Thursday, July 29, 2021

withdrawing

Once during residency, I was taking care of a patient having a large and lengthy abdominal surgery with significant blood loss and fluid shifts. My attending had scoffed at the idea of an arterial line (used to monitor blood pressure and labs intraoperatively) so we had none, and the patient had started to look increasingly under-resuscitated over the hours approaching 5PM. I asked my attending for help and other attendings for help (who told me to call my attending), and my attending came to the OR and made fun of my concern about the patient with the surgical team.  Then he left for the day without signing out to the next attending, who then also trivialized me and my concerns.  Eventually the patient crashed, and I got my invasive monitoring, and was finally able to start the resuscitation that should have been happening throughout.  Fortunately, the patient ultimately ended up doing fine.

Not that it matters, but I was also supposed to have been relieved at 6 that night, but ended up being at work until 9PM.  I had to be back at work at 6AM the following day, AND still had to read up on and discuss my preops for the next day with a different attending who was deaf.  After I did all of that, I finally went to bed at 11PM or some such.  At 2AM I woke up having a panic attack about: what had happened in the OR that day, my feelings of guilt about not being able to take the best possible care of the patient, what the next day would be like with this deaf attending who never understood anything I said, and what the following Saturday would be like since it was early Friday morning and I was scheduled for a 24 hour call that Saturday, and I didn't know how I was going to survive that.

So I called in sick.

I am 100% sure that my residency program held this against me.  They never mentioned the events of that evening explicitly, but... it was clear from the feedback I later received that calling in sick was not viewed favorably.  But you know what?  F*ck them.  I slept until 9AM that Friday, and then showed up for call on Saturday well rested and ready to go.  I have gone on to complete my training, and find a job that I really like where I feel like I can do meaningful work.  

Simone Biles withdrawing from the Olympics brought back these memories.  

My profession is really messed up too. 

Sunday, July 25, 2021

call call call call more call

My call last Friday was very busy, but I still got about 4.5 hours of sleep from approximately 1:30AM - 6:30AM.  Before you say, "Wait a minute, that's FIVE hours!" Please bear in mind this is call room sleep I am talking about, and I woke up several times.  I actually felt pretty good when I got home, and thought I might stay up until the afternoon, at which point the plan was to take a nap.  However at some point I went upstairs to shower, and at about 9:30AM decided to lie down and slept until about 12:30 or so.  I felt reasonably decent the rest of the day, and accomplished my goals of:

1) Going for a walk around the neighborhood.  It was hot, so it was just a short walk.
2) Not yelling at my family.

I had promised myself that I would do my shoulder exercises, but... I did not.  However instead I did my preops for Monday.  I still have one resident left to talk to about them for tomorrow.  So, not too terribly horrible for a post call day.  Oh.  I also went to bed at 8PM.  I thought I might have trouble falling asleep but... nope.  And I slept til (wait for it) 8AM.  And yes, I did have work-anxiety at around 1AM for probably 2h or so, but still.  

This morning my brain mostly feels better, but I have a muscle spasm that started in my left trapezius that has extended up my neck and it hurts to move, so... suboptimal.  But I did manage to drag myself swimming and do a small amount of weights, and while neither felt as good as they did on Friday, it wasn't as bad as I thought, and I did some real intervals.  So.  Yay.  At least that is getting better!  

I also: 1) am 2nd late tomorrow, 2) 1st late on Wednesday, and 3) on call next Saturday too, none of which I am excited about.  This is the part where my job flogs me over and over again and I barely have time to recover before it does it again.  And....?  Fuck them.  I am going to do what I need to do to take care of myself.  I work my ass off and I deserve to sleep the amount I need to in order to stay healthy.  Going to try to swim after work on Tuesday.  God I hope I'm not there heinously late that day as well.  

Speaking of which, I need to spend an hour or so on my specific aims page again today.  Part of my anxiety last night was this overwhelming sense of tidal wave of work that is coming my way and will all be due in October.  I don't think there's much I can do to mitigate the awfulness of that experience, i.e. I could bust my ass now and it won't end up mattering at all.  So I am trying to be ok with that.  

Research stuff is actually going great right now, but as per usual, is never enough.  

Oh!  Dylan is sick.  She's tested negative for COVID twice now, so that is good at least, but it also means no camp for her this week, or at least until she's fever free for 24-48h.  And hopefully the rest of us don't catch it also.  

Trying very hard not to fall into my post-call despair vortex.

Three things I am happy about:
1) Swimming
2) Two of my research projects are going great
3) Watching Olympics reruns on YouTube today has been really fun
4) And because I rarely drink anymore, the one beer I had last night was PLENTY, and tasted really nice.  

How has your weekend been?

Sunday, July 18, 2021

query spec

I went swiiiiimmmmiiiiiinnnnngggggg both yesterday morning and today.  It's amazing how much better my mood is after swimming. Today I did an 100 IM (very slow) for the first time since I've been back and 3x100 on 2:15 LCM marking the first time in 10 years I've done anything approaching intervals.  I'd like to make it to 2000m by the end of the summer, but I am cognizant that may not happen.  My shoulder didn't hurt today or feel loose, though, so maybe it will be ok.  

Luca thinks I should join Masters, but I have a few reservations about it.  One, they practice at 5:30 in the morning, and I am distinctly NOT a morning exercise person (especially not that early).  The other reason is that I am worried I will be the slowest one there, which is... quite possible, actually.  He has the benefit of a childhood of age group swimming in Italy, and I do not.  And while I am very good for someone who was never a real "swimmer," I'm really not that fast, and have always struggled with workouts >2000y.  He also has a tendency not to notice anything happening outside his lane, so I'm not sure he really knows if there's anyone who is my speed.  Also, they are practicing at Whitmore Lake HS, which is a little bit out there for me... but what do I know.  

Anyway, the alternative is join Liberty Athletic Club, which... this is probably what I should do, but then I worry I'll pay all that money and then never go.  

Ah decisions.  My life is hard.

Yesterday what else... I watched a bunch of Workin' Moms (which, yes this is a guilty pleasure).  When I finished getting through season 5 I discovered that Never Have I Ever has a season 2 out!  So exciting.  I hope Devi realizes that Paxton isn't worth the effort! 

I also worked on my specific aims page and curated three separate versions for the three separate NIH agencies we plan to contact program officers at.  It's getting there!  I am starting to believe in the project and the direction that all of this is going, and I'm hopeful I'll be able to get funded, eventually anyway.  I am also getting more integrated into the research group, which is also great!  I guess it's normal for it to take a year... but it has still been difficult.  

Went for a walk with the husband.  Realized I missed the A2 art fair, and briefly felt bad about "squandering" my day on the couch and doing work when I could have/should have done something else to take advantage of the nice weather, while we still have it, and the low rates of Covid in MI for now, until that ends as well (and oh, IT WILL -- probably just in time for school to start).  I think I need to make peace with the fact that yesterday was productive and restorative, and pretty fabulous, even if we didn't do any socially-approved family outdoor activities.  

Annnyway.  Working on my query spec for my next project now.  

Happy Sunday!


Oh yes there was a JAMA article that came out today put out by RAND showing that children's birthday parties were associated with outbreaks of COVID last year.  What was funny was that a person posted this on my local mom's group page, and comments were immediately closed because CHILDREN DON'T SPREAD COVID LALALALALA OMG THE AWFUL TEACHER'S UNION IS GOING TO SHUT DOWN THE SCHOOLS.  I can't wait until my child is vaccinated so that I can stop worrying about all the idiots around me (until a resistant variant happens...).

Friday, July 16, 2021

moving for me

Sooooo....

I have been asked more than a few times since I started working at my new job whether my husband's job brought us to MI, and if that was the reason I am here.  Most recently this happened two nights ago with a person who I have been collaborating with on a research project for several months, who... I am kind of appalled that she didn't know I came here specifically for research, but I guess looking back this explains a lot... and I will just leave it at that.

Similarly, my husband has said that at work he gets asked ALL THE TIME why he moved to MI, and most people are surprised to hear it was because of my job.

And while most people are pleasant and supportive after hearing this, just having to overcome this assumption IS a barrier and a burden, and... a bitch, and it honestly sucks so much.  I wish I could just walk into a room and have people assume that I know something, and I know deep in my heart that will never ever happen.  Probably I should either give up or try to stop thinking about it.  But that is actually impossible.

I was told this week that I "stand up for myself" and that most people aren't able to do that as well as me, and that this was good!  Why, then, dear internet, does it still feel SO GODDAMN AWFUL every time I do it?  What do most people do?  Just sit there and allow people (for instance) to continue on with their wrong assumptions?  To continue overtalking and mansplaining to them, and generally pushing them around?  I suppose maybe?  Is this what people mean when they tell me to "pick my battles", in pragmatic terms?  Is my main contribution to society going to be to be the difficult bitchy woman who "stands up for herself" and gets shat on because of it so that women who come after me don't have to?  You know what?  That SUCKS.  I'm sorry, dear internet.  That totally sucks.

On the positive side, it's been over a week since I was last assumed to be a nurse, so there is that.  And my projects seem to be progressing nicely, and I seem to be gaining some level of respect in the department, so there is that as well.  I just wish I'd be given actual credit for the expertise I already have.  

How's your week going, dear internet?

Wednesday, July 14, 2021

what a week

Well.

I expected this week of work would be a bitch, and... boy has it ever been.  I am on call tonight and I am freaking exhausted.  Went to bed at 9:30 last night and woke up at 6:15 without an alarm, and NO that does NOT mean I didn't need any more sleep.  It just means I have lost the ability to sleep until 7 if I need to catch up on sleep.  

Yesterday was one of the most difficult OR days I've had in some time, and no, none of it was my fault specifically, but since I am the attending I had to deal with it.  I am now up to 7 difficult conversations in the last 24 hours all of which I had to initiate.  And while yes, I will tell you that it is much easier to be on the giving rather than receiving side of these conversations, it still sucked, and it is likely that there will be several more to follow in the upcoming weeks to months.  These sorts of things take a LONG time to resolve and go away.

SO ANYWAY.

At least I like working with the staff I'm on with tonight, though if I have to be honest I hope the night is dead and I get to go home and sleep.  I do not think I will be so lucky, however.  Haha.

My original plan had been to sleep until 7 and then go swim and then go to work, but then I woke up at 6 and felt terrible and just languished.  And then I had breakfast.  I was going to not exercise at all but then decided EFF IT because I'm going to be working for the next 24-36 hours and goddamn it I should get to do something for myself also.  

My head is in a bit better shape now but I am still sleepy.  Ok now figuring out what work to work on. 

Saturday, July 10, 2021

Updates

Things are good!  

I am still cranky.  I think this is because I am working on the labor floor tomorrow, and am also in the OR Monday, Tuesday, and have call on Wednesday night.  It's not going to be a) fun, or b) a productive week from a research standpoint.  So I guess I have a bit of Sunday-night-itis on Saturday night.

What was good about this week?

1) I got a research proposal approved by my department.  What was noteworthy is that we submitted it for pre-approval, with the hope that they would ok us to move to the next step, and they actually approved us for the full project.  This doesn't happen all that often so it made me really happy!  It also a project I'm doing with a fellow -- my first real mentee -- so I am excited things are starting off so promisingly!

2) My specific aims page for a K grant I'd like to apply for this fall is coming along.  I am making daily incremental improvements, which is how these things get done.

3) I've been swimming three times this week, and I can feel that I am getting stronger.

Other good researchy things happened as well, those were just the best ones.

And also, the weather here today is PERFECT.  75 degrees, dry, sunny, with a light breeze.  And still I find myself sitting inside watching my daughter play Zelda.  Lol.

Oh also!  I figured out that I could use my phone as a hotspot, and was able to do work while at her horseback riding lesson this afternoon, which was merciful since otherwise I'd be doing that work now, instead.

Clinical life was more meh.  I spent waaaaayyyy too much time trying to accommodate unreasonable parental requests, and feeling generally unappreciated by my patient-parental units this week.  Also, working with new fellows who don't know the system here is hard and kind of exhausting.  

However at least more patients this week than last week were vaccinated for COVID.  And THANK FUCKING GOD since we are about to have another surge here.  Joy.  Hopefully I convinced two more people to get vaccinated this week.  Still sending Dyl to camp, but ugh.  This does NOT bode well for school this Fall.  I just hope under 12s will be able to get vaccinated by then.  

Ok, now I'm off to get Evergreen for dinner.  I haven't had it before, but I'm told it's good.  

Friday, July 2, 2021

haha another surge

Well, that was quick.  

It looks like some states -- mostly in the south so far (maybe including MI, but hard to tell just yet) -- are starting to see an uptick in covid cases and hospitalizations again, particularly among the unvaccinated.  Also, a 33% increase in positive tests among the symptomatic. Woo.

I suspect we will start to peak in MI riiiiiight when school is about to start.  I do hope that they open vaccinations up to kids <12 by then.  Not particularly excited about going through this AGAIN.  Grateful to live in a bit of a bubble with high vaccination rates among the people in my county at least.  

I was one for three for vaccinated parents this week, who have medically complex kids at risk for severe infection, so that was awesome.  

Also, I am on call 4/4 of the next 4 weekends.  

Yay.