I have seen so much sadness in the past six and a half months. I have done so many 'death exams.' I've ruined more sets of scrubs with bodily fluids than I know what to do with. But I love my job. I've hugged more patients than I expected and spent more nights crying myself to sleep than I did as a teenager. I've leaned on Jess in ways I never wanted to.
Internship is a rite of passage for doctors--a notoriously hard year that most attending physicians shudder to think about. Sure--its hours have grown shorter (now limited to 80 a week!), but it's responsibilities have changed, and the pressure to get everything right only grows. I didn't realize how care free medical student life is (save for all those exams) until I had my first crop of patients that I was ultimately responsible for. When I go home at night I am never settled, all I can think about is labs and x-rays and procedures and if my patients will cause trouble for the night float. Will my 90 year old with atrial fibrillation be able to be rate controlled? Or will she have a stroke? Will my patient with the mystery cough and weight loss start to understand the gravity of his situation? Or will he go out for a few smokes and breathe in the same fumes that likely set him down the road to lung cancer? Most of the time, between 7PM (when I get home on average) and 9PM (when my lame ass goes to bed), I am a basket case.
Don't get me wrong, there is a lot of joy. It's no secret around my clinic that I have a favorite patient and that her success (which is actually all hers, and very little mine) keeps me afloat. The happiness I derive from the lives and stories of my patients makes everything worth it--three times over. I have also never been more proud to be a physician, I have never felt like I have earned something quite like I earned this. (Perhaps that's because I have lived a crazy privileged life and it could be argued that I haven't really earned any of my acheivements in their entirety.) I am proud to stand among other doctors who have gone through the same trials and faced the same challenges. It's like a big club of tough-as-hell nerds.
I should have been writing though. I am sure my mental health has suffered for lack of reflection. Several things have held me back--I am sure you know I will mention time. Time has held me back. I just don't have any. And then the time that I do have is torn between QT with Jess (most of which I spend word-vomiting or crying/laughing about some patient/work story from the day), time at the gym (very proud when I work this in), or time in front of the TV/laptop (which, honestly, feels so good at the end of day). Pretty much the last thing on my mind is being self-reflective, because I know I'll find a lot of reasons to be sad. Here is a list of reasons I don't love myself at the moment:
- I have a bum left foot going on a month now. Why haven't I fixed it/gotten it checked out? Oh I don't know. All the reasons above, and the fact that maybe if I stare at it enough I'll develop XRay vision and be able to see what's wrong without having to pay the copay for an MRI. Also, I'm an MD. Shouldn't I know what to do?
- Less frequent trips to the gym... directly related to #1.
- My disorganized presentations on days when I feel disorganized. If I am feeling off on a certain day, it really shows on rounds. And it's embarrassing.
- My proclivity for products with warmth and cheesiness--think pizza and mac and cheese.
- The fact that I preach self-love (within reason--I also believe in being the best you can be), but can't practice it.
So, in order to avoid self-hate, I try to keep things as light and fluffy at the end of the day as humanly possible. This would also explain my distance from all things political this year. I am pretty sure I'd have a melt down if I fully understood the state of reproductive health in this country, at the moment. And so, avoid I have. This feels like an admission of guilt, but I am pretty sure it's a tactic of self-preservation at the moment.
These feelings/struggles also explain my hilarious purchasing habits over the last six months. There has been an uptick in acquisition of all things comfort: comfy pants, comfy undies, blankets, aforementioned mac and cheese, and anything that brightens my day or makes me happier. I have also painted my nails more consistently in the past six months than I have done any other thing--maybe including showering. At least my hands look good. Don't look at my legs (hairy) or my roots (egregious).
I think I will get around to recounting patient stories again. At least, I'd like to. Being a resident has also made me more acutely aware and paranoid about privacy. The current plan is to share stories in a vignette fashion--meaning, they won't be about any of my patients in particular, but will touch on things I have seen in a more general way. I'll probably start with end of life stories, because those have really dominated a lot of my experience thus far.
Oh I missed this. I do love writing. Hopefully I'll be back in the saddle soon. Perhaps tomorrow. I do have it off, but I also have nails to paint.