated the juggling act of being a momMD and residency with a husband who was equally as busy going through his pediatric residency at the same time. They expected me to stay on full track and to be just as up to par as the fellow residents who don't have kids. easier said than done.

She is now 4 y/o old. Although always a daddy's girl(which I contribute initially to the lack of time I had in the beginning with her), she does flip flop between us, desiring more time with whomever has a busier schedule for the month. Family quality time was primarily only on the weekends if neither of us were on call.

My husband is now in fellowship and we have large medical school debts to pay off. I sacrificed my desire for fellowship so that he can complete his. I am working at this time and earning more to help pay off rent, childcare,etc. We are even contributing to our family member's expenses due to the tough economy to help keep a roof over one's head. I don't even think those family members realize the significant debt we owe are more than their debts combined(though we have mentioned it). Supposedly they don't have enough to contribute but yet I see them shopping and taking their kids to classes,etc things that I wish I had the time to do. I feel like we need to pay off our own debts before helping others so feel quite split about helping yet it's family so it's tough.

I'm sure this will all even out in the end when he completes his fellowship but for now, I'm tired of the long hours,stress of demanding patients, and supporting others at the cost of my own immediate family.

I was working part-time but on a full-time schedule 5days/wk plus an additional 12hrs(work from home and weekend to catch up on charting, results, emails,etc). Worked for both an HMO and community clinic.

When i was working 3x/wk with my first job out of residency with the clinic,everything was so much nicer. But with the pressure to pay debts and supporting immediate as well as extended family, I picked up the other job and have been working extra long hours. Just not worth it. I work per diem to keep the little flexibility I have in scheduling. So no benefits but at least I can take the break I need when I need it without being locked down to a 2wk vacation only period in 1yr. DOn't do weekends since that is the only time I get with daughter, husband, and family.

I've given up my higher earning position with room to go up(opportunity wise) because of the crazy hours. Need to to also take care of family members health because being proactive will hopefully delay the consequences. I know already that should other members fail in their health, the responsibility will be shouldered onto my husband and I by default secondary to our position and earnings. Not ready to deal with that nor can our current circumstances handle that.

I am still working at a clinic on a part-time basis to keep things going, pay monthly dues, and I feel I am contributing to making a difference with the underserved population there. DOn't have to do additional work. DOne at the end of the day and I can leave it all there. That's the way it should be. I'm happier now because now I can also spend that time with my immediate family(esp devote the time my husband and daughter), rebuild my health, and do things I haven't done for quite some time. THe pressure to pay for rent,etc is still a looming concern but I think picking up part-time work here and there should be sufficient to get by for several months.

In the end I would prefer just keeping to a part-time job only because I've worked really hard to get to where I am and know I would miss clinical practice if I gave that up. I plan to eventually do a doctors without border somewhere down the line but obviously would have to be able to keep up the skills. I think working at least 3x/wk and/or half days is sufficient to do so. I wouldn't mind doing a nonclinical job in between as long as flexibility is there if I end up part-time permanently.

I do believe it is more difficult to return into the field after couple years out(both in keeping professional procedures, CME, etc to stay up to date and be rehired, having references when returning to work,etc). I went into med school late and took a year off from med school to residency so I already appreciated that difference then.


So for those of you are considering taking time off but planning to return to practice in the future, definitely keep yourself part-time somehow. IF you're willing to give up clinical practice, then it doesn't matter as much. You have to do what's best for you and the family.

http://emedicine.medscape.com/article/806779-overview

This link is to an article about physician depression and suicide. We need to be aware of this as it is completely different for us as physicians.

Almost everyone that practices direct patient care has an experience that causes them to doubt their ability in their early training. If this is what you are meant to be then you will get through it. Having a major crisis in confidence is very common--and everyone hides it from their colleagues.

My understanding it that once you get through, anesthesia is a field that allows you to have a relatively good salary with fixed hours, although I don't know this for sure as I"m not in that field. So that is a huge plus for someone with a family. The critical care, not so much, although now that many hospitals require ongoing inhouse there are some places that you can have fixed hours as well. Also, with either of these fields, you do do not have outpatient responsibilities that absorb huge amount of time. So what i am trying to say is, if you can get through this you may be in a very good position. Also, don't burn your bridges and act as a responsible person--if you decide to take a break or quit then if you can do it at then end of the year if possible.

I echo the "don't quit on your worst day" advice. EVERYONE struggles in training, but I know that I felt like I was the only one struggling. Doing a medicine chief year and now being 2 years in practice has given me some perspective on that. That said, I still have patients that I lose sleep over, still get that nauseous pit in my stomach from time to time. I hope I'm more practiced at experiencing those feelings, so that they don't totally undermine me. The important thing is to find support (does your hospital have a confidential "wellness" center? Also, I know that our local medical society has confidential physician support services)

I had my first child during my second year of IM residency. I had twins 2-1/2 months before starting my subspecialty fellowship. I found it physically painful to be away from my babies for 30 hours at a time. I'm married to an anesthesiologist and we don't have any family in town. The biggest part of our budget has always been childcare. We have always had a nanny, because of our schedules. It has worked for us, but I definitely experience feelings of resentment towards her (the nanny), which I figure is rooted in jealousy. I'm in private practice now, and have found a part time situation which is ideal. They want me to work full-time next year, so I don't know how long this will last.

My husband (anesthesia) works really hard, but there are women in his practice who limit the amount they work and the amount of call they take. I think that anesthesia does really have a light at the end of the tunnel, in terms of options, when you are done. Hang in there!