Conserving Energy (in which we discuss clicky balls)

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Energy, conservation of. I remember learning something about that in Physics class. In this case, I'm talking about emotional and spiritual energy, but that law of Physics still applies. Those clicky metal balls that captivated me as a kid (the ones where they're all in a row, and only the outside one swings away when the ball on the other side of the row swings back to its place) are kind of a metaphor for this concept of a finite amount of mental energy. Unless those balls are for conservation of motion.... it's been a long time since Physics class.

Anyway, I just got back from a great conference. The American Medical Writers' Association had its annual educational and networking extravaganza - this year, in Denver, Colorado. I got to put faces to the names of a couple virtual coworkers, and I got to catch up with a writer who has been a mentor to me as I changed careers and embarked on the medical-writing-and-editing journey.

I am an introvert. So I don't know if that means I have less energy than an extrovert, but I do know that it means that conferences are draining. Constant interaction and the dreaded "networking" are exhausting for introverts, no matter how much we may enjoy each individual interaction. So if this energy is "conserved," where does it go? I guess it goes outward, into the reminders to smile, make eye contact, and participate in conversations.  It must be stored somewhere in the closed system of the conference hotel, because it comes flowing back in when we can escape upstairs to our room on breaks or at the end of the day and just.... be.... alone.

I was talking with a friend who has recently been through a divorce. We talked about how so much emotional and spiritual energy is wrapped up in just getting through each day when one is going through a huge life transition. It leaves very little left over for, say, getting the job-work done so one can pay the bills! The energy is not "depleted," per se, so much as it is "redirected." Which ends up feeling a whole lot like depletion... I experienced this when I was getting ready to change careers. I was so emotionally exhausted by the demands of my job and the constant worries and the growing knowledge that I was on the wrong path, that I had very little energy left to put into the things that really mattered - my relationship with my husband and my own mental health and physical well-being. Luckily, I woke up to this in time to make a change and to prioritize the really important things. But the energy drain (redirection?) still happens. If I am worried about work (i.e., not enough freelance projects going; oh no, I have to go to a conference and talk to people), then I have less energy for my personal relationships. I guess that's the way these things go. And hopefully, one recycles one's energy in time to reinvest in the personal.

Energy cannot be created or destroyed. It just changes form. So I guess the clicky balls were the wrong example, after all. Perhaps a phoenix rising from the ashes? That's nice and inspirational (if one ignores the hell that burning up must be...). Perhaps the chrysalis is a better example. Cheesy, yes. Overused, yes. But cliches are cliches for a reason. So chrysalis it is.

Remember to conserve your energy when needed, whether you are an introvert or simply needing a little extra energy to get through life at the moment. Your inner butterfly will thank you.

Medicine-Adjacent Sexism (the Doogie Conundrum)

There are so many things to say about sexism in medicine.... I could write for days and days and not cover them all. So I've chosen to focus not on the sexism experienced DIRECTLY in medicine (pay discrepancies, attitudes, old-boys-club mentalities, etc) but rather on the sexism that exists AROUND the field... in other words, the public's perception of medicine and its practitioners.

I had forgotten how early the sexism starts in the medical education process until my cousin's daughter, in her first year of medical school, commented on something that used to drive me NUTS when I was in her place. Whenever she tells someone (who doesn't know her, obviously) that she is studying "medicine," they say, "oh, you're going to be a nurse?" That used to drive me bonkers! If you're studying nursing, you say you're studying nursing. Now, I know one could argue that those outside the field wouldn't necessarily know the correct lingo... True, but no-one would think of asking that same question of a man who said they were "studying medicine." Both medicine (i.e., "doctoring") and nursing are valid, respected professions, but they are not the same thing, and the assumption that, because of one's gender, one's choice of career is restricted to one or the other is what grates. 

This only got worse (or maybe just more annoying) as the training went on. In residency (in possession of an MD degree), I would walk into a room, dressed in surgical scrubs identical to those of the male surgeons, and the patient who happened to be on the phone would say, "I have to go, the nurse is here." I would walk down the hospital hallways, dressed in those same scrubs, often with a white coat, and patients would call out, "Nurse!" from their rooms. And this didn't just happen to me; all the female residents told the same stories. (for another take on this, see the last paragraph)

Now, I must clarify here that it by no means an insult to be mistaken for a nurse, those hard-working individuals that power the hospital machine. I am only complaining about the assumption that, as a woman, I could not possibly be a physician.

I complained about this until one of our black residents (male), said, "yeah, they think I'm the orderly." That shut me up for a while.  However, racism in medicine is another whole can of worms that I shall not open today (although I have asked a friend to guest-blog on the topic, so stay tuned!).

Back to residency ... I would go to the grocery store on the way home, still dressed in those scrubs because who has the energy to change after a 36-hour shift, and the cashier, usually a woman, would ask at what hospital I was a nurse. I would say (I'm sure in a testy, sleep-deprived tone of voice), "Actually, I'm a doctor." Then they would get all flustered and murmur something about me "looking so young." Yeah, right. If Doogie Howser walked in there wearing his scrubs, they would not have asked his 12-year-old self if he was a nurse. I doubt they would have asked him if he was a candy striper, either, something much more appropriate for his age than a physician. (fun fact: autocorrect wants me to type "candy stripper" - which is more sexist?)

image credit: hellogiggles.com

Now I'd been largely sheltered from overt sexism in my pre-med-school life, so I didn't really think of it as a huge issue that needed solving. I didn't really see it, even when it was subtly happening to me. Until it began to affect me directly, in undeniable ways. Once I started to bump up against that glass ceiling, it was suddenly obvious. Now, of course, I see it everywhere. Once our eyes are opened, we can't unsee. I'll stop here, because I know the new convert is the worst kind of prosyletizer, and I've harped on enough... 

Just a final thought: a friend of mine, in nursing, pointed out that patients have people wandering in and out of their room all day long, and that patients just want to be cared for, so they ask for that care from whomever happens to wander by. Good and fair points, spoken with a clarity and perspective I did not have at the time. But patients, as human beings, still make gender and race assumptions about the people walking into their room. Until those assumptions are questioned, people like my cousin's daughter are continuing to fight an uphill battle that should have been over long ago.

Ode on a Northwest City

Ah, Portland. How do I love thee? In countless ways. In fact, with apologies to Guns N' Roses, I have had the following stuck in my head the past few days:

"Take me down to the Stumptown City where the weather is weird and the girls are witty...."

This was prompted by our (most) recent spate of weird weather, with the high spanning 40 degrees in the course of a few days - taking us from baking sun to spitting rain.

Witty girls, naturally, abound in this climate. Powell's is our gathering place of choice.

image credit: yelp.com

But as much as I love my adopted hometown, there are a few things about Portland (and Oregon in general) that drive me nuts. Most of them seem to have to do with cars, driving, and parking. 

First, why does no-one know how to drive in the rain? It rains a lot here! And yet, without fail, the first drops of precipitation bring traffic to a screeching halt as everyone freaks out. And I refuse to blame the California transplants, as Oregonians love to do, because I am such a transplant (granted, from the honorary-Oregon northwest of the state) and I have a lot of experience with driving in the rain, thank you very much.

Second, why do people LOVE to drive in the rain/fog/mist with no headlights? Invariably, in grey/silver/beige cars that blend in with the atmospheric conditions? Are we a state full of ninjas that thrive on invisibility? People love to drive dark here...

Third, why does no-one curb their wheels when they park on inclines? When I even voice this phrase out loud, I get puzzled looks. It's on the driving test in California, yet no-one in Oregon seems to have heard of it. Someone I may happen to live with (but who shall remain nameless) had his car plow into the neighbor's car one night when he forgot to set his emergency brake. Wheel curbing would have prevented that... just sayin' ...

Fourth, why do people love to hate on California immigrants? I suspect that many of the clueless drivers (or clueless whatever-elsers) I encounter are, in fact, Oregonians. Californians are not the devil incarnate, despite what you might think from some comment boards on Oregonian topics (driving, housing, etc). My husband, a native Oregonian, likes to blame Washington drivers for a good chunk of the cluelessness that abounds on the roads here, although he readily admits the contributions of the natives. I suspect this is the universal tendency to want to draw a line between "us" and "them" (with "them" being, obviously, 100% in the wrong) (and yes, I realize most of my post is drawing us-them lines...)

And, oooh, I almost forgot my favorite one! Now, to be fair, this tends to be a general US phenomenon, but it still seems to be particularly prevalent in Oregon. People loooooove to hang out in the left lane on the freeway, rather than using it for its intended purpose (i.e., passing, then getting back over to the right). 

And now, a few defences:

People like to carp on Portlanders for not knowing how to drive in the snow, but I've gotta give people a pass, here. We only get a few days a year of snow that really amounts to anything, and half the time it's ice, not snow, that is the predominant problem. The city does not maintain enough plows or gravel/salt trucks to keep the streets clear, as it rarely snows enough to need them, so driving in the snow becomes a harrowing experience. I lived several years in Pennsylvania, where I could even ride my bike in the snow, the streets were so well maintained. This is not that situation.

When I first moved here, I thought that traffic was sooooooooooooo slooooooooowwwwwwww.....  Granted, I moved here from Phoenix, AZ, where people drive like bats out of hell... But now I'm used to it. It doesn't seem slow anymore, particularly given the preponderance of traffic cameras and hidden police vans. I got my one and only speeding ticket the first year I lived here, for driving 45 on a huge, wide-open 4-lane road, where the speed limit is actually 35 and where (I now know) the traffic van loves to hang out. Live and learn. I've gotten crap, ever since high school, for being a granny driver. Well, now it's paying off! 

I do love my adopted hometown, and my adopted state. I could go on and on about all the fabulous things here. But it's more fun (and more human) to do a little complaining. It's good-natured complaining, I hope (at least, it was meant to be). Now, please excuse me while I sip my amazing coffee and contemplate a trip through the aisles of the most wonderful bookstore in the world, while planning a hike either on the beach or in the stunning Columbia River gorge. Isn't that how all of us Oregonians spend our days?

Culture Withdrawal

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When I was first cutting back my hours to see if I could continue in medicine with a little more breathing room in my schedule (turns out, no), I got a bit of pushback about the "culture" of medicine in general, and ob/gyn in particular. And I get it. Doctors need to be there for their patients, and they should be there. But what happens when your doctor is out of town or unavailable? You either wait (if the situation allows) or you see someone else who doesn't know you or your history. That has obvious disadvantages for patient care, but I would argue that the disadvantages of sleep-deprived and/or burned out physicians can be just as significant. Is this "culture" a one-way street? Or a dead end?

When physicians go out into the world to practice, they have been taught that patients take priority over everything else, and of course this is true. But the problem with that way of life is that one's own life and family and pursuits are always going to come in second, at best. Patients are more important than your kid's piano recital. Than your wife's birthday. Than that one hour of sleep that you were hoping to get tonight. That is the necessary sacrifice in medicine, and thank heavens some people are willing to make it. Otherwise, who would deliver your baby at 3 in the morning or take out your appendix on the weekend? But not everyone is willing to make that sacrifice. And it's hard to know, when you're enrolling in medical school all bright-eyed and idealistic, exactly what that sacrifice is going to feel like when you are called on to make it. Oh sure, people try to warn you. But if you're like most medical students, you don't listen. Or you think it couldn't be that bad. Or you think that the person warning you is just jaded (which they are, but for good reason).

The topic of change seems to keep cropping up wherever I go - I see it in movies and read about it magazines. For example, I read a People magazine article featuring singer Tim McGraw; he said, "it got to a point in my life where the outcomes weren't the ones I wanted. I felt like changing was the only choice I had.." Now he was talking about quitting drinking, which isn't quite the same thing as walking away from one's career, but come to think of it, maybe there are some parallels after all. When I left medicine, I went through withdrawal. I continued to hear a "phantom pager" for about a year. Auditory hallucinations, check! I felt traumatized by the culture and lifestyle I had been a part of for over a decade. DTs? I had to re-establish relationships that had suffered from the hours I'd been working and the stress I'd been under. Is that one of the 12 steps?

It turns out that, like a lot of drinkers, I couldn't just "cut back" on medical practice. I had to quit cold turkey. And, like a lot of former drinkers, I tend to proselytize when asked about my conversion to a more normal lifestyle. I am filled with love and admiration for my former colleagues who can "hold their medicine," but I was just not one of them. Withdrawal was tough (see The Unhappy Known, among other posts), but now, 12 steps or so later, I am out the other side and life is grand.

Freelancing Freedom

Okay, it has been WAAAAYYYY too long since I've posted anything here.

You see, I kind of exhausted the topic on which I originally based this blog (transitioning out of the practice of medicine), and for a while, I was a bit stuck on where to go. That, plus I had a commitment to a contract project that took up most of my working hours (one has a mortgage to pay, after all, not to mention med school loans!).

That contract project ended today, on about 2 hours' notice. Five of us freelancers were let go... My contract said they had to give me 10 days' notice, but whatever....  So I find myself a bit at loose ends. Why not write something? Should I write about being treated poorly after 3 years of dedicated service? Nah, why encourage any negative karma...

Instead, I will write about freedom. Freedom is not always all it's cracked up to be (see above re: financial obligations), but a little break from the daily grind here and there can be incredibly beneficial and refreshing. Planned, scheduled vacations are certainly a less stressful form of freedom, although doesn't it always seem that you have to do so much work to get ready for vacation, and then so much work to catch up from vacation???  The freedom I am experiencing, beginning today, is naturally a bit more disconcerting, but at least I didn't have to stress about preparing for it!

Now I have a (little bit) of leeway to explore my next steps, and perhaps shift directions a bit. I have the freedom to re-establish some priorities, like finding time to write. I have the freedom to see a mid-day movie! Except I might not enjoy that movie as I will be fretting that I should be exploring employment opportunities. I have the freedom to finally finish putting my (planned) vacation photos in an album! Now, I am not completely unemployed - I do have a couple editing gigs on the side -  but I am most certainly UNDERemployed at the moment. I will use this time to seek out another long-term project, and maybe I will even find a way to enjoy the (hopefully short-lived) freedom.

Yes, the downside of life as a FREElancer is the occasional unplanned FREEdom from employment and from a reliable income source. But I am confident something good is out there. Time to start working the network!

As George Michael said, in Freedom '90, "Think I'm gonna get me some happy." Wish me luck!

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