Old MD Girl recently posted her thoughts on "The Good Life", specifically the musings about it she had heard from a male lecturer. It got me thinking a lot about my experiences so far and what I am facing down when it comes to being a mudphud, married to another mudphud, looking down the barrel of us both being interns and then residents, with a baby on the way and hopes for at least one more in the future.
Like Old MD Girl, I have also been privy to the musings of many a physician or practicing mudphud when it comes to "lifestyle", "goals", "balancing career and family", etc. The striking thing is how differently this is talked about by males vs females.
I do hate to generalize and certainly hate to generalize based on gender--Lord knows I resent it when anyone else does--but I would be lying if I said there wasn't a persistent difference in my experience. So far, without fail, when a man is talking all about how "you CAN have it all", how he has a thriving practice, two grants, and three great kids, he says it all has to do with balance and good decisions and careful planning. I always ask these men: "What does your wife do?" And so far, without fail, they look slightly abashed as they answer, "she stays at home with the kids." Aha. So she's the one running the parts of your life that aren't lab or patients; she's the one that makes sure that when you are at home you get Quality Time with the Family, because she's already done the laundry and the cooking and the shopping and the cleaning and the paying the bills and... well, you get my point.
When women mudphuds or physician-scientists talk about Life Balance, they almost always say you can't really have it all, that something has to give. They talk about hiring help; nannies, cooks, maids, whatever you need to get through. They talk about having to cut back hours sometimes, and finding lots of good after-school programs; about working part time if you have to, and having a very supportive spouse (interestingly, they always bring this up without me having to ask. So far, none of the men have).
There was one exception to this. We heard from a couple who were both physician scientists and had a young child. I'm sure they are perfectly lovely and accomplished people but please believe me of understatement when I say that after hearing their presentation on "balancing" professional and private life, my husband and I wanted to shoot ourselves. Their system went something like this: one would go in to to work around 4am while the other kept the baby until the nanny arrived; then they would both work all day; then the one who went in at 4am would come home around 6 or 7pm and relieve the nanny, while the other would stay at work until around midnight. The one who stayed at home would work from there, writing grants. Sometimes, they said maybe once a week, they would both be home and have dinner together--although this meant one would have to go back to work until 1 or 2am.
Horrible, horrible, horrible, we thought. There must be another way. I don't know about you, readers, but I can't live like that. As I said when I was interviewing for residency and was repeatedly asked why I couldn't expand my geographical area and just live away from my husband for three years: I married him for a reason. I like having him around, and honestly being apart for three years is not an option I am willing to consider. Sorry; life is too short not to be with the ones you love.
Likewise, I can't imagine never seeing my children. I have no delusions that I will not see my daughter as much as I'd like this coming year; however, I can manage because it is a temporary situation. The couple described above intended to keep up such a schedule for at least three years until their fellowships were completed (and hinted it would be many more before their labs were established enough they could give up such a schedule).
I'm sorry, but since when did becoming a doc mirror entering the priesthood? Is it reasonable to expect us to give up any chance at having a life outside of work? Although we both love our chosen fields, my husband and I picked ophthalmology and dermatology partially because we knew those areas gave us the best shot at being able to be fully functional mudphuds--patients and research--without guaranteeing that we would suck at one or the other (or both), and without having years of never seeing each other or our children. Had one or both of us chosen medicine, followed by a fellowship, it's hard to image a way to escape the misery of the docs described above.
I feel there has to be a better way to do things. I worry that by asking so much sacrifice, the most talented people are being driven away from medicine and research, and particularly those fields where they are most needed (primary care, etc.). And the sacrifices seem to only get bigger as time goes on--more debt upon graduation, more hours spent on billing and insurance, more days on the phone with some random dude who has a bachelor's in rhetoric and communications and is trying to tell you how to treat your patient, more years working such long hours that you don't have anything to give at the end of the day to research, much less your family.
We are going to have to face the fact that we would have more, happier, better doctors if we didn't abuse them so. I read that Obama is struggling to find the best way to address the current and growingly alarming doctor shortage. How about allowing them to have a decent quality of life? More debt forgiveness for those who go into primary care; more flexible schedules and hours (which would often mean hiring more docs); more autonomy from the HMOs in how they treat their patients.
Well, I've gotten off topic, but I'm sure you get the gist. I wonder--I hope--my hubby and I are doing the right thing. Most days, I feel pretty confident that our kids will be fine in daycare. We'll have time for them and for each other, and hopefully won't suck at patient care or research. I'm hoping that we CAN "have it all". I'm pretty sure I will need a maid, though, since I'm unlucky enough not to have a stay-at-home spouse running the rest of my life. To those of you who do, I salute you. Just be sure to thank him or her the next time you're bragging about successful you are.
Tuesday, April 28, 2009
Tuesday, April 21, 2009
T minus 18 days until MD
Crazy, no?
It's extra strange to me because I have been so completely focused on other things--lab, getting my medical license (pain in the ASS), doing the mounds of paperwork required to be a resident, getting ready for the baby (YIKES), the foils of pregnancy (being essentially handicapped with various ailments, frequent doctor visits, etc etc), and importantly the hubby's PET scan which is at the end of the week--that I haven't thought much at all about the fact that I am about to graduate and be a student no more. It's a mind scrambler.
In other news, I passed Step 2 CS, which is good, because it means that no one at the NMBE has to get a whupping from me. What a lame experience that was.
My internship starts June 15th, which is more than a week sooner than I had hoped. Mainly I am sad to have less "maternity leave"/time to recover from childbirth and attempt to build up a supply of pumped milk. By the way, though I have seen lactation nurses teach new moms how to pump I am not relishing the thought of having to pump myself.
Which actually kind of explains my whole take on this pregnancy/childbirth thing. I've seen a third degree tear up close and personal, as well as lots of C sections, births gone awry, or even those that go okay but still leave mental scars for those who had to witness them. Having seen so much from the medical end of things must alter how you view the experience, but I can't say, having only had the experience from this point of view. It's also weird because I am reading books about Lamaze, approaches to laboring, etc., most of which are pretty darn anti-medicine; however, clearly I am NOT so much with the anti-medicine. But apparently I am pretty susceptible to suggestion because I keep finding myself thinking, "Yeah! Why DO they make laboring women do that?!" It's very strange.
And even though all the books try to make you feel guilty about having any drugs, I am totally getting an epidural. Why? Because I've seen what happens to first time moms who don't, and... well, no thanks.
In any case, that's all for now. The countdown to labor and--gasp!--graduation is ON. Hopefully I will labor early enough to be able to go to graduation. It's going to be a close shave, as I am due the day after graduation. I think I would be pretty bummed to miss graduation; after all, this is a big end to a looooooooong road, and I feel I've earned hearing my name and walking across the stage. I guess there are more important things, but damn. Come a little early, girl, and let your momma have her day in the sun!
Now I'm back to all those chores and errands which somehow seem to take up WAY less time when you are working than when you are on vacation. How does that always happen?
It's extra strange to me because I have been so completely focused on other things--lab, getting my medical license (pain in the ASS), doing the mounds of paperwork required to be a resident, getting ready for the baby (YIKES), the foils of pregnancy (being essentially handicapped with various ailments, frequent doctor visits, etc etc), and importantly the hubby's PET scan which is at the end of the week--that I haven't thought much at all about the fact that I am about to graduate and be a student no more. It's a mind scrambler.
In other news, I passed Step 2 CS, which is good, because it means that no one at the NMBE has to get a whupping from me. What a lame experience that was.
My internship starts June 15th, which is more than a week sooner than I had hoped. Mainly I am sad to have less "maternity leave"/time to recover from childbirth and attempt to build up a supply of pumped milk. By the way, though I have seen lactation nurses teach new moms how to pump I am not relishing the thought of having to pump myself.
Which actually kind of explains my whole take on this pregnancy/childbirth thing. I've seen a third degree tear up close and personal, as well as lots of C sections, births gone awry, or even those that go okay but still leave mental scars for those who had to witness them. Having seen so much from the medical end of things must alter how you view the experience, but I can't say, having only had the experience from this point of view. It's also weird because I am reading books about Lamaze, approaches to laboring, etc., most of which are pretty darn anti-medicine; however, clearly I am NOT so much with the anti-medicine. But apparently I am pretty susceptible to suggestion because I keep finding myself thinking, "Yeah! Why DO they make laboring women do that?!" It's very strange.
And even though all the books try to make you feel guilty about having any drugs, I am totally getting an epidural. Why? Because I've seen what happens to first time moms who don't, and... well, no thanks.
In any case, that's all for now. The countdown to labor and--gasp!--graduation is ON. Hopefully I will labor early enough to be able to go to graduation. It's going to be a close shave, as I am due the day after graduation. I think I would be pretty bummed to miss graduation; after all, this is a big end to a looooooooong road, and I feel I've earned hearing my name and walking across the stage. I guess there are more important things, but damn. Come a little early, girl, and let your momma have her day in the sun!
Now I'm back to all those chores and errands which somehow seem to take up WAY less time when you are working than when you are on vacation. How does that always happen?
Monday, March 23, 2009
What Capstone Taught Me
-First, I am even more scared to get sued than I was before. I don't think that is what they were going for with their "Don't worry, you can avoid getting sued" talk.
-By the way, malpractice insurance is frickin' expensive.
-Also, it now seems inevitable that I, or someone I know, will develop a drug or alcohol problem. If it is someone I know, I will be forced to report that person to the Medical Licensing Board and potentially ruin their lives.
-Say what you will about the MD/PhD pathway (Lord knows I have), but at least I am not well into six figures in debt like my classmates, who will have to work just as hard as me (who am I kidding, I'm going in to Derm... they will have to work harder) and be much poorer for a looooooooong time.
-Docs sure do seem to get the s*** end of the stick.
-I figured it would be awful to have to tell the family of a patient that their loved one might die because I screwed up; standardized patient family members have helped me realize that "awful" is the understatement of the year.
-Sometimes, there are patients who have had bad health care experiences who have a lot of valuable things to say. And sometimes, there are patients you want to smack because they clearly think they understand what happened to them, but in reality they got most of their information from qacks and you have to listen to their ridiculous nonsensical ramblings about how awful doctors are.
-Apparently--and this TOTALLY blew my mind--it's a bad idea to have sex with one of your patients, especially if that patient has borderline personality disorder. Holy Cow! I am so glad I sat through an hour long lecture to learn this gem, because otherwise I might have gotten into real trouble!
-Residency is hard. No, seriously.
-You won't have time to take care of yourself, but you owe it to yourself and your patients to take care of yourself. Whatever that means.
-Finally and most importantly: I am completely done with medical school. Holy 8 year training program completion, Batman!
-By the way, malpractice insurance is frickin' expensive.
-Also, it now seems inevitable that I, or someone I know, will develop a drug or alcohol problem. If it is someone I know, I will be forced to report that person to the Medical Licensing Board and potentially ruin their lives.
-Say what you will about the MD/PhD pathway (Lord knows I have), but at least I am not well into six figures in debt like my classmates, who will have to work just as hard as me (who am I kidding, I'm going in to Derm... they will have to work harder) and be much poorer for a looooooooong time.
-Docs sure do seem to get the s*** end of the stick.
-I figured it would be awful to have to tell the family of a patient that their loved one might die because I screwed up; standardized patient family members have helped me realize that "awful" is the understatement of the year.
-Sometimes, there are patients who have had bad health care experiences who have a lot of valuable things to say. And sometimes, there are patients you want to smack because they clearly think they understand what happened to them, but in reality they got most of their information from qacks and you have to listen to their ridiculous nonsensical ramblings about how awful doctors are.
-Apparently--and this TOTALLY blew my mind--it's a bad idea to have sex with one of your patients, especially if that patient has borderline personality disorder. Holy Cow! I am so glad I sat through an hour long lecture to learn this gem, because otherwise I might have gotten into real trouble!
-Residency is hard. No, seriously.
-You won't have time to take care of yourself, but you owe it to yourself and your patients to take care of yourself. Whatever that means.
-Finally and most importantly: I am completely done with medical school. Holy 8 year training program completion, Batman!
Friday, March 20, 2009
Dr. VonB is a lucky, lucky girl
Well, I am still in shock, but I have managed to get everything I hoped for. Yesterday I found out that I matched into my top choices for preliminary year (pediatrics) and my advanced year (dermatology)!
Match day was kind of bitter sweet. Lots of friends leaving, lots staying; lots got what they wanted, some were disappointed. I was a lucky one, getting what I wanted, sticking around. I'm sure I will be even more excited as days go on, but for now I'm kind of still in stunned disbelief.
Here's the thing: I can't tell you how excited I am about dermatology!! I love, love, LOVE it. It is just about perfect for me. I've said it before, but I get to do everything I love. Great diagnostic work, surgery, and kickass immunology. Plus, my daughter will probably even know what I look like!
As for intern year, I am also very excited, but nervous. It's such a huge leap, going from not doing anything without four levels of permission to basically being able to make decisions on my own. Also: the hours. Scary. And even scarier... Capstone has given me a very clear understanding of just how much stuff I've already managed to forget in just a few months. But I'm not thinking about that now. Right now all I'm thinking about is packing for a short, weekend getaway with my hubby which we have been looking forward to for months. :)
For those of you out there who matched, I hope you are as happy as I am. For those with the match still ahead... sitting on this side of things, I can tell you that keeping up with that hard work and studying does pay off! Hang in there! And enjoy the first day of spring.
Match day was kind of bitter sweet. Lots of friends leaving, lots staying; lots got what they wanted, some were disappointed. I was a lucky one, getting what I wanted, sticking around. I'm sure I will be even more excited as days go on, but for now I'm kind of still in stunned disbelief.
Here's the thing: I can't tell you how excited I am about dermatology!! I love, love, LOVE it. It is just about perfect for me. I've said it before, but I get to do everything I love. Great diagnostic work, surgery, and kickass immunology. Plus, my daughter will probably even know what I look like!
As for intern year, I am also very excited, but nervous. It's such a huge leap, going from not doing anything without four levels of permission to basically being able to make decisions on my own. Also: the hours. Scary. And even scarier... Capstone has given me a very clear understanding of just how much stuff I've already managed to forget in just a few months. But I'm not thinking about that now. Right now all I'm thinking about is packing for a short, weekend getaway with my hubby which we have been looking forward to for months. :)
For those of you out there who matched, I hope you are as happy as I am. For those with the match still ahead... sitting on this side of things, I can tell you that keeping up with that hard work and studying does pay off! Hang in there! And enjoy the first day of spring.
Thursday, March 5, 2009
Changing gears, Step 2 CS, and OHMYGOD MATCH DAY
Well, clearly I have not been 100% on top of updating this thing, which is probably appropriate since things will be moving on soon. I have been trying to decide if I will blog about this next great phase in my training--moving from being a student to being a resident--and I'm undecided. With a baby on the way and a husband who will also be an intern, there may not be time. On the other hand, Lord knows I always have lots to say.
These days things have become considerably more peaceful. It's nice, but almost frightening--I feel as though I keep waiting for the other shoe to drop. My husband has completed chemotherapy. He gets his port out soon and in another couple of months will have his follow-up PET scan. Waiting for that is certainly a source of anxiety; I try not to think about it, and to just rejoice in seeing him slowly return to his old self. Another huge source of anxiety, which was finding appropriate child care for next year, is now gone. We found a wonderful situation which we both feel great about, with the tiny exception that it will take MY ENTIRE RESIDENT SALARY to pay for it. That's right, folks. My. Entire. Salary. Repeat after me: MD/PhD training is worth it... MD/PhD training is worth it... MD/PhD training is worth it...
The following year we will probably be able to use considerably cheaper child care, but for now this is really the only way that we can both do our jobs. I keep reminding myself that this is still an investment, and that one way or another we will be able to survive on one resident's salary. Hey, it isn't really that different than what we did before, so I guess we'll be okay.
The big YIKES on the horizon right now is: MATCH DAY. Yipe. I think that a week from Monday is when we learn if we matched or not; official Match Day, where we learn where we will be, is March 19th. Now, I know that a lot of MS4s out there are feeling anxiety about this, but allow me to put it in perspective for you: I applied to dermatology. And ranked two programs. TWO. It is the height of madness, but luckily, I have to say that the PET is scarier, so there you go. In any case, hopefully I will at least have a prelim spot for next year, and if I am a REALLY lucky girl, I will have a place to call derm home after that. One way or another it will be nice to know for sure.
I also took Step 2 CS. I don't want them coming after me so I won't say anything about it except that I expected it to be really stupid, and it exceeded those expectations like a champ. I have never been forced to do anything that was such a racket, so pointless and aggravating, in medical school or graduate school, and those of you have done either or both know that is saying something. I urge anyone with the power to do so eliminate this charade, this rip-off disguised as an exam. Everyone knows you make us do it for the money. Why give us that final slap in the face after we've crawled through the sewer tunnel to graduation? I'll say no more.
These days I am all done with rotations, and am back in my dissertation lab for a while to help out with progressing my old project. Going back to research, changing gears again, is a strange experience. It's both harder and easier than I thought it would be to come back to it. My main issue right now is fatigue. It's hard to focus, hard to care as much as I did when I was here almost two years ago. I'm trying, but it ain't easy. It's also interesting to see how my perspective has changed with just a few years of clinical work under my belt. It's a good thing, and it makes me more certain that in the end I've done the right thing with the MD/PhD. A nice place to be.
No other big insights here for now. I have a Capstone course coming up, and my forecast for that is Stupid with occasional chance of Helpfulness. It sounds like most medical schools have these, so I might post a little something there. Also expect a triumphant or tragic post regarding match results. And wherever you are, whatever stage you are in, I wish you godspeed in your endeavors. We all have it pretty tough no matter where you are in this drawn out hot mess of physician-scientist-dom. Hang in there. I can honestly say that things keep getting cooler with each passing year.
These days things have become considerably more peaceful. It's nice, but almost frightening--I feel as though I keep waiting for the other shoe to drop. My husband has completed chemotherapy. He gets his port out soon and in another couple of months will have his follow-up PET scan. Waiting for that is certainly a source of anxiety; I try not to think about it, and to just rejoice in seeing him slowly return to his old self. Another huge source of anxiety, which was finding appropriate child care for next year, is now gone. We found a wonderful situation which we both feel great about, with the tiny exception that it will take MY ENTIRE RESIDENT SALARY to pay for it. That's right, folks. My. Entire. Salary. Repeat after me: MD/PhD training is worth it... MD/PhD training is worth it... MD/PhD training is worth it...
The following year we will probably be able to use considerably cheaper child care, but for now this is really the only way that we can both do our jobs. I keep reminding myself that this is still an investment, and that one way or another we will be able to survive on one resident's salary. Hey, it isn't really that different than what we did before, so I guess we'll be okay.
The big YIKES on the horizon right now is: MATCH DAY. Yipe. I think that a week from Monday is when we learn if we matched or not; official Match Day, where we learn where we will be, is March 19th. Now, I know that a lot of MS4s out there are feeling anxiety about this, but allow me to put it in perspective for you: I applied to dermatology. And ranked two programs. TWO. It is the height of madness, but luckily, I have to say that the PET is scarier, so there you go. In any case, hopefully I will at least have a prelim spot for next year, and if I am a REALLY lucky girl, I will have a place to call derm home after that. One way or another it will be nice to know for sure.
I also took Step 2 CS. I don't want them coming after me so I won't say anything about it except that I expected it to be really stupid, and it exceeded those expectations like a champ. I have never been forced to do anything that was such a racket, so pointless and aggravating, in medical school or graduate school, and those of you have done either or both know that is saying something. I urge anyone with the power to do so eliminate this charade, this rip-off disguised as an exam. Everyone knows you make us do it for the money. Why give us that final slap in the face after we've crawled through the sewer tunnel to graduation? I'll say no more.
These days I am all done with rotations, and am back in my dissertation lab for a while to help out with progressing my old project. Going back to research, changing gears again, is a strange experience. It's both harder and easier than I thought it would be to come back to it. My main issue right now is fatigue. It's hard to focus, hard to care as much as I did when I was here almost two years ago. I'm trying, but it ain't easy. It's also interesting to see how my perspective has changed with just a few years of clinical work under my belt. It's a good thing, and it makes me more certain that in the end I've done the right thing with the MD/PhD. A nice place to be.
No other big insights here for now. I have a Capstone course coming up, and my forecast for that is Stupid with occasional chance of Helpfulness. It sounds like most medical schools have these, so I might post a little something there. Also expect a triumphant or tragic post regarding match results. And wherever you are, whatever stage you are in, I wish you godspeed in your endeavors. We all have it pretty tough no matter where you are in this drawn out hot mess of physician-scientist-dom. Hang in there. I can honestly say that things keep getting cooler with each passing year.
Wednesday, January 28, 2009
No, I do not have any more #@*$&! questions about the program, or anything else
Interview season has come to a close for me. My interview season was relatively very short and painless; with my husband having a spot at a nearby university for residency, I only applied locally. Let's not talk about what that means for my matching chances, especially given that I am attempting to match in dermatology. We will pretend that this is NOT the scariest thing ever, and move on. Very well.
In any case, I only had five total interviews, and had to travel for exactly zero of them. Given how ecstatic I am that I am all done, I have to wonder--how do people DO this? Most people have 10-25 interviews, all over the country. I was ready to stab myself in the eye after just five. Plus, I actually liked all of the places I interviewed, which makes it even less painful.
However, there is something weird about interviewing only where you have done rotations. It leaves a lot more blank space where there would have been questions, and as anyone who has gone through interviews can tell you, there is already a lot of blank space where they expect questions that don't exist. After you've gone through two or three lectures about the place and met with residents and faculty both formally and informally, there just aren't. Any. More. Questions. But yet they ask, at some point during every individual interview: "Any questions for me? Anything you'd like to know about the program?"
It is especially tough for derm interviews, where you have to meet with essentially ALL of the faculty individually, typically at least 10 or more people. It's nice in these situations to have a Blue Ribbon Pony of a question all picked out that you can parade in front of any faculty member, especially if you care about the answer. My personal Pony was: "What do you see as the most important goals for the future of (fill in name of residency program here)?" Interviewers love this question, and it gives a lot of helpful information to you, too.
That is my one useful tip for today. I have been heavily engaged in recruiting for our MD/PhD program, which is fun but busy and stressful. It is also very weird to have just finished being on the interviewee side of things, and then being on the interviewer(-ish) side of things. Now I have been chained in the garage by my husband to help him sort through the mind-boggling amount of ridiculous crap we have in there. It's nice, but now I need a nap.
I had something else to say, but it's gone now. Will post more when brain working again. Unless I inadvertently put said brain in one of the to-donate boxes in the garage... hmmmm....
In any case, I only had five total interviews, and had to travel for exactly zero of them. Given how ecstatic I am that I am all done, I have to wonder--how do people DO this? Most people have 10-25 interviews, all over the country. I was ready to stab myself in the eye after just five. Plus, I actually liked all of the places I interviewed, which makes it even less painful.
However, there is something weird about interviewing only where you have done rotations. It leaves a lot more blank space where there would have been questions, and as anyone who has gone through interviews can tell you, there is already a lot of blank space where they expect questions that don't exist. After you've gone through two or three lectures about the place and met with residents and faculty both formally and informally, there just aren't. Any. More. Questions. But yet they ask, at some point during every individual interview: "Any questions for me? Anything you'd like to know about the program?"
It is especially tough for derm interviews, where you have to meet with essentially ALL of the faculty individually, typically at least 10 or more people. It's nice in these situations to have a Blue Ribbon Pony of a question all picked out that you can parade in front of any faculty member, especially if you care about the answer. My personal Pony was: "What do you see as the most important goals for the future of (fill in name of residency program here)?" Interviewers love this question, and it gives a lot of helpful information to you, too.
That is my one useful tip for today. I have been heavily engaged in recruiting for our MD/PhD program, which is fun but busy and stressful. It is also very weird to have just finished being on the interviewee side of things, and then being on the interviewer(-ish) side of things. Now I have been chained in the garage by my husband to help him sort through the mind-boggling amount of ridiculous crap we have in there. It's nice, but now I need a nap.
I had something else to say, but it's gone now. Will post more when brain working again. Unless I inadvertently put said brain in one of the to-donate boxes in the garage... hmmmm....
Friday, January 2, 2009
It's not just good things that must come to and end
Bye, bye, 2008. Please be sure to let the door hit you in the ass on your way out.
This year has had a few nice points for us, but overall, it can go straight to hell. I have a very optimistic eye trained on 2009, and that eye is looking through the laser sight of a powerful rifle, so you'd better watch your step, 2009. It's time to pony up and be good to us.
In other news, I'm all done, and it couldn't have come a day too soon. PICU was definitely the most difficult rotation of medical school for me. I would like to say that unconditionally, without the qualifier of what was going on in my personal life during that time, but I can't. After all, to be fair, the second most difficult rotation was probably OB/Gyn, due not in small part I'm sure to the fact that I had a miscarriage right smack dab in the middle of it (stupid 2008). So, clearly, personal issues cannot be put aside here.
However, I must say that even without the whole husband with cancer thing and the being pregnant thing, PICU is amazingly difficult. I have a whole new level of respect and awe for critical care physicians, particularly those in PICU. There is a new dimension added to critical care when you have children involved.
It's very feast or famine; my first week, we mostly had kids that needed a lot of very careful care but would almost certainly be okay. Then we had weeks where we lost three patients and an additional 30% of our service was about to die.
It blindsides you. There's the kid who comes in with headaches and is found to have terminal brain cancer; the kid who was totally healthy until infection led to meningitis led to stroke; the kid who came in for a simple, common operation and died three days later from massive cardiovascular collapse. I couldn't put it aside like I could with older adults. Losing patients has always hit me hard, but this was something new. The grief of parents of young children is somehow much harder to bear than the grief of adult children of elderly patients.
Then, you add in my current personal situations. Having to go see a family awaiting biopsy results for their child's brain mass every day, for days and days, without having an answer for them--and then having to deliver bad news--was heart wrenching. I had just waited for those results for my husband, and it was the longest and most horrible two weeks of my life (and we got relatively good news at the end). We still have scary waits--PET scan results, blood culture results, etc. etc.--and every minute still kills me.
I was waiting to have our 20 week ultrasound during the majority of the rotation, and seeing a parade of tragic lethal congenial malformations being desperately, and unsuccessfully, treated kept in fresh in my mind just how many things can go wrong with a baby. I went from being excited about the scan to being terrified. Luckily, everything looked great. It didn't stop my obsessive worry, but it took it down a few decibels.
Intellectually, it was always challenging. These are the most complicated patients around, with multiple life-threatening medical issues balanced against each other like a house of cards; every day you were trying to shift one of the bottom cards without having the whole thing collapse. I never felt that I developed a good grasp of the sickest patients. Yet, looking back, I am somewhat disappointed that I couldn't find within myself the usual regret to be moving on from something before I felt I really understood it. When I finished the rotation, I felt nothing but relief.
I was exhausted, in every sense of the word. At one point my husband spiked his first fever--luckily, he was not neutropenic (Go Go Gadget Neupogen!) but it was still terrifying. Having to be away from him so much was really agony, worse than it had been since his diagnosis, if that's possible.
What got me through it was 1) my deep, deep desire to never, ever, ever ever ever have to go back and do it again; 2) my husband's constant encouragement; and 3) my fantastic residents. Thanks a bunch guys--literally couldn't have done it without you.
And now I'm done, done, done. Though I'm technically on vacation it doesn't feel like it; at least, not yet. Hubby got very very sick a few weeks ago and we had to postpone his chemo. It was the worst week since after we got rolling on the treatments. I was terrified. He had high fevers, night sweats--it was a perfect example of how horrible it is to be newly minted MD when something like this goes down. We knew every possible bad thing that could be going on, but we both lack the practical experience to offset those fears with less frightening possibilities. The one thing I hadn't thought of was relapse, and when the doc pointed out that possibility, I well nigh had a meltdown. There were several nights I just laid in bed next to his sleeping, sweat-drenched form and cried. But he got much better, and today the doc informed us he thinks it is much, much more likely to have been a virus than anything else; sometimes, a little reassurance is magical.
We also found out that one of our doggies has a cancerous mass--can you believe that @)%&@? She has to go back in for a wider excision, and get an ultrasound of her spleen to see if there are any mets. This is the kind of tumor that if her spleen is clear, she will almost certainly be fine; if she has mets to her spleen, she's a goner. So, that has certainly added to my current Climate of Frenzied Panic.
Once I finished, I had about eight metric tons of random life chores to get done, the holidays, the family in town, blah, blah, blah... and I have a solid week of interviews starting Monday.
So, vacation, but not really. Looking ahead I think things will become substantially more sane towards the end of the month, but I've been saying crap like that for a while. Hubby only has three more treatments, then a PET, and if that sucker's clean, it will be the best thing ever (of course we have to await the 3 month PET...). The doggie gets her scan next week and if that looks good it will be a big relief (and if not... LALALA, I CAN'T HEAR YOU!). End of Feb I have to take--and pass, unless I want to cough up an additional thousand clams--Step 2 CS. Then comes the rank list and match. Baby looks awesome, still kickin' me with a vengeance.
So that's it for now. The long update. I am thinking of some ideas for future posts, perhaps about interviewing and ranking, exciting stuff like that. Until then I hope everyone had a wonderful, safe, happy and healthy Holidays, and that you remembered all of the wonderful things you have in your life. They are too precious and delicate not to be treasured.
Except for 2008. That sucker can go into concrete shoes at the bottom of the Hudson.
This year has had a few nice points for us, but overall, it can go straight to hell. I have a very optimistic eye trained on 2009, and that eye is looking through the laser sight of a powerful rifle, so you'd better watch your step, 2009. It's time to pony up and be good to us.
In other news, I'm all done, and it couldn't have come a day too soon. PICU was definitely the most difficult rotation of medical school for me. I would like to say that unconditionally, without the qualifier of what was going on in my personal life during that time, but I can't. After all, to be fair, the second most difficult rotation was probably OB/Gyn, due not in small part I'm sure to the fact that I had a miscarriage right smack dab in the middle of it (stupid 2008). So, clearly, personal issues cannot be put aside here.
However, I must say that even without the whole husband with cancer thing and the being pregnant thing, PICU is amazingly difficult. I have a whole new level of respect and awe for critical care physicians, particularly those in PICU. There is a new dimension added to critical care when you have children involved.
It's very feast or famine; my first week, we mostly had kids that needed a lot of very careful care but would almost certainly be okay. Then we had weeks where we lost three patients and an additional 30% of our service was about to die.
It blindsides you. There's the kid who comes in with headaches and is found to have terminal brain cancer; the kid who was totally healthy until infection led to meningitis led to stroke; the kid who came in for a simple, common operation and died three days later from massive cardiovascular collapse. I couldn't put it aside like I could with older adults. Losing patients has always hit me hard, but this was something new. The grief of parents of young children is somehow much harder to bear than the grief of adult children of elderly patients.
Then, you add in my current personal situations. Having to go see a family awaiting biopsy results for their child's brain mass every day, for days and days, without having an answer for them--and then having to deliver bad news--was heart wrenching. I had just waited for those results for my husband, and it was the longest and most horrible two weeks of my life (and we got relatively good news at the end). We still have scary waits--PET scan results, blood culture results, etc. etc.--and every minute still kills me.
I was waiting to have our 20 week ultrasound during the majority of the rotation, and seeing a parade of tragic lethal congenial malformations being desperately, and unsuccessfully, treated kept in fresh in my mind just how many things can go wrong with a baby. I went from being excited about the scan to being terrified. Luckily, everything looked great. It didn't stop my obsessive worry, but it took it down a few decibels.
Intellectually, it was always challenging. These are the most complicated patients around, with multiple life-threatening medical issues balanced against each other like a house of cards; every day you were trying to shift one of the bottom cards without having the whole thing collapse. I never felt that I developed a good grasp of the sickest patients. Yet, looking back, I am somewhat disappointed that I couldn't find within myself the usual regret to be moving on from something before I felt I really understood it. When I finished the rotation, I felt nothing but relief.
I was exhausted, in every sense of the word. At one point my husband spiked his first fever--luckily, he was not neutropenic (Go Go Gadget Neupogen!) but it was still terrifying. Having to be away from him so much was really agony, worse than it had been since his diagnosis, if that's possible.
What got me through it was 1) my deep, deep desire to never, ever, ever ever ever have to go back and do it again; 2) my husband's constant encouragement; and 3) my fantastic residents. Thanks a bunch guys--literally couldn't have done it without you.
And now I'm done, done, done. Though I'm technically on vacation it doesn't feel like it; at least, not yet. Hubby got very very sick a few weeks ago and we had to postpone his chemo. It was the worst week since after we got rolling on the treatments. I was terrified. He had high fevers, night sweats--it was a perfect example of how horrible it is to be newly minted MD when something like this goes down. We knew every possible bad thing that could be going on, but we both lack the practical experience to offset those fears with less frightening possibilities. The one thing I hadn't thought of was relapse, and when the doc pointed out that possibility, I well nigh had a meltdown. There were several nights I just laid in bed next to his sleeping, sweat-drenched form and cried. But he got much better, and today the doc informed us he thinks it is much, much more likely to have been a virus than anything else; sometimes, a little reassurance is magical.
We also found out that one of our doggies has a cancerous mass--can you believe that @)%&@? She has to go back in for a wider excision, and get an ultrasound of her spleen to see if there are any mets. This is the kind of tumor that if her spleen is clear, she will almost certainly be fine; if she has mets to her spleen, she's a goner. So, that has certainly added to my current Climate of Frenzied Panic.
Once I finished, I had about eight metric tons of random life chores to get done, the holidays, the family in town, blah, blah, blah... and I have a solid week of interviews starting Monday.
So, vacation, but not really. Looking ahead I think things will become substantially more sane towards the end of the month, but I've been saying crap like that for a while. Hubby only has three more treatments, then a PET, and if that sucker's clean, it will be the best thing ever (of course we have to await the 3 month PET...). The doggie gets her scan next week and if that looks good it will be a big relief (and if not... LALALA, I CAN'T HEAR YOU!). End of Feb I have to take--and pass, unless I want to cough up an additional thousand clams--Step 2 CS. Then comes the rank list and match. Baby looks awesome, still kickin' me with a vengeance.
So that's it for now. The long update. I am thinking of some ideas for future posts, perhaps about interviewing and ranking, exciting stuff like that. Until then I hope everyone had a wonderful, safe, happy and healthy Holidays, and that you remembered all of the wonderful things you have in your life. They are too precious and delicate not to be treasured.
Except for 2008. That sucker can go into concrete shoes at the bottom of the Hudson.
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