False Summit

I finished my first stretch of call as an attending. Ten days of surgery coverage, two days of obs coverage mixed in there with a few ER shifts, consult clinic days, assisting, and scoping. Lots of "firsts" over the past 10 days.

I did my first middle of the night cesarean as an attending. No one there to tell me to cut higher or wider. No one there saying "it's safe to divide the omentum there" or showing me "the bladder is right there". It was just me standing there with sweat soaking through my bra and my socks.

The call came in around 3am, waking me and my husband up. I threw my pile of getting called back to the hospital clothes on. Duncan sleepily asked me what I was going in for.

Possible section. 

Good luck hon. 

Driving to the hospital I tried to breathe but it wasn't easy. I tried to remember the words of encouragement my attendings had given me over the last few years. Of course the only voices that easily came through were the words of doubt, the criticisms I've received. The houses along the way were quiet and dark as I rolled past, a contrast to my thoughts.

Later, when I got home. I was too wired to sleep. It was around five am. The edges of night were falling away and the morning bird songs had begun. I wasn't ready for bed but I went to our bedroom. I knew that Duncan would have had fragmented sleep after I left. I creaked open the door and he turned over.

How did it go?

It went well. It wasn't easy. I was terrified.  

I couldn't get back to sleep, I kept drifting in and out, wondering what time it was, hoping you'd be home soon.

I'm going to watch TV for a bit, I can't sleep yet. 

Thanks for coming in to tell me everything went OK, congrats. 

The big sleepy and warm hug was perfect. I went to the livingroom and put on Jim Gaffigan's newest stand up.

I thought that things would get easier when I finished residency. I thought that residency was really stressful because you were always having to do things the way other people wanted. You are always having to bend your preferences, practices, and schedule to the whim of your attendings. I had many days last year when I thought that being a resident would break me. I thought the stress and sleep deprivation was reaching the edges of sanity.

Like most things in life if I could go back I would do things much differently, and I'd chill the fuck out a bit too. The transition to becoming an attending has felt like taking off a 60lb backpack at the end of a hike, only to be handed a 100lb one while being told you have another 50 miles to walk. If only I'd known what was coming next.




Is this thing on…?

I wasn't sure if I still had a blog. I tried to log on from Switzerland and it wasn't working so I was a little concerned.

I finished residency (or rather, all my residencies) at the end of June.

This whole blog, which was meant to document my journey from nurse to doctor has technically come to an end. I am now a fully fledged GP-Surgeon. Want me to explain what that means? Do you have half an hour and half a bottle of wine?

It was a horrific year. Not like a horrific year compared to 70% of the world's population, I know. But, with respect to medical training, residency, life: horrific. I crawled and cried my way to the finish line. Then I worked basically 19 days straight and went on vay cay at the end of July. Sort of a holiday / honeymoon / end of residency party.

It was amazing.

It was an eating melted cheese in Switzerland, hiking in the Alps, drinking Champagne more nights than not sort of endeavor. I got to be a tourist, waking up to the mountains in France one day and then to freshly made scones and clotted cream at one of the finest hotels in London, the next. I had a 37th birthday that was OFF THE HOOK.

Now I am visiting family in BC and soon heading back to officially start my job as an attending-rural-medicine-GP-surgeon-ninja next week.

I am terrified and in debt. And I have so many stories, so many moments from the last year that roll around in my head. I don't even know how to start taking them off the shelf. I don't know if anyone even reads this blog anymore, but I promise, I promise to start writing again now that the dust is settling and a new story is starting.

The morning of my last call shift as a resident.

Sweaty Scapulas

I am finally half-way through my last year of residency. It has been the hardest year of training, without question. It is difficult to finish one residency feeling somewhat competent and able (Family Medicine) and begin a new residency where every day you just feel like a completely inept moron (Enhanced Surgical Skills). Stack on to that the sleep deprivation, increased debt, crippling self doubt, and sore muscles. It all makes me ask "why am I doing this to myself" on a daily basis.

I was finishing a cesarean section last July and I said to my attending afterward, "I've never actually felt sweat dripping off my scapula before". She just smiled and said, "welcome to surgery". And she was right.

I've seen and done things this year that I haven't even begun to process. I'd love to write about these experiences but I am constantly mindful of confidentiality, not that I have the time anyway. I miss writing. I miss looking back on my perspective on events, being reminded of things I'd completely forgotten about.

A good friend of mine recently published a very...very...brave piece about her life in Iqaluit many years ago. It is so beautiful and raw and brilliantly written. It made me wish I could be a writer and tell the stories we face, and the people we become as a result of being trained in the medical machine.

Maybe that will be my New Years resolution. Just to start writing again. Even if it is only for me.

Horizontal

That feeling.

When your feet are finally at the level of your heart. Your blood is returned without having to fight gravity. You feel the throb deep in your heels, the heaviness in your bones. There is a thin film of sweat covering your body but you don't care. All you care about is the fact that you are no longer standing, reaching, bending, pulling, straining, and concentrating. This moment, this...is bliss. You're not breathing in your own carbon dioxide or trying to see through your fogged eye protection.

You are finally horizontal. The scenes from the day intrusively play themselves out behind your eyelids but you don't care because you are still, silent, and free.

For a few hours.

Dr. Albinoblackbear, CCFP.

Hello Ye Dedicated Readers of My Blog.

I keep thinking about shutting the blog down but then I realized, I can't do it before I finish residency! There are so many unfinished, undocumented, unknown endings in health care, I hate to add this blog to the list of "remember that guy...what ever happened to him?" narratives.

Well nothing has really happened yet. It's all still happening.

I wrote the CCFP / LMCC 2 at the end of April and early May. I finished off my residency in a lovely little community where I had the opportunity to do some ER, some obs, some endoscopy, some surgery. They were a fantastic group of docs who offered me work there when I was done and I was so wishing I could say yes.

Seeing my cohort getting their offices together, planning European vacations, talking about paying down debt, I can't help but ask myself, "what was I thinking signing up for another year of residency?!?!"

To make matters worse, Duncan got a job in BC and is moving back there uhhhh tomorrow.  The job opportunity for him came a few months after I had accepted the PGY3 year training spot. So here I sit, watching him pack up and get ready to move back to my favorite place on earth, and I wonder, "what in the deluded hell was I thinking signing up for another year of residency?!?!"

So yeah. I have another year of training and two more years return of service here before I'll be able to join my husband-to-be-who-will-be-my-husband-by-then in BC. Until then, it'll be a looooooooooooong distance thing, I guess. Good old medicine. It isn't a train you can really get off if the destination starts to look less inviting.

I get a lot of emails from people who come across the blog. They ask me if they should apply for medicine or how to go about doing so. I think no one wants to really hear the real story. I feel like people want a Facebook version of events: big emotional moments where you save the day and feel validated, you steal an hour of two of sleep in call rooms with freshly laundered sheets then drive home in the morning, exhausted yet buoyed by the knowledge you made a difference. Really, it is just a lot of sacrifices and a lot of (mostly scut) work.

I started medical school when I was 30. I am not going to be done my training/return of service until I am 39. That is not an insignificant amount of time to hand-over in exchange for a new career. Putting on hold the place I want to live, a hold on having a family, a hold on traveling adventures, spending time with the people I value.

Many nurses have asked me "was it worth it?" to which I usually reply "ask me in 10 years". I really can't tell yet. I'm still too in it. Now I'm in horrific debt and have a lot more stress than when I was an RN. There were things I loved about nursing and things I hated about it, the same goes for residency. It's not better (yet) that is for sure.