New Year, New Life

First of all, Happy New Year!!!

As I write, it is December 31st, the last day of 2012.  The world did not end 10 days ago.... was I the only one that thought it would kind of take care of some problems if it did end?  But I digress...

As this new year is about to begin, I find myself surprisingly optimistic. I long ago gave up New Year's resolutions in favor of trying to be mindful every day (well, most days) (well, many days) of health and good habits. And so, while I have no distinct promises I'm making, I am excited to see what happens in this new year.  Last year, I had just left my career behind and had not yet found my way into my current employment.  I hadn't even started looking for work yet, but I was still terrified, as I really had no idea what I was going to do to make money.  This year, my freelance editing business is slowly starting to become more lucrative.  For the first time this month, I made enough to a) not have to draw on my savings account, and b) pay off a little of the debt I'd let build up.  I have enough projects lined up to keep this trend going for at least another couple months, and hopefully enough irons in the fire to bring in new work after that... This might actually turn into a real business!

I am also optimistic about my personal life.  As I get better-paying projects and can actually take days off here and there, my husband and I have been able to spend more quality time together, and who knows!  We may even start planning our belated honeymoon!  Or at least take another trip to the coast if the honeymoon is still a little out of reach.  And as I am able to relax, at least a little, about money, I am able to focus energy once again on personal growth.  Unfortunately, that's the tough stuff... having money worries was a nice excuse to not work on my issues, just as working 90-hour weeks used to be.  Here's to stripping away the excuses! Cheers (I think)!

These past two years have been a bit rough, with the one bright spot of my (awesome!) wedding as the exception proving the rule.  There were some big decisions made and big leaps taken during these last couple years, and I was plagued by a lot of worry, doubt, and self-deprecating thoughts. I don't know that 2013 will necessarily be any easier, but I do know that I am getting sleep (in my own bed, no less!) every night, working steadily, communicating with my partner, and toiling away, however slowly, at self-knowledge and self-improvement. A very wise person reminded me recently that peace is not the absence of adversity and hard work; rather, it is the ability to have a calm mind in the midst of those things.

Here's to peace in 2013!  I'll raise a glass to that!
Namaste, everyone.

Delayed Gratification. Wait for it....

It's almost Thanksgiving!  Where has the time gone?

As the gorgeous fall leaves fall from the trees and every other person on Facebook seems to be posting daily "I am grateful for..." lists, I have been thinking a lot about gratitude and its sort-of cousin, gratification.  I've been meaning to write on the topic of delayed gratification for quite some time, and this month of gratitude seems as good a time as any!

Physicians are experts at delayed gratification.  Really, anyone who is a Type A, workaholic, good student, etc has to be.  Studying now rather than going out to the movies - making a sacrifice that will pay off in the long-term - is what delayed gratification is all about.  The understanding is that you are giving things up, but the rewards will be worth it.  And delayed gratification serves a purpose.  Waiting until the weekend to eat that ice cream provides motivation to eat healthy during the week. Claiming that diploma at the end of 4 years of hard work, whether it's high school, college, or medical school, is the gratification payback for all the sacrifices that have been made (emotional, financial, personal, etc).

"I'll be happy once I read all these books!"

But what if you get there, to the place of "gratification,"  and it isn't what you thought it was going to be? The ice cream is that gross low-carb stuff, or you find yourself utterly uninterested in pursuing the work that your diploma prepared you for.  Does that mean you made those sacrifices for nothing?  I don't think so at all.  I may have spent 12 years of my life getting to where I was, only to find that I was not happy.  I may have gotten to the point where I was finally making enough money to pay off my loans and my mortgage and take nice vacations, only to jump into the financial insecurity of freelance work (something I NEVER thought I would do, mind you... a topic for another time).  But that doesn't mean those 12 years were wasted. It doesn't mean I'm not using my medical education.  And even if I weren't using that hard-earned education - even if I were slinging coffee in a diner somewhere - those 12 years would still have been worth it.  Those years were a journey, and there were lessons to be learned along the way.  Although you couldn't have convinced my goal-oriented Type A self of that at the time...  (nothing against coffee-slingers, by the way!  I've been there too)

College to some degree, and medical school to the nth degree, were all about chasing the next exam, preparing for the next hoop to jump through, all the while thinking that I would be happy when that next thing was accomplished.  "I can catch up on my sleep once finals are over."  "I can relax once I've passed the boards." "I'll be happy once I finally move back to the Northwest."  (OK, that last one was true!)  But there's always something else.  There's always another exam, another hoop. It took me almost 40 years, but I finally figured out that I was missing something by putting on the blinders and plowing ahead toward my goals.  It's tempting to think of those years as wasted. In terms of personal growth, I certainly missed out on time I could have been using to figure myself out.  But maybe I worked so hard BECAUSE I wasn't ready to go on that journey yet.  So I took a different journey.

Who knows what my life would be like right now, or what I myself would be like right now, if I hadn't had those experiences, good and bad.  Maybe I would be happier, maybe not. Maybe I would have skipped living in some places I really didn't enjoy.  But then again, maybe I always would have kicked myself for not going to medical school.  Maybe I would have met my life partner 10 years ago... or maybe I never would have found him if I hadn't waited to move to my current city until we were both ready for each-other.

It was just over a year ago that I quit my job and began my journey into finding fulfillment in both my personal and professional lives.  I think back to this time last year.  The leaves were falling from the trees. The gorgeous sunny days were beginning to have a little nip to them.  I was spending a lot of time on the couch, alone at the house, decompressing from 12 years of chasing down the wrong path, pursuing the wrong dream ( nightmare?).  It was several months before I began to look for work, not really knowing where I was headed.  I'm still not sure where I will end up, but I am busy and feeling productive.  For that, I am grateful.  I delayed the gratification of my life for 12 years, and now I am grateful for all of the experiences that have led me to this place.  I am grateful for my supportive husband who knows what it is like to pursue one's calling without much of a safety net.  I am grateful for those beautiful falling leaves.  But I am still delaying gratification... I tell myself I will be happy when I am earning enough that I can stop drawing on my savings, when I won't have to work every day of the week, when my husband and I can afford "real" vacations again.  But at least I know now that's what I'm doing.  And I remind myself that delaying gratification is fine, as long as I'm taking the time for gratitude right now.

So I will take a moment to be happy, no matter what else is going on.  In this month of giving thanks, I am most grateful that this big, beautiful universe has supported me in my leap. And now, I just may go jump into a pile of leaves!

To Market To Market...

Wow, it has been 3 months since I've posted anything!  I guess you can tell that I've gotten busy with editing work.  That's both good and bad...  I am working like crazy, which is good, but I'm working like crazy, which is bad!  Working 7 days a week is a bit tiring, and it has left me no time to blog, work on my book, or do anything creative!  Luckily, I will hopefully soon be able to ease up on the work-a-thon...  I have just returned from the American Medical Writers Association annual conference and learned a thing or two about marketing myself, and finding clients that will pay me what I'm worth!  I wrote the following right after (okay, maybe parts of it during) my marketing seminar:

I have never been comfortable promoting myself.  When I was in medical school, I would describe myself as "just" a medical student.  That "just" seemed to take some responsibility off my shoulders, and it allowed me to keep telling myself the story that I was worth less than other people.  Once I was a physician, in residency and beyond, you really had to pry it out of me that I had MD after my name.  If someone asked me where I worked, I would reply, "in a hospital," which was usually followed by the question, "oh, are you a nurse?"  and the questioner's embarrassed justification when I finally revealed, "no, actually, I'm a physician."  Part of me took a perverse pleasure in exposing the inherent sexism in the question, and part of me cringed at being "exposed" as a doctor (see, Why Doctors Suck).  I always wanted to distance myself from the stereotype of physicians as arrogant, entitled jackasses, and part of me was reluctant to claim the credit for years of hard work and financial, personal, and emotional sacrifice. I didn't want to be perceived as "bragging" or to have an inflated sense of my own worth, but I went too far in the other direction, downplaying my intelligence, drive, persistence, and personal value.

I am currently at a conference of medical writers and editors, where I attended a workshop on marketing.  This is basically anathema to a person who grew up downplaying her abilities and achievements.  It has taken me a long time to learn that there is a big difference between "bragging" and owning my own worth, both as a highly educated individual who deserves recognition and compensation for her hard work, and as a human being who deserves love and happiness.  I had to learn the difference between confidence and arrogance, and that it was okay to be confident.  Nobody was going to smack me down for pretending to be being so great.  Now, I have to learn how to present myself and my services in a way that will make people want to hire me. Hard to do when you approach every situation assuming that they won't.

Let's practice a little....  People will want to hire me.  People will want to hang out with me, even though I may think I'm boring and dull, with nothing to say.  Okay, hang on...  despite this negative self-talk creeping in, I do have people in my life that like me, love me, and even people who want to spend time with me and to hear what I have to say.

My marketing instructor made a comment that I am SO SICK of hearing, but also that I probably need to keep hearing.  I complained that I am working for companies that don't pay very well, certainly for someone with an advanced degree.  He told me that these companies will only pay me low rates if I let them.  Grrr...  I get so frustrated, because if I'm not working for these companies (who were willing to take a chance on an inexperienced editor), then I'm not working, and I'm out on the street because I can't pay my mortgage.  The people who make comments like, "they'll only pay you those rates if you let them!" don't seem to take into account that this may have been (or seemed like) the only option at the time, and crappy pay is better than no pay.

But I do recognize that I need to step back from that personal, emotional response and hear what people are actually trying to say (sorry, instructor, for bursting into tears at the break).  You are worth more than this.  Your degree and your experience are worth more than this.  Your personality, your soul, your self is worth something.  To quote The Help, "I is smart, I is special, I is loved."

And that is worth something.

Promoting myself as someone people will want to hire, and to pay well, is a challenge.  It requires not selling myself short.   How's this for an editing and self-promotion slogan:

I'm here!  I'm clear!  Get used to it!

How are your dangling participles doing?

When I left my physician career behind, I wasn't really sure where I'd end up. 

Well, to be honest, I kind of had an idea (a type A uber-planner doesn't just leave behind her career without at least a wisp of a plan, as hard as she tries to "let go" and not have a plan). I had joined the American Medical Writer's Association (AMWA) and registered for their annual conference - conveniently, taking place just a couple weeks after my last day at the hospital.  I had an idea in my head that, after some time off to decompress and veg on the couch, I would make a foray into medical writing.  This is a vast and diverse field, with plenty of niches within it - I pictured myself getting involved in continuing medical education (CME) and writing articles for other physicians to read. They say to write what you know, no?

I went to the conference and immediately discovered two things.  One, writers are much more supportive of each other than physicians are.  Two, I really need to brush up on grammar.  Knowing what "sounds right" isn't going to cut it.  Okay, three things.  Three, I like grammar!

I returned home and duly fulfilled my destiny of vegging on the couch for a good while.  For a time, I was worried that I would never be motivated to go back to work, as I really enjoyed the couch-vegging lifestyle.  A lot.  My day was divided between classes at the gym and Netflixed TV shows.  I kinda loved it.  But eventually, I did start to get that niggling feeling that I should be doing something, well, productive with my life. And I started to look for jobs writing CME.

This was not as straightforward as it may sound, as I really wanted to try for a telecommuting position.  After more than a decade on the end of a pager, setting my own schedule and working from home sounded awfully nice. I did find a CME company willing to pay me to write an article, so I dove in.  And realized that I hated it.  Writing this blog and writing my experiences into a book are an entirely different animal than writing a scientific article.  The former flows out of me; the latter is like pulling teeth. I also did not like the feeling that I was writing a gigantic term paper that would be judged not only by my professor, but also by any physician who might read this article for their education. It had to be perfect, and I had had about enough of demanded-perfection in my old career.

In continuing to haunt the job boards of AMWA and websites dedicated to telecommuting, I found myself applying for (and getting!) editing jobs.  Non-native English speakers do a lot of the research in this world, and they want to publish their papers in the English journals.  That's where I come in!  I take my newfound love of grammar and mix it up with some study of the American Medical Association guidelines for scientific journals, and it all bakes up into a career as a freelance editor!  And, wonder of wonders, I love it!  I get to correct people's grammar (always fun), and I get to learn about something different every day.  One day I might have an article on dermatology, the next on cardiology, and the next on gynecology.  It's bringing back the love of medicine and knowledge that took me to medical school in the first place.

I don't know if this will be a long-term career, or just a stepping stone to something different, but for now it's (almost) paying the bills and providing me with a sense of purpose.  I am also building my own business, something I never thought I would do in this lifetime.  A psychic told me a few years ago that I would have my own practice/business at some point, and I thought she was insane.  I loved collecting a salary, and had absolutely no interest in striking out on my own into the scary world of non-financial security that is one's own business. 

Moral of the story:  never say never (or, never contradict a psychic, one or the other...)

Label Me Elmo

I used to love those label-makers when I was a kid.  You know the ones, the big plastic doohickeys with the wheel you spun around to find the letter you wanted.  You spun, squeezed the trigger, spun, squeezed the trigger, and on and on until you had a lovely little embossed strip of thick tape-stuff.  Peel off the backing, and voila!  A label you could stick anywhere!

Turns out, adults love labels too.  But instead of squeezing out tape strips to put on our lunch boxes, we turn to labeling ourselves and each-other.  Married.  Single.  Doctor.  Writer.  Smart.  Dumb.  How convenient it is to know which box to put people in.  The first question out of most people's mouths when they meet a stranger at a party is, "what do you do?"  The person's occupation provides a handy label, by which we think we can tell a great deal about them.  Ooo, they're a teacher so they must be dedicated and poor.  They're a physician so they must be arrogant and rich.  They're a writer so they must live in their pajamas and eat a lot of Hot Pockets.

But what if we are not defined by labels, but by our essence.  This becomes trickier for cocktail-party conversation.  "What is your essence" is a tricky question, and I would wager that most people have not done enough soul-searching to be able to answer it.  Or maybe we can never really answer it, not in words.  In deeds, perhaps, but maybe not even then.  In intention.  In our wishes and thoughts and dreams. In how we treat our partners, our friends, strangers, animals.

I've been told that people let go of labels when they are close to death.  The man who was a cattle farmer and could talk about nothing but livestock his entire life, loses interest in this topic at the end.  He moves beyond the labels and into his essence.  I haven't spent enough time with the dying to tell you whether I've observed this for myself, but it makes sense.  No-one really cares, at the end, how you made your money.  They care who you are. People stop identifying with their labels, and find out what's really inside.

Labels are powerful things.  If you let go of one, another comes right in to replace it.  I discovered this when I was getting ready to leave my career as a physician.  I knew I had to make a change, but my label said "Doctor", and what was I going to do with that?  Every time I tried to peel it off and let go of that label, a huge wave of fear swept in.  What are you going to do?  Who are you going to be? What makes you think you can change your life?  Haven't you read your label?  It took several months (years?) before I summoned up enough courage to rip off that label and actually make a change.  I tried very hard not to put a new label on while the wound from the old one was still so fresh, but that was a challenge.  An exercise in letting go, in just "being". Not easy for a type A who is used to jumping through all the hoops set up in her path. 

Making it even more challenging, I found that people like to project their labels onto us, even as we try to let go of our own.  When I announced I was leaving medicine, every single person wanted to know what I was going to do instead.  Now, I know this is natural human curiosity, but people had a really hard time with the answer, "I don't know".  My mantra became, "I'm going to take some time off to figure that out," but I could see the new labels forming even as the words were leaving my lips.  Unemployed.  Lazy.  Quitter.  Crazy.  Maybe they didn't want to think these things about me - but since I didn't give them another label to take the place of the old one, they gave me whichever one came first to mind.

Now, this isn't entirely true, or fair to the people in my life, or to me for that matter!  I had just as hard of a time refusing a new label.  So usually the second sentence, after I completed my mantra, was, "well, I am going to a conference on medical writing so we'll see...".  I just couldn't leave it at, "I don't know", and I could see the sigh of relief in my listeners too.  "At least she has a plan..."  As it turns out, my "plan" has shifted and changed and I'm now doing something I never thought I would be doing...  but that's how life goes.  I'll leave my new career a mystery for another blog post, just to avoid giving my readers a comfortable label.  Ha!

So the next time I visit my hometown, I'll have to see if my mom still has that old label-maker lying around.  Maybe I can make all-new labels.  Just so I can cut them into bits and scatter them to the wind...

Cutthroat Yoga

Do you go to Yoga classes?  If you do, you know how wonderful it makes you feel.  How blissed-out, stretched-out, and strengthened it makes you feel, no matter how crummy or fat you felt when you walked into that room.  You also, if I'm not mistaken, have probably run up against the Aggressive Yoga Ladies. 

You know the ones.  The ones who will cut your throat if you dare to place your mat on "their spot".  On an average week, I go to three yoga classes, at three different branches of my gym, with two different instructors.  Every class has its regulars, and people gravitate toward their favorite spots.  I'm no exception - I admit to having "my spot" and to being bummed if someone beats me to it.  I will even try to "scootch in" with other people, so that I can get something close to my spot (for the record:  the front row so I can correct my posture in the mirror, but not on the crack between mirror panels, on the side of the room closest to the door but a couple spots over from the instructor.  Yeah, I'm not particular at all...).  In two of my three regular classes, this isn't usually a problem.  I'm usually able to get my spot, and people are willing to scoot around so that everyone can see the mirror and no-one's bumping arms when we swan dive into forward fold.  Maybe some of the people in those classes even classify me as one of the AYLs, (I will admit it - that which bugs me about others is probably something I don't like in myself) but I really do try to work with other people in a friendly manner so we can all have a spot that makes us happy.

What I am not:  one of those people who likes to barge into the room and unfurl their mat before the preceding class has had a chance to put away their equipment.  One of those people who will actually ask someone to move out of their spot.  One of those people who will refuse to "scootch" when asked.  Those are the ladies at my wednesday yoga class.  They actually had to install a guard at the door (a hapless gym employee) so that the frontrunner AYL would stop barrelling into the room the second the music ended in the class before ours.  With the herd mentality that overcomes humans in such situations, once one person enters that room, the rest immediately surge forward so as not to be left behind.  I was even shoved once, I kid you not.  After a few weeks of the guard, the frontrunner cooled her jets a bit and would let the prior class - mostly - put away their weights and mats, and our class was no longer guarded.  Still, you can feel the energy shift the second the weightlifting class ends - sometimes even before.  People start scooting closer and closer to the door, the natives becoming restless.  Once the frontrunner breaks the barrier of the door jamb, all bets are off.  The frontrunner runs to the front of the room and stakes her claim, and that of her slightly slower friend, by throwing both mats down.  My problem is not with the frontrunner as such (although she is the one that asked me to move out of her spot the first time I attended this particular class and didn't know the dealio - she must have been late that day).  No, I'm willing to breathe, let it go, and let her have the spot if it means that much to her.  My problem is with her friend.  The friend usually nabs the spot I'm after (I'm just not willing to give in to the aggression and race her for it).    I used to naively try to share space with AYL #2.  I put a smile on my face and asked if we could share the mirror panel (necessitating her to move a little to the left - she was planted in the center of the panel) so that I wouldn't be staring at the crack (it throws off your balance, in case you're wondering why the big deal).  She told me that she didn't want to be on a crack either and moved her mat about an eighth of an inch.  She was about a foot from the crack - there was plenty of room to share.  I kept smiling and thanked her for her accomodation.  She suggested I move to a spot on the other side of the room.  Oh, now it's on!  Passive-aggressive doesn't work when it comes up against plain old aggressive!

I am trying to be the nicer, bigger person here without being a total doormat.  I still try for that spot on the mirror, but I set up a little bit staggered behind AYL #2.  I'm a little close to her mat for both of our comfort, but since I'm staggered back we don't bump into each-other.  If she just scooted a little to the left, she would still be nowhere near the mirror crack and we'd both have plenty of room, but apparently to suggest this is anathema.  I've given up.  I refuse to move to the other side of the room (it's just as crowded, the spot she was suggesting was even more cramped than the one I was trying to occupy, and who knows what kinds of AYLs are over there?).  I am letting the bullies win, but only up to a point.  They will just have to deal with me sharing their mirror panels.  If I am a fly in their ointment, so be it.  It's good for them.  :)

It's good practice for me - I have a tendency to get too attached to things, including "my" yoga spot.  This class is a weekly reminder that I can let that go, that I can be in a spot slightly more cramped and slightly behind where I'd like to be, and it's okay - I still get a great yoga session.  I feel myself getting anxious about the weekly encounter with these ladies, and I practice letting go of that anxiety.  Neither AYL #1 or #2 will budge an inch on where they want to be, so that forces inflexible me to be the flexible one and adjust what I want to fit what I can get.  It's good for me, I suppose.  I could always throw an elbow or sprint ahead of those ladies, but it's not worth it.  I don't want to become one of them, and encountering them each week is a good reminder of that. 

I'm sure they don't see themselves as AYLs, just as I don't see myself as one.  I'm sure they don't think they're being at all unreasonable.  I don't know if they see the irony in racing to stake out their spot for a class that's supposed to be about calm, and about letting go of competition.  I need to stop being an AYL for long enough to realize that I can't teach them that lesson.  I can just angle for my spot and hope for the best!

See?  I'm smiling!  Not aggressive at all.

Fear

I'm back!  I haven't posted for a couple weeks - partly because of the holiday weekend coinciding with my wedding anniversary, and partly (okay, mostly) because I hit a wall of fear.  Kinda like this:

photo:  Wickpedia.  The Scream by Edvard Munch

I think it's a common human experience... We overcome fear in order to take steps toward happiness, then all of a sudden, fear rears its head again.  "I thought I was over you," we say.  "Nope," fear replies, "I'm always here, waiting for you". 

There are many types of fear, but the one I've been dealing with, in many areas of my life, is fear of success.  It sounds bizarre, but fear of success is a very real, albeit oddly self-defeating, entity.  I thought I had dealt with the fear when I made the decision to leave my career and embark in a new direction.  Naturally, there are day-to-day fears (financial being the number-one when one leaves a physician's salary but still has a physician's mortgage).  Those are normal, healthy fears.  It keeps us safe to be afraid of disease, ax-murderers, and telemarketers.  But fear of success?  How is that helpful?

Our minds, those whirling, busy maelstroms of thought, really resist change.  Even if the status-quo is painful and hurtful, at least it is a known quantity, and our minds will always choose the known over the scary unknown.  Unless we set the intention that we are going to try something new.  Even then, the mind balks.  "What do you mean, something new?" it cries.  "We don't want new!"  If you've ever wondered why people don't leave abusive relationships, why people lose (or gain) weight only to relapse to their former selves once they're achieved their goals, this fear of change has everything to do with it.  We'd always rather fight the battle we know, than take on a new one and have to change the way we see ourselves.  Even if we see ourselves as helpless, fat, ugly, weak, or any of the other perjoratives we hurl inward, at least these are known battles to us.  If we shift our worldview, our perception of ourselves in that world must shift and the mind recoils.  You'd think the mind would want to feel better - isn't it "better" to think of oneself as beautiful rather than ugly?  But if "beautiful" requires the mind to reset its go-to patterns, it will resist mightily.  It will think of (and shout at you) every possible reason that the new view cannot be true.  It can take a herculean effort to reset those automatic thoughts. 

This is fear of success, in a nutshell.  I've mentioned that I'm writing a book, and using this blog to explore some ideas and concepts for that book.  You'd think I'd want the book to be successful, and for this blog to become a worldwide phenomenon, right?  Apparently not!  Success opens one up to criticism, which is always scary.  And so, as I thought about what to write next, I got overwhelmed with the magnitude of the project and just shut down.  Ideas dried up.  I found other things to do with my time (not difficult when one is a master procrastinator!) 

How does one overcome this fear?  With faith.  It can be faith in a higher power or the support of the universe.  It can be faith that one's self-preservation instinct will not let one make a deadly mistake. It can be faith that you can take whatever criticism (or praise) that comes your way and keep your self-esteem intact.  Faith that people (or even just one person) will like what you have to say, will get something out of it.  Faith that there is a happier version of you, just waiting for you to take that leap, make that change.

It's not called a Leap of Faith for nothing.  You just have to jump, without knowing where the safety net is, or if one even exists.  The fear will always be there, waiting for you.  The fear will always take you back if the leap of faith doesn't work out... but what if it does?  What if?

Psychic Travels

So it turns out I'm not the first person to want to leave medicine!  Or even to write about it!  Wayyyyyyyyy back in 1988 (yes, that's sarcasm, although when I do the math, it's been 24 years and that makes me feel old), Michael Crichton (yes, him again) wrote a book called Travels. In it, he describes his extensive travels around the globe, mostly to lesser-trodden locales.  He details the self-insight and life lessons each journey teaches him, but he begins the book with a description of his four years in medical school. 

This book was recommended to me by my wonderful career-change coach, and at first I wasn't sure why.  Sure, I love to travel and MC has traveled to some amazing places.  He also describes his journeys on the spiritual plane - from psychic readings to astral projection to meditating in the desert, talking to a cactus for two weeks!  Initially, I wasn't really sure why he chose to begin his book with his med school days, since it doesn't really match up with the rest of the book, but he eventually spells it out - if he hadn't changed careers, if he had stayed in medicine, he might not have been forced into the sort of change that lays the track for all kinds of other life-changing experiences. 

MC started out as an English major, but found the English department at Harvard to be less than pleasant.  He switched to anthropology, and took some premed courses, "just in case".  He found the pre-med world to be quite different from the rest of Harvard, where people were less caught up in grades, and more eager for the learning experience in general.  In pre-med courses, he stepped "into a different world - nasty and competitive".  People would sabotage their classmates without a second thought - we called those people "gunners" by the time I went to med school.  No thought or consideration for anything but their own success.

He makes a couple comments that I found laugh-out-loud funny.  The first, regarding the gunners who gave out wrong answers to classmates who asked for help in his chemistry class and who sabotaged his lab experiments so he would start fires: "I was uncomfortable with the hostile and paranoid attitude this course demanded for success.  I thought that a humane profession like medicine ought to encourage other values in its candidates.  But nobody was asking my opinion."  How could I have found this LOL-funny?  Because it's true...  A quarter of a century later, medicine is still encouraging hostile, inhumane behaviour.  Not overtly, of course, and I do believe that things have improved.  My medical school had very few gunners, and overall was a pretty supportive place.  We were encouraged to explore our humanity, and we even had a humanities requirement in the curriculum (my favorite course - Red Flag #382 for my clinical career).  But I believe that the training, particularly by the time one gets to residency, beats most, if not all, of the humanity out of one. MC describes, "This... seemed more like hazing, like a professional initiation, than education."  I had to hunker down to get through it, and that hunkering down necessitated a complete absence of work on my inner self and created a version of myself that I really didn't like.

He continues, "I got through it as best I could.  I imagined medicine to be a caring profession, and a scientific one as well.  It was so fast-moving that its practitioners could not afford to be dogmatic; they would be flexible and open-minded."  Ha, ha.  Very funny, MC.  I am priveleged to know a lot of physicians who are wonderful people, caring as well as scientifically smart.  But I also know a lot of the other kind...  I will say that I believe that med schools today are trying to create more of the former, but unfortunately the profession does attract a fair number of the latter.  MC elaborates, "I learned that the best doctors found a middle position where they were neither overwhelmed by their feelings nor estranged from them.  That was the most difficult position of all, and the precise balance - neither too detached nor too caring - was something few learned...
 "It was certainly interesting work, and there was no doubt that you were doing something worthwhile with your life, helping sick people." This is true.  Medicine was, and is, an incredibly worthwhile profession, and it can be a very rewarding one as well. 

He goes on to tell some anecdotes about his pre-clinical and clinical training.  He explores the development of the gallows humor that anyone who deals with illness and death on a daily basis develops to some extent.  He describes the apalling behaviour of residents and attendings with whom he interacts, and his struggles with some patients.  He develops a theory of illness that requires that people take ownership of and responsibility for their mental and physical health.  He quits medicine.

MC tried four different times to quit medical school.  At the time, he was required to meet with a psychiatrist before he could quit.  The psychiatrist talked him into continuing every time, basically telling him he hadn't gotten yet to the part he wouldn't hate.  The psychiatrist did this each of the first three years of med school, then finally gave up the ghost, saying "I thought you would quit in the end".  MC finished out his four years, then quit medicine before ever becoming licensed or practicing.  Here's where my experience differed.  I actually enjoyed the classroom aspect of medical school, and I enjoyed many of my clinical rotations.  I still had (a little) time to devote to outside pursuits (reading, dancing).  The rotations I didn't enjoy were the ones that impinged the most on my outside life, or that were extremely stressful.  Red Flag #936. 

Now, MC had a backup.  He was already making money as an author during medical school.  He quit to become a writer, and he was already somewhat established by the time he gave up medicine.  He also had a tool with which to meet the naysayers when he publicized his decision to quit medicine.  "In quitting, I was following my instincts; I was doing what I really wanted to do.  But most people saw only that I was giving up a lot of prestige...They admired my determination, but they thought I was pretty unrealistic."  Hmmmm, sounds familiar.  MC, though, had written a little thing called The Andromeda Strain which was about to become a movie.  Once it was known he was a successful writer, people got off his back.  "All the doctors and residents who had shunned me became suddenly interested in me."

I have no Andromeda Strain in my back pocket.  I've got this blog, I'm working on a website, and I'm doing some medical editing and writing on a freelance basis.  My future best-seller of a book (think positive!) is still a mass of unorganized, unedited words on my computer.  But I do have one thing in common with Dr. Crichton:  I am following my instincts and walking away from an unhappy life, forward into the great unknown.  Cheers!

Sick of Being Sick

I've had an annoying, nagging cough for the last couple of weeks.  I never got really sick, but I'm sure taking my time getting better...  Before leaving medicine, I would have ignored it and plowed ahead with my busy life.  Now, I wonder what my body is trying to tell me...  Sometimes a cough is just a cough, but let's back up here to a little object lesson in psychosomatics...

I felt like I was sick all the time in residency.  I had been ill here and there in medical school – the worst was on my Pediatrics rotation.  All those little kids sucking on your stethoscope and coughing in your face will give you the flu like nobody’s business, I don’t care how many flu shots you get.  But in residency it got truly ridiculous.  Serotonin levels were down and cortisol was through the roof!  I was always getting the cold-of-the-moment, and when I wasn’t sick, I was feeling ill.  I often had stomach upset and general malaise.  Occasionally, more concrete abdominal pain.  Too bad I couldn’t see that it was probably psychic, not physical.  My body knew I was on the wrong path, even if my consciousness hadn't yet gotten the message.  But I didn’t pay attention, and continued on to graduation.  No surprise, it continued after I finished residency and began practicing out in the real world.  Yes, of course, when you see sick people for a living, you’re bound to get sick once in a while.  All the hand-washing in the world can’t save you from that cold or flu virus when it’s all over the hospital or your office.   But it’s not just that.  Working crazy hours compromises the immune system and raises cortisol levels.  The body is so stressed, it can’t muster the energy to fight off anything else, so you get sick.  But it's not just that, either. 

When you’ve stuffed down all of the emotions and inner voices that are crying out at you to make a change (you must suppress these in order to do what you do), they're going to come out physically. That's what psychosomatic means, although any good physician knows that only happens to other people, right?  I saw patients all the time who would come into the OB triage unit with vague complaints of dizziness or non-specific abdominal pain.  Often, there was something going on at home – either domestic violence or just being ignored on a Friday night.  They wanted a little attention, and a physical complaint was a "valid" way to get it.  I could recognize it in my patients, but couldn’t see my own “I don’t feel well” status as Red Flag #256.  Zero Insight Girl, that was me!

By the last year I was practicing, I was breaking out in angry, painful red welts under my arms each time I had a call shift.  I thought it must be the surgical scrubs, so I would take hospital scrubs home to launder them in my own detergent.  I saw my dermatologist who tested for allergies - all negative.  It took seven courses of antibiotics and a few rounds of topical steroids to calm  my skin before my wedding day.  I also took six weeks off work before the wedding, both allowing my skin to heal and because I felt I needed that time off to be a sane person on my wedding day (Red Flag #257, there you go!  If you need that much time off to feel and look like a normal person, something is wrong with your working situation).  Maybe it truly was a bacterial infection, but I think it had not a little to do with stress and something in me screaming out to be heard – if you won’t listen to me, I’ll give you physical symptoms so you have to pay attention! 

The thing is, that only works if you are tuned into it.  Otherwise it just leads to more denial, and an outward focus on the physical symptoms.  They at least detract your attention from the inner turmoil, and give you something upon which to blame your misery.  They will only heal, however, if you learn to dig out the real issues and deal with them.  Since this is both difficult and scary, most people choose never to go there.  I was not exactly raised to embrace my emotions, so allowing myself to feel them was terrifying, and it took a few years - this is certainly not something that happened overnight.  Once I started paying attention, however, there was no going back.  Luckily, by the time the outbreaks started, I already knew I was on my way out of medicine.  That didn't stop my body from trying to reinforce the message.  "What do you mean, you're giving six months notice?  Are you crazy?  You need to get out now!" 

And since I quit?  Clear skin and clear skies...  except for that stupid cough.

Coming Out

Today, I proudly present my first guest blogger, Rob Baginski MD.  I spotted this post on a website dedicated to physicians contemplating career change, and it really resonated with me.  I had struggled (and still do) with how and when to tell the people in my life that I am no longer a practicing doctor.  I hadn't thought about the comparisons to "coming out" until I read it here, and it's spot-on!  How will my parents react?  What will my friends think of me?  Read on, my friends, for Rob's words of wisdom, and feel free to pour a glass of wine whilst you peruse....
 

Telling Mom

So, I want to change careers. More specifically, I would like to change my career from that of a clinical, emergency department physician to that of… well, something non-clinical. I suppose the exact “what” has yet to be determined. I must say, the process is a daunting one, fraught with worries about what it is that I wish to do, what it is that I am qualified to do, how I can afford to leave clinical medicine, how to break into a new field, and many, many others. Nevertheless, a conversation with my mother the other day added yet one more concern, one more stressor to the list.

Now, as many of you who have or have had mothers in the past know, there is almost nothing in this universe that cannot be made more stressful by a conversation with her. There is something inherently anxiety-producing in getting helpful advice from the woman who bore and raised you. In this case, we were talking quite nicely about day-to-day things when I casually mentioned that I was speaking later that afternoon to my career counselor. There was a pause, and she asked, “Why, honey, are you speaking to a career counselor?”

I sighed, as we had discussed my desire to leave clinical medicine several times in the past.

“She is helping me figure out how to leave the ER, Mom. You know I’ve been wanting to get out of the ER for a while now.”

“Oh, sweetheart. You know you love the ER. You’re just confused right now. Give it time, and you will realize you want to stay there after all.”

And then she let drop the phrase that stunned me.

“You just haven’t found the right ER yet.”

It was then that I realized that I had to come out.

No, I am not talking about coming out as gay. I’m talking about telling the people around me, my family and friends, about my life choice to leave clinical medicine. I didn’t realize how my choice would affect them and how they see me. Like telling people about sexual orientation, revealing a dissatisfaction with “being a doctor” can be shocking to people who see you in a certain way. They now have to see you as a person who is unhappy at work, who has other dreams or aspirations other than medicine, and who is not fulfilled in a career that American society has somehow glorified and idolized. Therefore, I need to come out… again.

My mother’s words struck a chord that pulled me back 15 years ago. How many gay men and women have told their parents that they were homosexual only to be told, “You just haven’t found the right girl/boy yet.”

Well, it has been 10 years, and I still haven’t found the right ER. And, Mom, it isn’t that I haven’t tried. Believe me. I have dated around. I have tried small community ERs and large, city ones. I have flirted with urgent care centers. I have tried long-term relationships where I have stayed with one ER for years, and I have experimented with short-term, per diem trysts. None of them have satisfied me. As much as I want it to work out, whenever I am in the ER, I can’t help but fantasize about something else. Something more satisfying. I have to admit that I have desires that the ER cannot satisfy. I need something different, something more.

Now, I’m sure my mother doesn’t want to hear this. Coming out can be difficult not only for the person but also for his or her loved ones. For some reason, becoming a doctor has taken on a certain mystique, sort of like becoming a priest. Once you are a doctor, you are always a doctor, at least in many people’s eyes. Asking those around me, in particular my parents, to alter that perception of me is not easy. I understand that it will take time for my mother to adjust to this new reality. I also understand that this transition may be aided by her two close friends, Chardonnay and Pinot Grigio.

Coming out for a parent also affects how she interacts with people outside of our relationship. One of the time honored perqs of having a physician for a child is bragging about this to your friends who preferably have children who have failed out of beauty school or who have become roadies for the local Grateful Dead cover band. For my mother to confess to her book club that I have decided to leave medicine must be akin to telling them that I am leaving my beautiful, blonde, real-estate agent wife and 3 adorable children for a drag queen named Miss Kitty Litter. I can hear the conversation now:

“Mimi, how is that doctor son of yours doing?”

There is an awkward pause.

“Well,” Mom hesitantly begins. “He has decided to leave medicine.”

There is a shocked silence. But now that the confession has been uttered the dam has broken, and she tells all.

“He says he doesn’t feel happy as a doctor. He wants to quit and become… Oh, I don’t know, a… a…”

“A what?”

“A marine biologist!”

There are gasps of horror all around. Chardonnay is spilled on dog eared copies of “The Bridges of Madison County.” Finally, someone takes my mother’s hand and whispers..

“Don’t worry, Mimi. Don’t worry. I’m sure it is only a phase.”

And with that the coming out comparison is complete.

So, with my career transition in its beginning phases, I have come to understand that this decision doesn’t just affect me. It is something that touches my family, my friends, and my spouse. It is something that, while necessary, is a life-changing event for not only me, but for those who care about me. Nevertheless, I will forge on. I know that, no matter how difficult it may be, this change is for the good and that I, and those around me, will be the better for it. It is, therefore, with confidence and no small amount of pride that I proclaim:

“I’m here! I want to change my career! Get used to it!”



BIO: Rob Baginski is an emergency medicine physician in Massachusetts who is in the beginning stages of transitioning to a non-clinical career. He lives in Rhode Island with his husband and a spoiled dog who doesn’t care what he does with his life as long as there is enough time for belly rubs and an ample supply of Milkbones.

Relief

As an obstetrician, I helped bring life into this world.  What cooler job is there than that?  But honestly, I was not really the one bringing life into this world.  The life was there, I was just guiding it out.  It’s an interesting thing, being a deliverer of babies.  Most of the time I’m really not needed.  I’m there to help coach the mother, make sure her delivery is progressing and that both mother and baby are safe.  Most of the time, mothers do what they do and nature takes its course, bringing another baby into this world, just like the last seven billion babies.  A good attendant, whether obstetrician, family practitioner or midwife, can help guide the delivery to minimize injury to the mother, but the baby would arrive safe and sound no matter what we do or don’t do.  Not all the time, however.  There’s a reason mothers and babies used to die in childbirth in such huge numbers compared to today.  Things can go wrong, and when they do, they often go wrong very quickly.  

As I was evaluating my relationship with my career, I had to ask myself:  did I want to be in a job where I was often not needed, but when I was, it was an emergency?  That is a very stressful way to live.  When you tell people you deliver babies for a living, every single one of them says, “oh, what a joyful job you have”.  And they’re correct – most of the time.  I’ve not once had someone say to me, “ gosh, that must be so stressful – every mom is expecting a perfect birth experience and a perfect baby, yet nothing in this world is perfect – you have a lot to live up to!”.  This would be a more accurate description.  And so would, “wow, you have to make complex decisions quickly, and sometimes tell people things they don’t want to hear – what a responsibility!”.  I’ve never heard that.    It is a joyful job, until it’s not.  And I was finally realizing that I was not cut out for the hard parts.

People also think, when you say you're an ob/gyn, that all you do is deliver babies.  They don't think about the annual exams, the hysterectomies, the laparoscopic surgeries, the trips to the ER in the middle of the night for suspected ectopic pregnancies or for miscarriages in progress.  They don't think about the fact that I have to tell women they have cancer.  They don't think about the fact that I have to tell women they have an STD (and, therefore, that their partner has been less than faithful and/or forthcoming).

So what, just cut and run when things get difficult?  No, that’s not what I’m trying to say.  Every job has hard parts.  When I was sixteen years old and waitressing, I had a volatile Neopolitan boss who would scream at me in front of customers.  That was hard.  But the good parts (earning money for my class trip to France) outweighed the bad.  Life has hard parts, but you make it through them to enjoy the good parts.  But when you’re in a situation where you are dreading the hard parts of every day, when you just want to curl up in a ball under the comforter and never come out, when your job is making you clinically depressed, that’s a pretty good sign you’re not cut out for that job.  I’ve worked with fantastic doctors and nurses who ARE cut out for their jobs.  That’s not to say they don’t feel the difficulties, but for them, the rewards outweigh anything else.  That was just not the case for me, and the sooner I admitted it, the sooner I could move on to something that would make me happy.
Yes, I did some pretty cool things in my former career.  I even saved some lives, and I don't say that with any sense of bragging or arrogance - it could have been any trained ob/gyn or surgeon who saved those lives - I just happened to be the one on call when the patient came in.  But do I miss it?  Nope.  Someone else can save the lives, I don't need the glory.  I needed to save my own life. I needed relief.  And I am relieved that I made it out before I spent the next 30 years in misery.  How do I spell relief? Q-U-I-T-T-I-N-G.  Not as catchy as the Rolaids jingle, but it'll do.

When I think about my former career, from the vantage point now of six months out, I feel an overwhelming sense of relief.  Relief that I'm no longer working those hours, under those pressures.  Relief that I don't have to know everything anymore.  Relief that I have my life back.  Relief that I made the right decision.

There were amazing moments in my job and I will miss them.  (The fact that I don't miss them yet probably means I'm still healing from the PTSD...)  Delivering babies  - there’s nothing more beautiful than that.  But I give it up willingly to bring MY life into this world.

Medical Divorce

You know how once you hear about something, or begin thinking about something, you start seeing it everywhere?  Well, once I decided to quit my career and branch out into the unknown, I started meeting people right and left who had made career changes.  All of them were incredibly encouraging, and much happier with their lives post-change, even though the process of change itself was stressful and challenging. 

It came down to this:  I chose my own happiness and my relationship with my husband over my career.  Okay, it was not even nearly that simple, but it's a good place to start.  I had reached the point where I realized that if I wanted to stay a) sane, and b) married, I could not stay in this career.  And once I realized this, I started seeing it echoed everywhere I looked.  I met a luxury vacation planner who used to be an attorney.  I met a massage therapist who used to be a military engineer.  I met a yoga teacher who used to be a mortgage banker.  A friend of mine got married and moved to a different country to be with her husband, leaving behind her just-taking-off business.  These were the stories that, once upon a time, would have made me say, "are they crazy?"  But one and all, they are happier now.

Even magazines and books I pick up remind me I made the right decision.  Just last week, I was reading about the physician at OHSU that developed Gleevec, the miracle-drug that has saved the lives of thousands of CML (chronic myeloid leukemia) patients.  His first marriage was a casualty of his career.  He states, "I wasn't what you would call a devoted husband.  I was a devoted researcher and scientist and physician.  And that took a toll."  Obviously, the thousands of people who have avoided the death sentence of CML are grateful that he is such a dedicated scientist.  Clearly, we need people like him in the world.  But I don't feel the need to be one of them.

Sacrificing one's relationship on the altar of career just isn't for me.  When I went into medicine, I honestly never thought I was going to meet the right person and get married.  So why not throw myself into this career?  But it's not just about spending quality time with my husband.  What if I'd never met him?  What if I were still single - would I still have quit?  I'd like to think so.  The fact that this career was wrong for me on so many levels remains, regardless of whether I am married or single. It may have taken me longer to get to the point where I was ready to quit without that support at home, but I do believe I would eventually have "seen the light",  realized how unhappy I was, and made the decision to make a change.

I just finished reading Michael Crichton's first book, A Case of Need.  Originally published under a pseudonym, it revolves around illegal abortion (published in 1968), and is a decent noir-ish medical mystery, although it got more than a bit implausible at the end.  There were lots of interesting themes running through it - how doctors stick together, for one - the "old boy's club", as it were.  How a physician is vilified for making a human error, for another (the author doesn't seem to have insight into this one, but it caught my eye and grated).  But what really grabbed my attention were the throwaway comments he made about doctors' relationships.  He refers to the abbreviation M.D. as standing for Medical Divorce.  (see above re: wanting to stay married!)  He describes one doctor thus:  "He has a surgeon's view of right and wrong.  He sees only black and white, day and night.  No gray.  No twilight."  Black and white thinking - a topic I addressed on this blog only last week!

But the passage that really got my attention was this:  "Certainly he is bitter toward his profession.  Many doctors are, for various reasons ... I suppose in any profession you meet men who despise themselves and their colleagues.  But Art is an extreme example.  It is almost as if he went into medicine to spite himself, to make himself unhappy and angry and sad."  I could relate to this last sentence in a big way.  I've hinted on this blog about how I didn't feel I deserved happiness, and I am writing a lot about that in my book-in-progress.   But I don't think I'd seen it written down anywhere else.  That you can choose a profession in order to guarantee that you will not be happy.  Clearly not a conscious decision, but a decision nonetheless.  Once I woke up to it, I decided that I didn't want to stick around long enough to "despise myself and my colleagues".  I didn't want to look back thirty years from now and wish I'd made a change...

Now is the time for change!  Now is the time for happiness!  Okay, Universe, I get the message!  Now, if you can just start sending some how-to-be-fabulously-wealthy clues my way....

Gross(er) Anatomy

Back in the 80's, I loved the movie "Gross Anatomy".  Okay, okay, I still love it, although I haven't actually seen it in years... I had a big crush on Matthew Modine as the lazy but smart med student, and maybe on some subconscious level that movie fed into my eventual decision to go to medical school.  They had such fun, those first-year students, even when they were studying hard.  The study-all-the-time female lead, in the end, found time for romance with our hero.  And of course there was the professor with the mysterious disease (lupus, naturally) who saw something special in Matthew's character, Joe. 

What was not to love? 


My own gross anatomy course was not quite so humor-and-romance-filled, but we did have a good time.  It was our first class in med school, and took up the first several weeks of the first year.  We actually combined gross anatomy with pathology in an integrated "structure and function" course, but it was basically gross anatomy.

We were divided into groups, and my group of four got along well.  Besides myself, there was the large, black former football player, the tiny, white New York Catholic girl, and.... some guy I really can't remember at all.  Isn't that awful?  We were lucky in our cadaver.  He was a skinny guy, which made for easy dissection.  We didn't have to spend the extra hours clearing fat away from the structures we were meant to identify.  Some groups were not so lucky and spent those lab hours covered in grease as they tried to "melt" the fat. 

Everyone going before had told us the hands and face are the hardest parts, emotionally, to dissect.  These were kept wrapped until we were ready for them.  I agree that it felt odd to cut into them, but not as problematic as I'd thought they would be.  The face, for one thing, was so distorted by death and the tissues so hardened by embalming that it was hard to get a sense of what our guy had really looked like in life.  The hands were a bit more challenging, but mainly because I have a squeamishness about hand/finger pain to begin with.  For our group, the worst part was the arms.  The right arm in particular.  Because there, inked onto his cold, dead skin, was a big, racist Nazi tattoo.  We didn't see this until many weeks into class, when we unwrapped the relevant body part.  It was very hard to reconcile our gratitude for this man's unselfish act of donating his body to science and knowledge with this very visible proof that he was an ignorant bastard, or at least had been at some point in his life. 

What to do with this contradiction?  There wasn't really anything to be done.  Just proceed with our dissection, our education.  But now with an odd puzzlement.  We owed our intimate knowledge of the human body to someone who was quite possibly an abhorrent human being.  Yet he made this incredible donation, his very body, so that we could learn.  This tended to mess with our type-A, med-student predeliction to see the world in black and white. 

Many years later, I would again be challenging that black and white thinking, as I got ready to break free from my career.  I was learning to see shades of gray, and the more I got used to this new way of thinking, the more liberating it became.  I didn't have to use my medical education, or even my residency training, in one particular "approved" way.  I could help people in a different way.  All the shades of gray were possibilities, and I'm working on turning them into color!  I'll spare you the "Wizard of Oz" analogy... except, darn, already went there...

Maybe this racist little man, in his own way, planted the seed all those years ago that everything was not as straightforward as it seemed.  He showed me that people could surprise you, and I went on to surprise myself, and everyone around me.  And for that, I must be grateful, no matter what.

Wedding Flowers

This is my first time participating in Let's Blog Off!  The current topic is "Flowers". 

What a lovely topic.  I love flowers!  Who doesn't?  Okay, perhaps those with allergies might not be so fond.  But what could be wrong with beautiful, lovely, colorful, fragrant flowers?

I'll tell you what.  When the florist for your wedding messes them up.

My favorite flowers are daffodils and tulips.  Those gorgeous harbingers of spring, that peep their little shoots out from their bulbs just when you think that winter is never going to end and the rains are never going to let up!  I probably prefer daffodils just slightly more than tulips, but it's a pretty close contest.  Since red is my favorite color and, naturally, the wedding color, daffodils weren't really going to work as a decorative flower for the wedding.  No worries, tulips would save the day!  Gorgeous, red tulips.  Heaps of them.

I met with the florist that I had picked from the ones recommended by our wedding venue.  I had loved the online pictures of her work, and was excited to discuss my tulip mania!  I didn't want them everywhere, not even in my bouquet, but I did envision the centerpieces for all of the tables as bowls of rich, lush red tulips.  The tablecloths were to be black, and the glass vases were to sit on a mirrored panel, so I know that the lovely red would pop, and the beautiful flowers would be a show-stopper!  On the advice of the florist, we decided to incorporate a little bit of white hydrangea, to have some contrast between the red flowers.  I trusted her - flower arrangement is her job, after all.  I would have my bowls of red tulips with little bits of white in between to set them off to best advantage.

The day of the wedding came.  My bouquet was delivered - gorgeous!  I absolutely loved it!  I wasn't as crazy about how the bridesmaids' bouquets turned out, but I could live with that.  My flowers were stunning - just what I wanted!  See here:

Tons of red, lots of texture, with hints of white and green to break things up a little. 

Then I walked out to see the centerpieces...  What's this?  All I see are white blobs on the tables.  Where are the real centerpieces? 

Honey, those are the real centerpieces.  See your tulips?  I saw them, all right.  A few tiny little shrimpy red tulips, poking their feeble heads out of a sea of white hydrangeas.  Straggly and sparse, not at all the overflowing bouquets I had envisioned, and thought I had asked for.

To her credit, the florist was quick on her feet.  There was no way to get more tulips, but she could tone down the overwhelming white-ness of the blobby centerpieces by airbrushing them.  This pink was the closest we could get to red, but believe me, it looks way better than the way they started!

So, that is my flower story.  Is it a huge catastrophe?  No, just a disappointment.  I was a little embarassed that our wedding guests might think I had picked pink hydrangeas and straggly tulips on purpose, but really... who actually pays close attention to the flowers at a wedding.  The important thing is that I got to marry my beloved on that day, not that my centerpieces were masterworks of tulip gorgeousness.  But it would have been nice...  Maybe for our anniversary I'll buy some tulips - and arrange them myself!!!

Meditation for dummies

I'd like to introduce a little variety into this blog.  While I have heaps more to say on the topic of leaving medicine, I think I'd like to throw in some self-helpy, woo-woo topics here and there.

First self-helpy topic:  Meditation. 

Now don't run away scared.  I am by no means an expert in meditaiton, or even a good meditator.  I am, in fact, rather terrible at it!  And that has everything to do with my re-evaluation of my life path.  How can being a crappy meditator help me in finding my purpose, my inner self?  Read on...

For years, I avoided mediatation like the plague.  Just sitting quietly with no book in my hand?  What a waste of a reading opportunity!  Thank you, I'll pass.  Eventually, I did become interested in the possibility of quieting my mile-a-minute mind, and started to ask people about meditation.  Each and every one, including my beloved husband, was absolutely unhelpful.  One person told me to sit in front of a flower and "focus on the flower."  What the heck does that even mean?  Another told me to focus on the emptyness between thoughts.  Huh?

I would start to read about meditation, and give up.  I was convinced I'd never be able to do it.  Convinced that my mind was too jumpy, too full of thoughts, to ever find a still place within.   What I didn't get yet was that I was not unique.  EVERYONE's mind jumps around, particularly when we try to quiet our thoughts. 

The very act of sitting quietly makes the mind act up - hey, pay attention to me!  It's not a failure, it's normal! 

I took a class from a local spiritual center, and for the first time, had someone explain to me a technique that I could understand.  There are tons of different meditation techniques out there so I won't go on and on about the details, but suffice it to say that I finally felt that I understood (sort of) what everyone had been trying to explain to me for so many years.  I could actually meditate - in class, anyway.  Sort of.  Once I came home and tried to sit quietly, however, all of my grocery lists, things to-do, places to go, what was on television last night, what time I have to get up in the morning, who got kicked off Dancing with the Stars.... all of that kicked in and there was no inner light or peace to be found.

Every time I tried, I would be distracted by runaway thoughts after about 1.5 seconds.  Or I would fall asleep. Or both. I was advised to gently acknowledge that I was having a thought, let it float away on a river, and bring my mind back to focus, to stillness.  The only problem was that I wouldn't realize I had wandered until I had been wandering for at least 10 minutes, or until I woke up in the morning (perhaps meditating lying down was a mistake...) 

The challenge for me was in adjusting my approach. I felt that this constant mind-wandering, this inability to shut down my thoughts, constituted a failure.  I was no good at meditation and I never would be.  Finally, someone pointed out to me the connection between this attitude and my type-A, goal-oriented approach to life.  That approach is necessary to make it through medical school and residency and a career as a physician, when there's always one more hoop to jump through, one more exam to pass.  That approach is the absolute opposite of what is needed for meditation, or any work on your inner self.  For the first time in my life, I had met something that could not be "achieved" or "accomplished."  I was looking at meditation as something to "do," and that when I got "good at it," it would be effortless.  I would have conquered it.  I had to adjust my worldview here, and learn to value the experience, not the goal. 

No prize to be won?  No exam to pass?  What kind of malarkey is this?  Very important malarkey, as it turns out.  I am still trying.  Sometimes I try to meditate every day, sometimes days or weeks go by between attempts.  It still feels foreign to me to just experience whatever comes up whenever I try.  There is no accomplishment here.  I don't suddenly "achieve" inner peace, or self-esteem, or any of those things I've been "working on."  The journey is the important thing.  A cliche perhaps, but cliches exist for a reason.  As long as I was focusing on the destination, I was defining myself as a failure.  I am trying to re-learn my approach to life, to approach it as a journey and to be mindful of the experiences along the way.  So even if my mind wanders after 1.5 seconds, that is part of the experience.  I can acknowledge that and try to just be...

We'll see how it goes!  As a mentor of mine has said, "don't worry, your old way of thinking will take you back if you change your mind."  That can be a topic for another time:  the scary unknown versus the unhappy known...  For now, I leave you with this lovely image...  Just be...

photo credits:  Chris Quinn

Quitter (and I Know It!)

Hello friends!

Well, last week I took the plunge and made my blog "public", by sharing it on facebook. I was extremely nervous and anxious about this. I had shared my posts with a few friends, but I lack the self-promotion gene that makes one want to publicize one's writings far and wide... I will have to get over this if I want to build any kind of platform for the book I'm writing, and the website I'm contemplating! I finally took a deep breath, said, "screw it, I'm going public!" and here we are!

I was truly overwhelmed by the amount of love and support I felt as people read my words and responded to them. Within 24 hours, I had messages from two people I didn't even know, which meant that people were sharing my posts! My husband commented that I was "touching strangers" until I pointed out how inappropriate that sounded.

It's not just shyness that inhibited me from sharing these posts, and my story, earlier. There is an ingrained thinking in the medical profession (shared by many professions, I am sure, but I think it may be particularly strong in medicine) that one simply doesn't quit. And that's exactly what I did. I walked away. I am a quitter, and I have embraced that as a good thing.

It wasn't always so.

I was taught from early childhood that if you commit to something, you follow through on that commitment. This extended to everything in my life. I was/am incapable of putting a book down half-read - even if I'm not enjoying it, I feel obligated to finish what I started. Besides, what if it gets better and I miss it? By the same token, I will fast-forward through a terrible movie rather than turn it off after the first five miserable minutes (one does not have this option in the theatre – I have yet to muster the courage to actually walk out of an abysmal movie or play). This sense of obligation was one thing, but I think my bigger fear was this: what if someone calls me a quitter? And what if they are right? What does that say about me?

And so I took this soldier-on-no-matter-what attitude and marched with it through my life. I took it through medical school, then residency as I grew more and more miserable. Still, it never occurred to me that I could leave. What if it got better and I missed it?

I was indoctrinated (get it?) that I was on the only path; the only option was to continue. And indeed, I questioned people who got off the path. I just couldn’t relate or understand when a couple of my classmates left medical school after only a few weeks. Now, I get it - they were honoring themselves, their truth. They were wise to not put themselves through something that wasn’t right for them, but I didn’t understand it. It was not my truth at that time. I judged, I'll admit it - you started something, how could you not follow through and finish it? I also heard stories of people that dropped out of residencies, or almost finished residencies, or did finish but never practiced medicine. Why? Why would you put yourself through this torture, but not follow through? I just couldn’t get my mind around that.

I was in denial. I rejected others' choices because I wasn't ready to really think about what those choices meant. I wasn't ready to examine the possibility that I, too, was unhappy. On a deeper level, I believed I deserved to be unhappy, but at the time I was not conscious of that thought process. As long as I was in denial about my unhappiness, I could remain unconscious. I could accept the hours and stress as part of the bargain. I could refuse to take a look inside myself to see what was actually there. I could bury my emotions so deep I wouldn’t even know they were there. Learning to identify those emotions, to feel them instead of numbing them has been a long and difficult challenge - worthy of a post (or a book!) all its own.

Once I knew I was unhappy and this was not just a passing phase of burnout, I spent a couple of years trying to figure out whether I could make a change within the same career – after all, I’d spent thousands of hours and dollars to get where I was. I wasn’t about to quit. What I finally realized, however, was that quitting was exactly what I needed to do. I rolled the word around in my head “QUITTER”, until the sharp edges were worn off, the stigma washed away, and I was left with the concept itself. Quitting was not good or bad, if I didn’t attach those words to it. It just was. Leaving something. Stopping. I realized that quitting was the best thing I could do for myself – in fact, it was necessary. I would never become the person I was meant to be, I would never be happy until I QUIT. Until I got off the treadmill, stepped off the merry-go-round to catch my breath, I could never see my way to the right direction. I wasn’t able to see anything else while I was plowing ahead on the path I’d set for myself. Once I quit, I was able to take a deep breath and look around me. I was able to see all the wonderful things by the side of the path, and miles off the path, that I’d been missing. I was able to find myself.

When I made the decision to leave my job, the only (out-loud) naysayers I encountered were in the medical field. I'm sure there were and are many silent judgers, but only other medical people seemed truly baffled by my abandonment of our shared career. Every one of the people in other areas of my life were very supportive of the decision. Indeed, they were amazed I managed to work those hours in the first place. They were perplexed as to why the people we expect to heal and help us are chronically overworked and sleep deprived. Thats not to say that people weren't surprised by my decision, but no-one called me crazy (to my face, anyway). My decision has been justified every other month in book club. These people who only see me six times per year invariably remark at each meeting that I look healthier and happier than they've ever seen me.

When I discussed jobs, careers, and vocations I stated that medicine is truly a calling. I believe this with all my heart. It just wasn’t my calling, and so I was miserable. Now I am looking around at this bright, beautiful world, and proudly declaring myself a Quitter.

Resting My Brain

I thought I would get over my need for brainless entertainment once I quit my mentally taxing job.  Not so much, it turns out.  I still love my celebrity gossip magazines (I do restrict my reading of these to the elliptical machine at the gym, so at least I’m benefiting my body if not my soul).  I still love my TV shows, and I love to watch them alone, without my husband, for a little me-time.  We do watch a few things together (travel shows, Buffy, even Downton Abbey!), but he really has no interest in some of my shows, and I have none in his.  He watches a lot of political analysis programs, which usually serve only to make me mad and indignant.  Also, he’s a big geek (and I mean that in the best possible, most loving way).  I’m just not interested in the Star Trek-this-and-that, or in the Ancient Aliens.  He shakes his head when I put on the E! channel.  To each his own.  In residency, I used to tell myself I needed to “rest my brain” with The Girls Next Door when I got home from cogitating all day.  Now, with that excuse defunct, I will just have to admit that I love me some brainless entertainment.   Judge away!

Why Doctors Suck

Full disclosure:  I am a doctor.  Having said that, sometimes doctors suck.

I have always been reluctant to identify with the title "Doctor." Perhaps that has a lot to do with the fact that somewhere, deep down, I knew I was on the wrong path and this was not my calling. It could also be low self-esteem, but that's a can of worms for another time... I think it also has a lot to do with the fact that, frankly, sometimes doctors suck. Not for nothing do you hear nurses complaining about doctors, patients complaining about doctors, pretty much anyone who ever interacts with doctors complaining about them. Why all the vitriol? 

Why Do Doctors Suck? For one, we’re rude. Arrogant. Perpetually running behind schedule. We interrupt.  e are perpetually multi-tasking and therefore don’t do any one thing to its best potential.  

We are entitled slobs. That's enough to start with...

Doctors are rude. We interrupt other people because what we have to say is so much more important – we went to medical school, didn't we? We have a quarter-million dollar education to impart, so listen up! Or perhaps it's because our time is at such a premium we have to get it out while we can, before moving on to the other ten thousand things demanding our attention. When you only have fifteen minutes with a patient and they are in danger of spending twenty minutes expounding on their family history of the vapours, you need to intervene a little!  It is important to keep the visit focused; however, trying to be efficient can have the side effect of being rude. I have always had an unfortunate tendency to interrupt, and becoming a physician did not improve this personality defect.

We yell at and talk down to lab techs, support staff, anyone "under" us. I personally strove to never do this, but I will admit to the occasional eye-roll over the phone as someone "clueless" attempted to answer my question or address my complaint. When one is being pulled in twenty directions at once, it can make one a little abrupt.  Sometimes even a little pissy. We're human beings, even if some doctors do succumb to Over-Inflated Ego Syndrome and identify with deities.

 I could tell stories of expletive-laced tirades, of people throwing sharp objects across the operating room, of plain old unprofessional, bad behaviour. What gives us the right to act like spoiled children? Historically, little has been done to address these problems, as doctors held all the power. Thankfully, this paradigm is changing, but change is slow in coming and it's hard to undo personality traits that have run rampant for thirty or forty years, in some cases, without check.

Doctors answer their cell phones in the middle of meetings, lectures, movies. I have never done this, I’d like to point out. My low self esteem at least had the benefit of counteracting the doctor-arrogance to which I might otherwise have succumbed. When possible, at lectures and conferences, I always took my pager/phone out of the room to answer if I was on call, and silenced it if I wasn’t. But I can’t tell you how many lectures I’ve been in, only to hear a phone ring, after we had been asked to silence such devices. Rude enough, I know, but then would come the loud “HELLO?”  And, more often than you would believe, an entire conversation would follow because the doctor in question couldn’t be bothered to leave the room so that others could focus on the presentation. (by the way, these were invariably men - coincidence?)

Why this rudeness? I think it becomes part of the training. You are so beaten down that you can’t remember to take other people into account. You are focused on surviving that hour, that night shift, that year of residency, that decade of training. At the same time, you are becoming highly educated, with things to say that people will want to listen to – indeed, will pay you to impart. This breeds an arrogance and contempt for other people’s time that I don’t know is entirely avoidable. Another reason for me to get out!

Speaking of contempt for time, doctors multi-task. Recent research on multi-tasking shows, no surprise, that when we try to do several things at once, we don’t do any one of them to the best of our ability. So your doctor who is trying to write a note on a patient, answer another patient’s question, respond to the nurse asking yet another question, and plan ahead for the surgery coming up - that doctor is not giving any of these tasks the attention it deserves. Blame it on the training. Multi-tasking is necessary when there are literally several things that need to be done NOW and only one person to do it. But it’s not a good thing. Yet another way our medical system is broken.

Offices running behind schedule....  another example of how doctor's time is perceived/treated as more valuable than the patient's. There's a lot to say here, but this is already getting very long... I'll just tell a little story.  
My mom was visiting me during residency, and I was giving her a tour of the hospital. I swiped my badge as we approached labor and delivery, and the large doors swung open automatically - I didn't even have to touch the door handle! I thought this was convenience and hygeine - my mother remarked, "ah, so this is where the sense of entitlement starts..." Good food for thought...

Finally, my personal pet peeve: Doctors are slobs. Walk into any physician or surgeon’s lounge at the hospital and there will be trash, half-eaten discarded food items, papers, and various detritus strewn about. Who do we expect to clean this up? Why the housecleaning staff, of course. It galls me every time I see it. Just because we have magical initials after our names, that does not entitle us to not clean up after ourselves.  Yes, I appreciate the housecleaning staff vacuuming the floors, dusting, wiping down tables, and generally making the office and lounge a nicer place to be. That’s their job. But that doesn’t mean I expect them to clean up my candy-wrappers or crumbs I’ve left behind, or trash I couldn't be bothered to throw away. Sorry, but it’s not okay. Clean Up After Yourself!!!!! End of rant. 

This all begs the question: Is it possible to become a doctor and retain some human decency? Of course it is.  But that's not as fun to write about.

Do you have other reasons that doctors suck?  Let me know and maybe I'll put them in my book!