Taking Hits

A lot has happened since my last post. I am still lost, but now I am in a position where I can start to care for myself as I continue working towards my dreams.

Man, self-care as a grown up is hard. Especially when you don’t even realize that you are struggling with it. I took a lot of hits since July 1st 2013, but I realized that I had taken some hits even before that. I went back and re-read my July 1st 2013 post, and yeah, thats probably when I started taking those hits. When I say hits, I mean the punches of stress that hit you in your gut and heart.

The difficult part of being a resilient doc is that, either you are so used to taking hits you don’t even realize it until you get knocked out, or you feel them, and keep going anyways. I think I did both.

You see, I am where I am today because I keep getting back up, no matter what. That is what I needed to do to survive. But this past year and a half or so has been really stressful and scary, and I didn’t get the relief I needed to make it tolerable. I just kept on going.  In other words, I ate up my reserves without realizing it. So, I wound up in a place where I am armored up to the hilt, ready to keep on taking more hits. Worse than that, I am in a place where I expect nothing but hits to come at me.

The good news? I finally realized it. I have a good job now. A job that gives me the flexibility to work on a lot of my dreams, and the potential to do so much more than I could before. Now, I need to work on myself as well. I wonder if a lot of other young professionals get to this point. We work so hard for so long, we don’t even realize that we can start relaxing. Wow, even typing the word “relaxing” just stressed me out. Made me feel weak and lazy. I don’t want to let my guard down, I want to be ready for whatever comes next, but maybe I don’t have to expect whatever comes next to be bad. In order to get to that place, I still need armor, it just doesn’t all have to be my own.

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Another July 1st post…2 yrs and 4 months later

I woke up this morning at 3:47am with my heart racing and a heavy feeling. I woke up scared and nervous. Today is July 1st, and I don’t have a set course. I am not starting a new year of medical school. I am not starting a new year of residency. I am not starting my first day of fellowship. Today is July 1st, and I am not in training anymore.

How did this happen? June 19th was my graduation ceremony. That was when I first had the idea of starting this blog. I was lost then. I was broken; I had lost my voice, my value and my confidence. I had forgotten everything that I had gained this last year of training and could only focus on what I had lost. I didn’t  know who I was, what I wanted to bring to this field, or if I could even bring anything to this field. I had thrown away great job opportunities…for what?

A week later, June 26th, I finished my last clinical day of fellowship. I felt better, felt renewed. I remembered why I wanted to pursue this fellowship, and I could reflect on how that vision changed from what it was, to what it is now. That night was the night I wanted to write my first post. There I was, full of hope and light, with a renewed strength and sense of purpose. But I didn’t. For whatever reason, it didn’t feel right. There I was with something to say and share, but I couldn’t write.

Somehow today felt right. Even though I woke up with the same anxiety that is correlated with the same heavy heart that comes with fear or dread associated with a new beginning lacking a starting point, today felt different. I was on a challenging path, but it was one which I knowingly chose.  Somehow, today felt like the first day to start my journey and invite you along.

So, who am I? I am a pediatrician who just completed her fellowship in hospice and palliative medicine. When I started this fellowship, it was because I wanted to fill in the gap that existed in caring for adolescents and children with chronic illnesses. Particularly those with sickle cell disease. I wanted to hold the hands of parents who were in the ICUs helplessly watching their babies suffer and die. I wanted to learn how to give them a voice, so they didn’t feel helpless.

Now, I have finished my fellowship, and I learned I wanted to do all of that, and so much more.

I have fallen in love with caring for adults as well. I enjoy hearing their stories, and meeting their families. I want to hold their hands and give them a voice too!  I “enjoyed” the painful process of learning from these adult families about how I dealt with my sister’s struggle with cancer, and how I am still processing the loss of my father. I learned that I love working with the children of these adult families and helping them normalize– as much as those situations can be normalized.  I learned that I want to continue working internationally, particularly in Nigeria. I still want to incorporate what I have learned in palliative care into my work with children with HIV and AIDs in Nigeria. I learned that I want to continue to work in the arena of public policy, to continue to fight for children who cannot fight for themselves. I learned that I want to advance the field of pediatric palliative care, to take what my mentors, have developed and grow it. I want our patients and parents to have engrained in their heads that pediatric palliative care means living as long as possible, as well as possible. I learned to read what is out there, and to share with others. At the end of my fellowship, I learned that I have a lot to learn, and I have a lot I want to do, and that I am tired. I remembered that I am just out of training.

That is how I arrived here. My first July 1st without any real structure,  job, or security. I choose this path because, well, maybe because I am naive, but mostly because nothing felt right at the time and I needed to heal. In my head I have a plan, and in my heart I have a dream.

July 1st! Here I am with an amazing network of friends and mentors to help me forge my path. Here I am with nine of the best co-fellows anyone could ever ask for to keep me honest. Nine fellows who will help me stay on my path. I am still scared, but I am hoping that  sharing more often will help both myself and others who might find this blog.

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Independence Day

It is only slightly ironic that I am writing this post on July 4th of my 3rd year. The start of one’s real independence from residency. I say that because as a third year pediatric resident, you are expected to start working independently, in my program, this is where you are on night team, supervising your intern and your medical student. You are supposed to have most of the answers. You are supposed to be making that great leap from being a resident to being a solo full fledged on your own doctor. Well, shucks to that! I don’t feel that way at all. I am no where smart enough, confident enough…I am just not ready. And to make matters worse, on this particular independence day is when my eldest sister moved away. Yes, she is on her own (well, with her fiance), making her own trail, advancing her career and in a way (if you knew my family) achieving her own Independence. Well, guess what? I don’t like that either!

Too many changes, too fast, and all of them forcing me to grow up when I don’t feel as though I am ready to, or worse not sure I can. I mean…yeah, its sad. I am almost 30 years old, never been away from home, always, ALWAYS had my sisters and mom by my side, readily available, and have always well, stayed in the small  pond. Not always a conscious decision on my part, but the way things have always been for me for nearly 30 years, now all of a sudden, things have to go and change! Well I say bullshit! BULLSHIT!!!!!

I know how sad and pathetic this sounds, I know that. I look around me and have thousands of friends who made this change ( or close to it) when they were leaving high school to go to college or medical school, or residency….Well, I never had to. Now, starting my third year, my sister moves away from me, and everyone is asking me what I am going to do next year. I had it, I had it all. I am scared, and I am unsure. I don’t know what will happen. I applied to some fellowships, I am looking at some jobs in the west coast, but who knows what will happen…what if I can’t do it? What if I don’t get any of the fellowships I applied for? That will just make it that much easier to say here and be complacent. I mean, I can do what I want to do for my patients here. There are poor kids here, I can travel internationally here…can’t I? So, why the rush? why the need to leave everything that is near and dear to me? Why the need to see what else is out there? I am perfectly happy here?

Because there is something in my heart saying go out and experience life….maybe every girl needs to leave home to appreciate what they have, maybe there is something better out there? But, I KNOW I have it good here! Yet, I know that I will always be able to come back home…right? RIGHT????!!?

 

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Pediatricians are Nice People

I have no Ivy league education in my resume. I am a dork. I am socially awkward. Contrary to popular belief I do have a filter, but it is a very, very loose one. And, I would never be picked out of a line up as the pretty girl. That said, I just spent a weekend at a conference with the most Intelligent, amazing, charming, fantastic, and yes oddly all very attractive pediatric residents/fellows who are all at the top of their game, in ALL of the top programs and they made me feel like one of their own.

The only reason I can fathom for this, is that, well, we all have the best interest of kids at heart, and we are all so passionate about being better advocates for our patients, and helping other residents find their passion in pediatrics, that nothing else mattered. We all came together to unite for the kids, and for other residents so that we can become better doctors for our patients. Everyone was so nice and genuine and welcoming of new ideas and of everyone, it was great.

What an amazing weekend. I know there is not much dept to this post, but I just wanted to share it. Pediatricians are nice people. More than that. They, (we) are amazing, caring dedicated people, and I am so happy to be part of this group. I feel like one of the cool kids.

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The Case of The Ferocious Ferret

Or, the case of the really fucking stupid ass hole horrible excuse for human being parents. And yes, I did just drop the F-bomb. I don’t normally do that, but as you will soon see, it was warranted.

So, as I stated in my last post, I am in the full term nursery this month, and actually, today was my last day. All in all, it was a pretty good month, no crazy parents, with the exception of the mom who decided to only smoke pot for the first three months of pregancy. No big deal. Nothing really happens in the first three months of pregancy anyways right?

But, generally, a pretty laid back month. Well, today,  I hear about a child that was being transported to our inpatient service. He is a six month old male infant whose parents left him alone with the family pet ferret While left alone with the family pet ferret, said ferret ate 17 of this little infant’s  20 digits.

Sadly, no, this is not a joke. Its just sad. I mean, the poor baby was left alone, while the ferret at 17 out of his 20 digits. Essentially, this baby was tortured, while his parents were God only knows where. The story given by the parents was that they were in the “other room” and when the father came in ( he thought he heard the child crying) and saw the ferret over his bloodied child he threw the ferret against the wall and killed it. Now, how true can this story be? I mean, I am sure he did infact kill the family pet out of anger. But, this whole being in the “other room” buisness while his child was being eaten. Lets take a closer look at what it would take for a ferret to eat 17 digits.

You many not be able to tell by the picture on the let, but turns out, that ferrets have four types of teeth.  1) Twelve small incisors located in the front of the mouth used for grooming. 2) Four canines used for killing prey.  3) Six molars used to crush food.
And lastly4) Twelve premolar teeth that they use for chewing food. The ferret uses these teeth to cut through flesh, using them in a scissors action to cut the meat into digestible chunks.

Now, lets look at the cute little digits of your average sized American six month old baby.

 

So, given what you see here, and knowing now what you do about how ferrets use their teeth, how long do you think it took to take out all but one pinky and two big toes? I mean, think about it, at most using the premolars, it could take out two fingers at a time. That is really generous because most likely using the premolars, it would be more like gnawing off one finger at a time., because yes, the bones of the fingers were also gone. For those of you who may not have any experience with babies you know…at all, let me just say, with any noxious stimuli, they will cry, and more accurately screem with a high pitched intensity. So, if the parents really were just in the “other room” that ferret could have most only taken out two fingers, and or toes before they should have come running. But now, that poor child underwent pain that most adults couldn’t endure and will be marred for life.

Why? Because his fuck up of an excuse for parents, were clearly no where near that child, or if they were, were so high that they were not paying any attention. I mean, this kid’s life…I just can’t imagine. There are so many things wrong with this whole situation, I don’t even know where to start. But then again, do I need to say anything more?

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Shame on Me!

So, after only about what, seven months of being a senior resident…the jadedness of the medical field showed its ugly head. I am on the full term nursery right now, and the other day, we had an explosion of patients, and not just any explosion, a Burmese speaking explosion, and well, I thought IT. I thought, for just one quick nanosecond, I thought to myself, “God, why don’t these people just learn the language!” And then I caught myself. But, yeah, for that small moment, that thought actually crossed my mind, and entered my heart.

I mean, lets forget for a second the blatant hypocrisy of that thought; as my own family immigrated to the states when I was seven. Lets even forget that, the very reason I wanted to be a pediatrician was so that poor kids, including those from different countries, could get access to quality healthcare and not be treated differently because of their SES and immigration status. Yes, lets forget all that for a second, and focus, on what was truly wrong with me thinking that thought.

I mean, can you imagine what it must be like to have to flee from your own country, leave your life, most of your family behind, and come to this new place, this place that is so completely different from what you are used to? And, as if that wasn’t bad enough, your wife is pregnant, and people are poking her, doing all sorts of things to her that you don’t totally understand because they can only find someone who speaks your language every once in a while, or they use this phone in which someone on the other line speaks a different dialect than you do, so you still don’t completely understand what is going on. Then, you have to tell your story to different people everyday. Your baby is born and different people keep taking her out of the room, and you still don’t really get what is going on, and you hope that your wife and baby are ok?! I mean, can you imagine that? Cause I can’t. I cannot imagine how scary and confusing and difficult that must be. Nor, do I want to have that feeling. But this person, and his family didn’t have a choice.  And then, for me to want them to assimilate to a culture that isn’t really fully my own just to make my life easier?! Well, shame on me. I mean, really. The only inconvenience I face, is having to use an interpreter line. That’s it. And yes, it takes me a little bit longer to do my rounds. But really, that’s it. A small dot of an inconvenience, when this man and his family have this well, new inconvenient life to live now. EVERY DAY!

Dang.

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New Start?

Hi,

Yes, it has definitely been a very, very long time. Lots happened since that first 14 days. But really, it culminated in me finally hitting the wall in a very big way. I lost all motivation, I lost all drive, my heart got broken ( for about the 1000th time), and well, quite frankly so did my “give a damn.” I won’t insult you, or myself, by going into this long speech about how it is a new year and time for new beginnings. No, because, that’s not really how I feel. I know that I have accomplished a lot, and it’s just too bad that since…September, things just kind of went down hill, and I just needed that break. Luckily, I finally did get that break. Over the week of Christmas, I got 6 wonderful days off, and then went back to the NICU. Oddly enough that combination kind shook my system back into gear.

I needed time to realize that I hit the wall, and it was ok that I was burnt out. July was brutal, educational but brutal. August, was supposed to be nice, but I just ended up putting more pressure on myself to get things done. September, I signed up for too many projects, and didn’t get any of them done, but got Mono instead. October, AAP conference and the beginning of the end, of a lot of things. November hit rock bottom, but fought to keep it from affecting me or my work, December, accepted that I hit rock bottom, and held it together till I got those much needed 6 days. No, 6 days was not enough, and I could have used more, and but I will take what I can get. I promised myself that I will be more even in 2011, and yes, in my mind that does rhyme. But really, it just means that I just want to be more balanced. Work, extracurricular, and me time. I was trying to hard to be this perfect resident, and perfect doctor, sister, friend, that I forgot about me, and then well dropped the ball on all fields. I mean, being perfect in all those things, will be good for me, and is a part of taking time for me. But not really. You know what I mean. So yeah. I am going to try to be more even and balanced. Huh, guess I still gave that little speech anyways didn’t I? But in my defense, I made this decision on December 27th, not January 1st.

So, happy new year everyone, and here is hoping for a better more balanced year.

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