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. 

My Current Theme

My current theme appears to be death. Not that I am thinking so much about my own eventual demise, more about the process and ritual around death and dying. I seem to be stumbling across a lot of articles, books, and podcasts theses days about mortality and I've been so fascinated and appalled and intrigued by it all. Thought I would share a few, in case any of you are interested.

CBC has a great radio show called, Ideas, which recently ran a 3 part series called, "Death Becomes Us". Wow. Spent three evenings walking in the hilly, drizzly Irish mist listening to those. Very captivating and eye-opening. Who knew the origins of embalming? Who knew about death midwives? Who knew people buy concrete blocks to go around coffins? Woodland burial sites? I certainly was ignorant on all of these fronts. I found the whole series quite good, but I think episode 3 was my favorite. Of course the whole thing led to a panicked call to Duncan regarding changes to my death and dying wishes! I think he's become enured to these sorts of phone calls, no longer worried something is actual wrong with me, just that I've read something or watched a TED talk which has caused these addendums.

I also recently finished, "Being Mortal" by Atul Gawande. He's just such a legendary author, I instantly read everything of his that I can track down. Some of the discussions and concepts highlighted in Being Mortal have already changed my fledgling practice. If you want to hear him speak on these matters he also did the Reith Lectures on BBC recently.

And, a smattering of op-eds, old articles and new, and the shifting landscape in Canadian medicine as we face the potential changes to physician assisted suicide. Death is all around us in health care. It's easy to focus on the potassium levels, the next chemo drug, the ventilator settings. The real effort for me is pulling back and looking at all of these aspects of dying in a bigger sense, and including myself in the picture.

When Will I Be Good?

I really need to just start writing again, it's starting to make me crazy. I know I've said this on the blog before (maybe I need to go back and start reading old posts again) but the best advice/word of warning I received on this journey was "make sure you like the person you become at the end of your training".

Well, I haven't become a maniacal, self-important, egotistical, jerk. Yet. But I have let so many parts of who I am, fall away. I've definitely stopped being a somewhat multidimensional human. I hardly read (for enjoyment) anymore, I don't play music, I don't train physically like I used to. I've basically stopped doing yoga, writing, traveling. I know this is just a residency-routine-rut but it's frightening sometimes to see hobbies and loves that I once had just gradually fade into the distance, and not even (really) notice. I still am excited about medicine, about learning, about getting better, safer, wiser. But I keep coming back to somehow wanting to make sure I do indeed like the person I am becoming. Right now, it's iffy.

There are good things happening too. Very exciting times, even.

Duncan and I got engaged just a couple of weeks ago!

I got the surgical/obsetrics training spot for next year!

I am temporarily back in Ireland for some surgical training with M.C. It's fantastic being back here.
The thing is, because I am now moving towards my surgery and obstetrics training, I feel like I am back at the drawing board. I feel clumsy and hopeless again as a learner. My knots, my draping, my grasping. The simplest things you see surgeons do, then suddenly you're doing it and dammitiwatchedthisa1000timeswhycantidothis basically runs on repeat in your head. It makes me wonder when I will be good? Will I ever be good? Then I try to remember that I am on a much different path and that I will have to forge some of it myself, instead of constantly worrying about my exact endpoint.

So I will close on this perfect Rumi poem. For now. Evidently "Shams" was Rumi's living mentor. Thus, this poem struck very close to home when I read it this week, as my legs are, indeed, feeling heavy. 
 
Unfold your own myth

Who gets up early to discover the moment light begins?
Who finds us here circling, bewildered, like atoms?
Who, like Jacob blind with grief and age,
smells the shirt of his lost son
and can see again?
Who lets a bucket down and brings up
a flowing prophet? Or like Moses goes for fire
and finds what burns inside the sunrise?

Jesus slips into a house to escape enemies,
and opens the door to the other world.
Solomon cuts open a fish, and there's a gold ring.
Omar storms in to kill the prophet
and leaves with blessings.

But don't be satisfied with stories, how things
have gone with others. Unfold
your own myth, so everyone will understand
the passage, We have opened you.

Start walking toward Shams. Your legs will get heavy
and tired. Then comes a moment of feeling
the wings you've grown, lifting.
 
View from a hill, on my Sunday walk.
 

Reality

I felt a lot of genuine support and was buoyed by the reader comments after my last post. Been thinking a lot about the different things people said. I received some emails that also echoed the comments in the "thank you for being real" vein.

I think I'm feeling a little overwhelmed by the "is that really your life?" emotion when I flick to FB and see an endless stream of perfectly manicured children, lawns, engagement photos, work achievements, and exercise updates.  I look down at the jeans I've been wearing to and from work for the last three days, the stacks of review books I should be pouring over to study, and the pile of t.v dinners I've gone through over the past week for sustenance and I think, "Where am I going wrong here??"

And I don't want to use FB or my blog as a permanent venting space but I think there is a distressing lack of REALNESS in the world these days. We're not supposed to admit that we're scared, or unfulfilled or unhappy. And we are certainly not allowed to admit to failure, mistakes, bad decisions, or regrets.

There are a lot of people out there who I wouldn't want to disclose my shortcomings to, or my sadness to. But many of my blog readers are on a similar path and probably think they are alone. And to those people I want to say, "No, you are not alone.".

I had a beautiful, challenging week. I was up early and in bed late. I was able to sneak in a couple of bike rides on my wind trainer, and eat a couple of meals before 10 pm. But mostly, I was at the hospital with a full bladder and an empty stomach. I picked up a devastating diagnosis on a fit and rugged man, and held up a fresh, slippery, crying baby while grandad took photos on his SLR. I missed my boyfriend and my own bed. I bought a lottery ticket once again hoping magic would erase my student debt, freeing me to chose if medicine was still what I wanted to do instead of had to do now.

But there is no choice now but to carry on. As Winston Churchill famously said, "If you're going through hell, keep going."