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.