On Endings and Beginnings

Hello....hello....hello. 

Wow. Um. Not really sure where to start.

I quit my job. I am no longer a rural GP-Surgeon. So, there's that. I moved. Enrolled in a Dermatology Diploma through Cardiff University, got a new full time job, a part-time locum. Oh and a full time LIFE again.

I bought a new house, adopted a second dog, moved. Is that everything? I guess that is the big stuff.

It's awkward as I have so much back tracking and so many half written half cocked stories and posts and its overwhelming. And were does one pick up the thread?

I will start by saying that physician burnout is a real thing. I read somewhere recently that around 80% of physicians in their first year of practice report feelings of burnout. It made me feel reassured. I haven't really sat down and dissected the past 15 months since finishing to see if the diagnosis would be burnout but I can certainly see that there were moments, really long moments that lasted weeks or months at a time where the over arching theme could be described as "burnout". Sure.

And I cycled through the emotions of feeling guilty for being overwhelmed when I should have actually felt good that I was acknowledging that too much was being asked of me. Feeling I was weak instead of seeing that the load was too heavy, and all of that.

So now I'm staring at all these books in my basement. Do I get rid of the stacks of emergency medicine books? ECG guides, Operative Obstetrics, Mastery of Surgery, Palliative Medicine? I have Care of the Newborn and PALS guides strewn beside Colorectal Disease atlases and AIME study manuals. It's nearly comical. I am letting go of some of my skills, some of my training but I am weirdly clinging onto these books. I am not a nostalgic person. Ever since I Marie Kondo'ed the shit out of my house 2 moves ago I have paired down and donated, sold, and dumped a lot of my belongings. These books feel like haunting reminders of the person I thought I wanted to be or the person I thought I'd become.

When people would ask me, "How are you?" at work my response was always "living the dream!" And this was an intentional response (for me) even though it may have sounded flippant. I said that because if you go back, all the way back to even before this blog started, I wanted to be a rural physician. A rural emerg or rural gp-surgeon or full scope rural GP. I turned my life upside down. I left my house in the mountains, all my friends, all my family. I left my financial security and traded it for crushing debt. I left the freedom to chose where I got to live. I left my hobbies, my boyfriend, my favourite recreation. I left my country! I traded all of that in to become a doctor. I came back to Canada and was lucky enough to land a residency in a fantastic rural program. Then landed another residency in enhanced surgical skills. Then I was offered a full time job in a full scope GP service practice in a place that I had spent 6 months as a resident. And everything was just finally lining up perfectly and I was reaching the end goal of 8 years of moving, studying, exam writing, wondering, hoping, and guessing.

And my "dream" finally came true.

And then it all went to shit.

So I purposefully reminded myself every single time someone asked me how I was doing, that I was in fact, living my dream. It's so easy to remain in this goal oriented, delayed gratification, head down, life will be great when....mentality. "At the coal face" as my husband describes it. You are in survival mode, you don't look up you just grind grind grind. You will one day live your dream, you tell yourself.

Then you arrive and the unicorns aren't sliding down rainbows to greet you. I can't even go back and read the post I wrote when I finished medical school because I may actually punch myself if I do. I was taught this lesson before but I suppose I never learned it.

I wanted to remind myself so I could stay in the moment. So I could find that thing and see the beauty in where I was even when it felt like it was crushing me. Something had drawn me to this exact place in the world so I had find those rewards and acknowledge them. Even when it felt really really hard.

I'm sure there are many, many people who chase certain goals in medicine, and achieve those goals and the rainbows and unicorns are there to greet them when they do. And to those I say, "you're so lucky". But to anyone reading this who felt weird and sad and stressed and unfulfilled when you finally got to live your dream I say, "you are not alone, dude".

So I finally gathered up the courage to admit all these things to myself and those around me. And here I am. Trying to focus on how I am going to make this whole medicine thing work for me, instead of the other way around.

To be continued.







Only in the Prairies

My patient, sitting there heavy with pregnancy is looking dismayed at the thought of having to be induced now that she is post-dates.

I ask her what is up.

She tells me her garden isn't done.

Then she asks me if she can come 30 mins later than the scheduled time so she'll be able to milk her cows.

Later in the same clinic I had another woman who had come in for a possible abscess. She informs me that her mother in law gave her some ointment they use on the animals when they get infections. She was using it all weekend.

Evidently it worked. 

I love my prenatal patients on the prairies. 

Rural Doc Realities

Even though alcohol is legal and I don't have an unhealthy relationship with it, I always feel a little awkward about stocking up on wine and beer in my local liquor store. I have this irrational fear that I will see a patient and they will think it's inappropriate that their doctor drinks Chelada's or American reds. I hated buying booze as a resident because I always looked so haggard and forlorn I was convinced people would assume it was the alcohol that made me that way and not the fact that I'd been up for 44 hrs on a surgical "bender".

As an attending I hardly drink as I'm on call 1:2 (or 1:3 at best). Alcohol has become a treat because it also means my phone can be off and I can shower without having a "get to the hospital in 5 minutes" outfit laid out on the bathroom floor.

So I go to the (one and only) liquor store the other day in the hopes of maintaining a low profile. I do my sweep while trying to eye out the selection. It's pretty disappointing, as I expected it would be. But, in a way I'm glad it's no Wine Cellar* because it would be too hard to stick to my new $100/month budget if I had their glorious products to choose from. When Barefoot and Yellowtail are rounding out the options it makes splurging on a Rodney Strong or a Layer Cake seem indulgent.

I'm perusing the boxed wines and wondering how rapidly I would descend into alcoholism if I started drinking Copper Moon by the box when I hear "DR. BLACKBEAR!! DR. BLACKBEAR! How ARE YOU??" My eyes have still not quite adjusted from the sunlight outside so I look around, trying to locate the voice while half-hiding behind the Pilsner stand. People are milling about and looking in my direction. A staff member is waving wildly at me and smiling. I think I recognize her from the clinic...? The ED...? I don't think I've delivered her baby recently...did I ?

Hi.

Hiiiiiiiii!!!! ARE YOU ON CALL TODAY?

Yes. (I can't lie, dammit. I was on call. What if she ended up going into the hospital that night with an appendicitis and they called me in to see her? Then it would seem even sketchier that I'd lied about it. I wasn't planning to drink the booze THAT night, I just knew I wouldn't have time to get there any other day this week. Besides, I am on call all week anyway!)

OH MAN YOU WORK SOOOO MUCH! THEY REALLY WORK YOU GUYS TO THE BONE!

Yes. (Now people are staring at me, they are judging me not only for my choices in alcohol but the fact that I am a doctor and buying it during the day, when I'm on call!!)

ARE YOU TAKING PATIENTS YET?

No...erm...I am doing so much call and covering the surgical program right now so I am not really in the clinic that much and I ...... (I'm mumbling, trailing off, and deciding if I should just pull the pin on this whole endeavor and leave without buying anything. But I feel like I am committed and really, my husband would come and buy just one bottle of Malbec then try and convince me I liked it in the past).

WELL I DON'T HAVE A FAMILY DOCTOR!!!

I think I then sputtered something about continuity of care and resources and some apologies while going to the farthest till away and hoping things would peter out from there.

A lady with tight permed curls and a wrist brace starts ringing in my order. She keeps her eyes locked in mine as I fumble with my wallet and hit the automatic start on my key ring.

What is your name? Says wrist brace without looking away.

Albino. 

No, what is your DOCTOR name?

The other people behind me in line lean in slightly.

Dr. Blackbear (WHY WHY WHYYYYYYY)

Hmpf. Well I don't have a family doctor EITHER. 

So, so sorry to hear that I think there are a few doctors at the clinic taking patients....byyyyyeeee thank youuuuuuuuuu.........!

I grab my bag and head for the door. My initial greeter yells, BYE DR. BLACKBEAR SEE YOU LATER HOPE YOU GET A BREAK SOON!!!

You and me both, honey, you and me both.

--

*I was not paid to put that endorsement there. The Wine Cellar and 124st St Liquor Store were my two favorite places to go when I lived in Edmonton and was discovering the world of wine. The staff were super knowledgeable, the selections were varied and interesting, and I never felt intimidated about asking questions. I loved pretending I knew anything about wine and pretending I could afford the good stuff. And look how far I've come in the past 15 years, now I know even less about it all and can still only afford the cheap stuff!