Jab Joy

 

                                                      Image credit: I couldn't find an attribution on Google - if it's yours, lemme know so I can credit you!

I was never so thrilled to get a vaccine in my life! Jab #1 against COVID, check!

I went from thinking it would probably be 2022 before I got a shot, to cautious optimism when my state's governor said we could all get our vaccines starting in June... Then my group was bumped up to May 1, and just last Friday I found out that, as the spouse of a frontline worker, my eligibility was moved up to April 5! And now our governor is saying everyone 16 and up will be eligible starting April 19!

It was sheer stupid luck, however, that got me an appointment this quickly (April 6 - one day after becoming eligible). The system (or lack thereof) is daunting. I know people that tried for two months before they could find an appointment. My husband had been trying for days - in vain - to find an open slot, once he know his eligibility was coming up. He just happened to stumble on an appointment and booked it, even though it was a 30-minute drive. We then found out that I would also be eligible on the 5th, and lightening struck twice! He was able to find a time slot for me - a 45-minute drive, but whatever. I'll take it! I was trying for a couple days with zero success. I have no idea what kind of sacrificial rituals he was performing in his office to get us these appointments so quickly!

So far (5 hours in), my arm is starting to get a teensy bit sore. I know that it's the second jab that often causes some pretty crummy (short-lived) symptoms, but it will be worth it.

I love that I might actually get to see my parents this summer! I love that I am doing my part to protect my community! I love public health!

And I'm totally looking forward to the improved cell reception.

Another goodbye

It was with heavy hearts - hearts that have another cat-shaped hole in them - that we said goodbye to Max today.

He has been my buddy since 2003 and my husband's buddy since 2007. Actually, he was originally Gracie's buddy. Gracie was an only cat. A very needy only cat who did not do well with the hours I was working during residency. So I got Max for her. Once she accepted him, they were inseparable. Max wasn't sure what to do when Gracie passed on 5 years ago. He really wasn't sure what to do when we introduced new kittens into the house, but he eventually figured that out and mostly got along with them.

He has always been a high-maintenance cat, with some sort of health issue pretty much constantly since kittenhood. But he was such a sweet, low-key guy that one forgave him the maintenance required to be his buddy.

When he was a kitten, I called him my little monkey because he had these looooong legs and a loooooong tail and a looooong skinny body. He let me carry him around, cradled in my arms like a baby. He let me carry him that way right up to the end. He was also a fan of being carried around in a stretched-out position against his human's torso, looking out over his carrier's shoulder, with his front legs splayed out in a slightly undignified fashion. But who cares about dignity when someone is carrying you around and letting you check out the world? My husband took him on walks around the neighborhood like that, every day during his last week. He got to listen to the birds and sniff the flowers.

He's been blind the last several years, but he still seemed to somehow find his way to the top of the cat tree when he felt like it. For someone who couldn't see, he certainly got around. My little monkey.

He always wanted to be near us. When I started working from home, I gained an office buddy who would follow me downstairs when it was time for lunch and back upstairs when it was time to start work again. I've missed that companionship these last couple months as his health deteriorated.

Goodbye, sweet boy. Say hi to Gracie for us when you see her. We'll miss you.

Yoga Fight Club

I thought a fist fight was going to break out in my yoga class yesterday. Allow me to set the scene:

Class is just getting started, and we are all sitting in the darkened room. There is still a bit of chatter, as not everyone has quieted down yet. I hear, from the other side of the room, someone say in a bit of a loud voice:

Yoga Lady 1: "Please turn off your phone."

Class continues to quiet down. Now it's pretty quiet. The teacher is giving us some instructions.

Yoga Lady 1: "Please turn off your phone. The light bothers me."

No response that I can hear.

I peek over and see Yoga Lady 2, sitting on her mat, with her phone just to the side of it. It's a larger-sized iPhone, facing up, and the screen is lit up. It is fairly bright in the darkened room. Bright enough that I can see it from across the room.  I think, yeah, that would probably be distracting if I were sitting closer to her.

Yoga Lady 1: (quite loud now): "Please turn off your phone!"

No response that I can hear.

Yoga Lady 1: (almost shouting now): "PLEASE TURN OFF YOUR PHONE!"

Yoga Lady 1 repeats this a couple more times over the next 5 minutes or so. Now, while her words are, on the surface, polite, her tone of voice (and increasing volume) is not polite at all. She sounds very angry and hostile, even from the first request. Meanwhile, the yoga teacher (who I suspect, like me, does not like confrontation), giggles a bit nervously and otherwise tries to ignore the drama.

Yoga Lady 1: I HAVE ASKED NICELY SEVERAL TIMES. PLEASE TURN OFF YOUR PHONE! (note: she does not sound nice at all)

Finally, a response from Yoga Lady 2: "It will turn off on its own. Take a chill pill."
(yeah, that's the right way to defuse the situation)

I peek over again. Yep. Phone still lit up. Our teacher goes over and has a quiet word with YL1 and YL2. I don't hear what (if anything) she says about the phone, but I do hear her say, "... or take this outside," and I do hear her point out that there are other spaces available if YL1 wants to move her mat.

A couple more minutes go by. Then Yoga Lady 1 stands up, picks up her mat, and moves to a different spot in the room. But before she quits her original spot, she leans over Yoga Lady 2 and shouts, "RUDE! RUDE! RUDE!"

For a minute there, I thought we had a fight on our hands. But class proceeded apace. And I think YL2's phone did eventually go dark.


Am I the only one who thinks it's hilarious (and ironic) (and ironically hilarious) when people get aggressive, passive-aggressive, or otherwise confrontational in yoga? Isn't this the place where we go to learn how to let things slide off our backs? How to focus despite the constant chatter from inside our own heads and distractions from outside our own heads?

I have written about Aggressive Yoga Ladies before (Cutthroat Yoga). I fully admit that I can sometimes be one of them. I do like "my spot," but I would never yell at anyone over it!  I have actually heard women shouting at each-other about someone "stealing" a spot—that was another potential fist-fight in the making!

I have been guilty of mentally shaming people who answer their phones in class. I get a little judgy when the phone rings, but I calm myself down and chalk it up to the person forgetting to silence their ringer. But when someone ANSWERS their phone without stepping out of the room, I feel I have the right to get a little peeved. I had enough of that with entitled doctors at medical conferences.

Okay, I've gotten a little off-topic. This transgression was a mild one. Leaving one's phone lit up is inconsiderate, sure, but hardly the same as answering the phone and carrying on a conversation. And yes, it was also inconsiderate to refuse to turn off the phone. But Yoga Lady 1 was hardly a model of kindness and compassion, either.

I guess the moral of the story is this: be kind to one another. This includes being kind to ourselves. And if you can swing it, disconnect from your devices for an hour here or there. It will drastically lessen your chances of getting into a fist-fight.

Conserving Energy (in which we discuss clicky balls)

image credit: thebitcoinnews.com

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

image credit: picserver.org

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.