Sunday, May 20, 2018

I won an award!

Yesterday I went to an anesthesia resident conference and.... (drum roll please) I won an award for my poster!

Of course this is just a poster (not a talk), and it was a small, relatively insignificant conference in the grand scheme of academic medicine, but still.  It was a project that I conceived of and executed entirely by myself.  It generated some interesting content, and formed the basis of an idea I'm trying to write a grant on.  I did it with very little help, despite plenty of people telling me how stupid my idea was, and it turned out pretty great in the end.  At the end of my spiel to the judges, they commented, "You obviously know this very well," which made me feel pretty damn good.

So, Yay!

Next I give a presentation on my grant idea.  Hopefully that will go over well and I will get some useful feedback.  Crossing my fingers.

Speaking of fingers, I got fingerprinted AGAIN for my child abuse clearance for fellowship yesterday.  I think this is the 4th time in the past four years that I've been fingerprinted.  However, it is a necessary step. 

Progress is being made.  Thank goodness. 

Sunday, May 13, 2018

The list

Last Wednesday when I got home I was TIRED.  And annoyed.  It was about 8, and post-post call me really wanted to go to bed.  Still, I hadn't seen Dyl really since Sunday, since I'd been on call Monday, and had been pretty out of it when she got home from school on Tuesday.  So I went upstairs to try and convince her that she should stop playing with AP#6 and read books with me in her room.  Ha.

It turned out she and AP#6 had made a list.  Of her friends.  In order of preference.  Actually, I think Dyl had thought of the idea, and AP#6 was helping her with the spelling or something.  Anyway, there was a list.  AP#6 was #1.  Her best friend A was #2 followed by E&C who were tied for 3.

I asked her if I was on the list and she blushed and nodded yes.  Where was I?  I know you are dying to know.  Well, I was #12.

At least I beat Luca, who was #13.  The dog was #14, but Dyl has been very vocal in her dislike of the dog recently, since she leaks pee on Dylan's bed sometimes.

His is where the story is supposed to end.  Like haha my daughter ranked her friends and I was #12 isn’t that funny??  And it is.  Particular since I beat out her father and the dog.  But since I’m not good at being funny this morning I’m going to tell you what happened next.

So, I didn't really know what to think.  I mean really, NUMBER TWELVE???  Come on!  But most importantly I didn't want her to think that ranking your friends was a good idea.  I had done something dumb like that when I was old enough to know better and it had ended... badly.  I didn’t want my daughter to make the same mistake.  So, I told her that she would really hurt her friend's feelings if they found out, and then they wouldn't be her friends anymore.  I started to pretend cry, which actually wasn't that hard to do since I was in such a foul mood to begin with.  And then I said that I didn't want to read with her anymore anyway and that I was going to bed since I was only #12.  And left the room.

Wow did I hit a nerve.  She burst into tears and was completely hysterical for.... oh.... about 30 minutes.  At least.  I came back and tried to console her.  I told her that I didn't really care that I was only #12 (true) and that no matter what she would always be my #1.  Didn't work.  She tried to tell me that it was just a list, not a ranking, and I was like, ok.  But she was still hysterical.  Finally it got to be about 8:45 and I was like look Dyl, I really want to spend some QT with you, but you can't stop crying and I need to go to bed badly.  Do you want to come to my room and say goodnight to me?  She was still sniffing but agreed to do that.  We said goodnight, and I passed out.  Hard.

She came running to my room in the middle of the night in her doggy costume (she wears it when she gets cold at night, and it is soooooo soft and cuddly), leaped onto me in my bed and told me that she loved me so much and that I was her favorite mommy.  I felt really touched.  She went back to bed a few minutes later.

Yesterday I asked her if her favorite friend was still A.  She said, no mommy, all of my friends are my favorite friends.  I would never rank them.  That she loves us all equally.

Good girl. If she grows up being only half the asshole I’ve turned out to be, I will consider that a success.

Finally, I just wanted to say how happy I am that she loves AP#6 so much.  It makes working for these horribly long hours that much more bearable.

Saturday, May 12, 2018

The new normal in medicine?

I am back in the main OR at the moment, and it is.... exhausting.  Call Monday night, and working 5:45 AM til 7:30 or 8 every night this week (at home or in the OR).  Was talking to a research attending who is 60% protected for research who was telling me that he still works 30 hours a week clinically, which seems a little ridiculous to me.  When I work here, it is hard to remember why I want to do all of this because I start feeling like I just can't.

Before residency, I never felt like needing 8 hours of sleep was a disability.  I hate working at a place where it quite literally is.  We regularly work 14 hour days, not including the 25 hour shifts when we are on call.  The very nature of our job as anesthesiologists requires extreme vigilance and ability to think and plan quickly, potentially with a patient's life in the balance.  If I don't get enough sleep, first I start getting cranky, and then I stop being able to think quickly, and plan for all contingencies.  My bad mood actually makes me perform worse too.  It's not good for patients, but honestly just as importantly, I don't want to live my life feeling like this all the time.

I spoke with a medical student this week who casually dropped that he was planning on getting a prescription for Modafanil.  He had a sleep study, and he had no problems at all -- I mean obviously he did not have narcolepsy or sleep apnea -- he just wanted the medication so that he wouldn't have to sleep as much.  So he could have the higher prestige clinical job, which obviously requires obscenely long hours, in order to compete more effectively with the people who really only do need 4 hours of sleep per night.  Listening to him made me want to vomit.  I know several people who take prescription stimulants for "ADHD."  The reality is many of them take them in order to stay awake longer and not feel like garbage all the time, even though they still do.

Is this the new normal among doctors?  Stimulants?

Anyway, how's that for an uplifting post.

Tuesday, May 8, 2018

Things vs. experiences

Apparently I act like a millennial in a lot of ways.  I prefer texting to talking on the phone (I haaaaaate talking on the phone), and I expect my feedback at work to be constructive, whether it is positive or negative. 

However apparently millennials prefer experiences to things?  I don't necessarily fall into that category.  Experiences can be so hit or miss, especially when you have a small child.  Sometimes it is safer to get a thing.  Sometimes you just really want a thing.

For instance, last weekend was a birthday weekend for me.  I made a reservation to a restaurant with my husband.  Fond.  But I also bought a present for myself: new going out heels (old ones disintegrated on my feet last week.  oops.) and a blouse.  I wore the new outfit to the restaurant.  I have to say, I enjoyed the experience of wearing my new outfit more than the going out part.  The food was... fine, but not especially memorable, and my husband and I didn't really have anything to talk about.  Meh. 

On the other hand, I love my new shoes. 

Also, my husband got me this pretty bouquet which... I can look at it even today and it makes me happy. 

What experience could I have purchased that would have made me as happy for my birthday as those things did?  Perhaps I am just not creative enough to come up with something sufficiently fabulous.

I can't really think of anything off hand.  Fly off to London for a solo weekend with my husband?  Oh whoops.  Between work schedules and childcare, can't do that, nor will I be able to for probably another 10 years at least.  Plus it would have cost a lot more.  Plus the thought of doing that completely exhausts me.  Surely you could just go to Lancaster county for the weekend, you might argue.  BUT WHY????  And also, childcare. 

Sunday, May 6, 2018

a professional woman

I recently received advice that after residency, that I should try to dress like an executive at all times at work when I do not have to be wearing my OR scrubs.  This would include walking to and from the hospital.

I was told I didn't have to cut my hair (though, women used to have to do this in order to be taken seriously at work).

I also don't have to dye my hair.  I've been told I need to do this in the past, but 1) white hair happens to be pretty au currant at the moment, and 2) I think it gives me a certain amount of gravitas that I would not have otherwise.  For sure people definitely remember me (for better or for worse).

Now, I totally get -- and agree with! -- the advice that you should dress for the job you want rather than the job you have.  However there are several prominent men in my department who ride their bikes to work and show up drenched in sweat in their bike shorts and jerseys every morning, shower, and then go to their job, whether it be in the OR that day, or in the office.

Bottom line?  I want to be that person when I get to be an attending.  Which would clearly involve me parading around work in less than professional attire for a short period of time, not to mention wet hair for a slightly longer period, unless I cut it all off (which is tempting in some ways).

I sort of feel like times are changing and that as long as you produce, you can kind of do what you want, within limits of course.  I also need to fit exercise in someplace, and my commute seems like as good a place as any.  Obviously, if I had an important meeting or something, I would dress for that, but every other day?

Any thoughts on this?

Friday, May 4, 2018

Sunday-night-itis has come early

Ugh last research day of this block (not including this weekend, and yes I plan to do work this weekend as well). 

Next week I start my neuro rotation.  My favorite attendings to work with in the department do neuro.  I had a legitimately good time last year on this rotation, in large part likely because I rotated with people I get along with.*

Still, the schedule for Monday will come out this afternoon, which means I will have preops to do, and a preop conversation to have with an attending who would prefer not to have to talk with me.  Prolly on Sunday night. 

And I haven't been in an OR in a month.  It always makes me a little nervous when I go back.  I feel a little off balance.  I do not expect I will be sleeping well this weekend.  Monday's OR setup is likely to be a bit of a clusterfuck.  God I hope they don't give me an awake craini or some wretched trip to the MRI scanner.

God I hope I don't get pulled to cardiac. 

And.... I am on call.  So this well rested state I am feeling now will end abruptly at around 10PM Monday, not to return again until... who knows.  Probably a month from now.

All this work I didn't finish will have to happen sometime.  I have a presentation next Wednesday after work at 6:30 and hopefully will get some useful feedback.  Hopefully I won't be too tired to absorb whatever useful feedback I get. 

And then I have another poster to prepare for another conference this month.  And revisions to make to the presentation based on feedback on this presentation next week so that I can present it again a few weeks later.  As well as practice runs to go through.

It's going to be a busy month.  Annoyingly, I probably won't be able to get much studying done for my boards because of all this other stuff. 

But... only two more calls and two more mandatory overtimes (plus I'm sure at least a few nights where I'm involuntarily held late as well), and then I will be, should be, done with call during residency.  So, yay.  Four hard weeks ahead, and then I will have time to refocus.  A week of vacation.  A conference.  And then done with residency. 

Wow.  It's almost over. 

*vs. loathe

Thursday, May 3, 2018

Women in anesthesia

Last night was the second women in anesthesia event for our department.  It was about work life balance/integration.  I was afraid that it was going to be the usual advice to women (if you want kids, have them, outsource outsource outsource, don't pick a jerk for a husband), but it wasn't!  A few people asked really relevant questions, and had great points.

Such as the person who said it was actually more difficult to balance work/home when she was no longer long distance with her spouse.  Several people reflected that they would be able to work more and be more productive if they didn't live with a husband who wanted to see them in the evenings.

There were also several people who reflected upon the unfair comments made by members of their family regarding the amount they work.  It made me feel grateful that my in-laws don't speak English and I can't understand them if/when they make comments like this.  To be fair, they also think my husband is insane for working as hard as he does too, so they are equal opportunity in that regard.

It also made me realize that I am in a bit of a unique situation.  In theory, I could move anywhere for work.  I don't live near a parent or sibling who is helping me make things work at home.  Basically what is tying me to Philadelphia at this point are 1) my husband's job (he is awesome at it, and they love him), and 2) my daughter's amazing school (she is totally thriving).  Though.... I have to say, those things alone are enough to make me fear messing everything up by moving to find a better job for myself.

It's like I'm personally responsible for the happiness of everyone in the family.

- my daughter
- my husband
- my dog
- the au pair
- my in-laws (Who complain that they never see their granddaughter all the damn time. But who, now that we fly to Italy sometimes, have stopped visiting us completely, even though they have an open invitation to do so -- EYE ROLL.)

(Interestingly, my own parents seem to have taken care of their own happiness, and don't lay guilt on me for much of anything, which.... A.M.A.Z.I.N.G.  I hope I'm able to do that for my own daughter one day.)

I brought this up last night, and everyone is like, BUT YOU'RE NOT RESPONSIBLE FOR ALL OF THAT.  Which is  false, actually.  If we move because of me and my husband can't find a job or hates his new job or has to travel a ton for his job as a result, or my daughter starts at a new school that is a bad fit (possible -- there are an awful lot of sucky schools and sucky people out there) and she does less well because of that, then their unhappiness sure feels like it would be my fault.

I wonder how men who move their families a lot for work cope with this?  Do they just not give a crap?  Is this a source of conflict and stress for them as well?  Do their families resent them?

I also brought up the feeling of never being done with training.  How with research there's always something else you need to do, additional years of sub-attending status and pay to get to the next step.  How my husband keeps delaying making decisions about his own career because he is waiting for me to get to a stable place in mine.  How do I deal with that pressure?

So anyway, after the seminar one of the group leaders came up to me and thanked me for bringing up some issues that *are* specifically woman issues, but aren't just about having babies and hiring a housekeeper.


Any advice about any of the above would be most appreciated.