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.

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!

image: songfacts.com

The Fountain of Youth?

So something interesting and flattering and humbling happened to me in yoga class today.... or technically, right before yoga class.

One of the ladies who previously I had labelled  a pushy yoga lady (see Cutthroat Yoga) was standing next to me as we removed our shoes to get ready for class. We pretty much interact on a friendly smile-when-we-catch-each-other's-eye basis, but that's it. I didn't even know her name until today, even though we've been in the same class for years. Anyway, she approached me and said that she's been noticing me in class for a long time, and I seem to look younger to her all the time - how do I do it? I was flabbergasted!

First of all, I've been feeling my age recently. Injuries that don't heal anywhere near as quickly as they used to (hello, torn meniscus from 3 months ago and touchy hip muscle that I pulled years ago). I used to love my youthful freckles, but they have faded with the years and been replaced with lentigo, otherwise known as age spots (I get rid of them with chemical peels, but I feel like they're always lurking, waiting to come back). I stopped pulling out my white hairs a few years ago and promptly grew a white stripe down the right side of my hairstyle... unfortunately, the white hair is no longer confining itself to the stripe but seems to be spreading, fighting for dominion of my scalp with my intrepid colorist.

Second of all, how flattering! Aging in reverse? I'll take it!

Third of all, I felt bad for judging her as a pushy yoga lady all these years. She was so sweet! Although, to be fair, perhaps I am a pushy yoga lady, too. Or at least an uptight yoga lady (I am rather enamored of "my" spot and get POd if someone takes it). And I like to think I can still be sweet.

So I tried to think of an answer... the first thing that popped out of my mouth was, "sunscreen." And that probably has a lot to do with it. But here, in no particular order, are the things that may be helping me reverse-age.

1. Sunscreen. Luckily, I've been wearing it religiously since adolescence. I have no choice in the matter - I am the ultimate pale white girl who burned a million times in her youth.

2. No kids. Ergo, much lower day-to-day stress level than many of my peers.

3. Good genes. My mom, despite going white prematurely, still looks far younger than her years.

4. Yoga. I'm convinced it is a fountain of youth.

5. The yoga lady needs glasses. Entirely within the realm of possibility.

6. The real answer: my career change 4 years ago. How can I look younger now than I did 4 years ago? Simple. Four years ago, I was stressed, sleep-deprived, and miserable. Changing careers was not easy, but I now sleep in my own bed every night, I have time to go to yoga on a regular basis (see #4), and I no longer lie awake wondering who is going to sue me and when. I think that I am WAY more relaxed than I was 4 years ago, and I'm sure the other human that shares my household would agree. The felines would probably agree, too, plus I work from home so I get to indulge in cat-petting therapy as needed. That surely can't hurt.

So the secret to aging in reverse? Enjoy your life. Be happy in your choice of work. Stop doing the things that make you miserable. And wear sunscreen.

photo credit: bringfido.com

Sweet (or sour?) Solutide

When did I become pathetic?

I used to be such a great single person. I figured, if I was stuck being single for the vast majority of my life, I might as well have a good time. I didn't have my first serious relationship until I was 24, and I didn't meet my now-husband until I was 34. I had no problem going to the movies by myself, eating by myself, living by myself -- in fact, I LOVED living by myself. I went to dance classes by myself, coffee shops by myself (with a good book, naturally), and traveled all over Europe by myself.

I was such a good single person, that it was quite difficult to adapt to relationships. I was used to doing things my way, on my terms, on my time. Particularly when I had huge demands on my time during medical school and residency, the way in which I spent my limited time off took on huge importance. Coincidentally (or not), this time spent in higher-higher education coincided with that 10-year period from first boyfriend to husband.

Yes, then I met my husband. And then we moved in together. And then we got married. And somewhere along the way, I kind of got used to the guy.

The first time he went away on a 10-day business trip, I had a hard time falling asleep without him there. What? When did I become THAT pathetic person? What happened to my independence? To my great-single-person-ness? On the other hand, once I did fall asleep, there was no-one snoring or lighting up their godawful-bright iPad screen beside me (screens have since been banned from the bedroom, but there's not much I can do about the snoring). But still, it was hard falling asleep without that familiar presence next to me.

I have since gotten over that. I fall asleep (and have great quality of sleep!) just fine when he goes on these yearly trips, yet I am still excited for him to return. Huh. I must actually have learned how to adapt to another person in my life.

That great single person is still in there... I do love watching Masterpiece without snarky comments coming from the peanut gallery....  and I do enjoy a few days to myself, without having to accommodate anyone else's schedule. But a few days are enough. I'm ready for my partner back. If only to help me with the cat's medicine...  Just kidding about that last part. Mostly. Cats are hard to wrangle by oneself, you know.

But seriously. Welcome home, sweetie! I missed you! And now that I've learned to live with you, it's hard to live without you.

Goodnight, Gracie

A little over 3 months ago, we had to say goodbye to our Gracie. I don't think anything ever really prepares you for how devastating it is to lose a beloved pet... even a really annoying beloved pet...

I've always had a cat in my life, whether it was the cats I grew up with (cheers, Punky and Merry) or the cat at my parents' house when I was in college/traveling the world and couldn't have a cat of my own (miss you, Roxy). But Gracie was the first cat who was truly mine. Living with me in my own apartment. My responsibility. My vet bills. Moving with me cross-country (twice!) and then up to our final destination, my own condo in the beautiful Pacific Northwest. She even gave the stamp of approval to my now-husband when he first came around.

She picked me, really. I had just moved back to my college town after a year living abroad. All my stuff was still in boxes in my new apartment, and I went for a grocery-store run. The pet-supply store next to the grocery store had the ASPCA animals out for adoption. Surely it wouldn't hurt anything to just look... I certainly wasn't ready to adopt... but there she was. A fiesty, tiny kitten with grey fur and a spark in her eye. She came home with me that day and proceeded to rule the roost from then on.

I got a second cat during residency, as Gracie was an extremely people-oriented, needy cat, and I felt guilty that I was NEVER home. So Max joined us.

Now Gracie was never what you'd call a lightweight... She started off as a normal-sized kitten, grew into a normal-sized cat, then proceeded to explode, due to her resemblance to a food vacuum. When she moved with me to PA, she weighed 16 pounds. So we went on a slimming regimen, and she stabilized around 13 pounds - pretty normal for a cat. She stayed there for years, until the summer we moved to the NW, seven years ago. Then, she started vomiting more frequently (she'd been a bit of a pukey cat for a few years before that) and dropping weight. Our wonderful vet (who was with us from then till the end) couldn't find anything wrong at first, so we messed with her food, and got her to stabilize around 9 pounds for a while... but her blood work eventually showed changes, and her intestines began to thicken. It became a struggle to keep her above 8 pounds... The most likely culprit seemed to be lymphoma. We weren't going to put her through an endoscopy and biopsy to confirm that, and we weren't going to go nuts with treatment, but we were able to give her seven years of pretty great quality of life. She was on a low-dose steroid for those last few years, which stopped the vomiting and, at first, helped to stabilize her weight. By the end, even the steroid couldn't keep weight on her.

We had her annual check-up when she was about 16-and-a-half. She was doing great, although her blood work continued to worsen. Then, all of a sudden, she wasn't great anymore. It's like someone flipped a switch and her disease went into overdrive. She gave us one last week, with my husband and I giving her fluids and cuddling with her every night before bed (she would never tolerate that before - but I guess she got too tired to be ornery anymore). Then it was time. We said goodnight to our Gracie with the help of our vet, and laid her to rest.

I'd been working from home for over two years at the time of her death. The advantage to this is that I got to spend so much time with her at the end of her life, particularly that last "weekus horribilis." The disadvantage is that now there was nothing to distract me from her absence. Nobody was curled up at my feet or on the love seat behind me. Nobody was alternately grooming, cuddling with, or hissing at their buddy. In fact, for weeks, our other cat was hesitant to set foot anywhere Gracie used to hang out... so it was a very lonely office for a while. Also, nobody was biting my computer cords anymore... Sure, we'll save money on iPhone chargers and coaxial cables, but it's a sad trade-off.

This cat really represented my adult life; she came along just as I was setting it up. She was with me through working life, med school, residency, and as I settled down into my forever-home. She was with me through my career change. She was my companion for many, many long single years, and when my husband came around, she promptly adopted him and proceeded to prefer his company to mine!

She had one of the loudest meows you'll ever hear, particularly when you might be trying to sleep at 3 in the morning (3am was her favorite time to begin her campaign for breakfast) or when you might be stumbling around the kitchen in the morning, trying to get her food and medications organized. She would batter down any closed door (literally, launching her head at the door to make the loudest possible noise) to get to you. She always had to be ON someone; near the end, arthritis limited her movement somewhat and she settled for being NEAR someone, but she was still constantly underfoot if you got it into your head to try to walk somewhere.

Looking back, we recognized that in those last couple days before her final week began, she wasn't pestering us in the mornings anymore. She was tired and getting ready to leave us.

We miss you, Gracie.

We now have two new kittens and they are rambunctious and hilarious. One is very loud and mischevious; the other is demure and sweet. They are fantastic and their energy is definitely healing (when it isn't pissing off poor Max). But there will always be a cat-shaped hole in our hearts that Gracie left behind.

The Unhappy Known

image credit: thisnext.com

No, I said KNOWN, not GNOME.... but we'll come back to my little friend in a bit.

I recently re-read my own post,  Meditation for Dummies. At the end, I had a note to myself to discuss the Unhappy Known versus the Happy Unknown. I've gotten busy and sidetracked along the way and haven't really gotten back to this topic in any depth. But the idea has recently cropped back up in my life, so I thought I'd give it a go...

It's not an easy topic to write about in a coherent way. It's also not easy to deal with in life. I came across one of those Facebook "memes" that had a little flowchart. It said, "Are you happy?" You could pick Yes or No. If you picked Yes, the flowchart told you to keep doing whatever you were doing. If you said No, the chart told you to "Change Something."  Simple, right?

Not so simple to put into practice. If happiness were easy, everyone would do it, I suppose. I was miserable in my former lifestyle, yet I stayed for years. It was the Unhappy Known. I may have been unhappy,but at least I knew how to do that! The Unknown.... maybe there was happiness there, but it required a leap of faith, with no guarantee that the Unknown would be any better.

The thing is, once you get used to the Unhappy Known, you begin to think there is no other way. Anytime you contemplate change, the mind rebels. The voices (let's call them the Fear Gnomes)  start yelling at you that you couldn't possibly change. You want to be happy, but changing the Unhappy Known is too scary. You may want a romantic partner, but going out there to meet someone is too scary. It is the Unknown. Even if it might be a Happy Unknown, the mind doesn't want that. Instead, it tells you that you will never find a romantic partner because you are unloveable. Even though this is an awful thing to think about yourself, if it is the Unhappy Known; you know how to do that. And continuing something you know how to do is always easier than making a change. So you believe that you are unloveable, and unconsciously do things that will fulfill that prophecy. Now, not only do you get to stay in the Unhappy Known, you get to be RIGHT! See? I told you I was unloveable, and here I am without love. If you changed that story, if you were actually Happy, well then you would have to admit that you were wrong.

The Fear Gnomes also love to yell about career change. You say you're unhappy? You want to change careers? Well, who are you to think that? You trained for 12 years to get here, what makes you think you can even DO anything else? You then begin to believe that you really can't do anything else - that nothing else will make enough money to pay the school loans, or the mortgage. You don't know how to do anything else, now that you are so highly specialized. So you stay where you are, unhappy, with only the Fear Gnomes for company. But hey, you get to be RIGHT! And that's always cool... right?

Those Fear Gnomes are loud little suckers. But guess what? They're just scared. They are just, in their own counterproductive way, trying to protect you. Give them some love, and let them know you appreciate their concern for your welfare, but it's time to try something new. The Unknown may or may not have the secret to happiness, but if you stay where you are, you are guaranteed Unhappiness.

So go on - take a hammer to that loud little Gnome and break him into pieces. Or better yet, thank him for his concern. He is, after all, just trying to do his job. Thank him for that, but reassure him that you've got it from here. It's time for him to go take some more of those vacation photos.

And now for something completely different

image credit: angelfire.com

OK, time for a bit of a change-up.

I feel that this blog has become a little repetitive. I am completely at peace with my decision to leave medicine, but I realize I wasn't coming across that way, as I kept harping on the topic. Time to start branching out. I will (mostly) save the delving-into-why-I-left-medicine for the book I'm (supposedly) writing (including lots of gory details I haven't yet gotten into here), and start to explore some new topics on Ye Olde Blogge.

Change is good. I have always been a person who changed paths every few years. What on earth made me think I could stick it out for 30 or 40 years in one career? Or for very long on a single-topic blog, for that matter... After four years of high school, I was off to spend a year in Sweden as an exchange student. Back home, I went to college for four and a half years. Then another year abroad, working in Ireland and Scotland. Then back home again, working in clinical research for a year and a half while I applied to medical school. Four years back east for med school, then four years in the desert for residency. I liked making a change every few years, although I was mighty sick of moving. I am now resettled in the beautiful Pacific Northwest. I hope never to leave, but I like the idea of changing directions every few years, keeping things fresh. How did I ever decide to commit myself to a lifelong career path? I was clearly not listening to ALL the voices in my head, including the ones that indulged in two minors in the Humanities.

I have been radio-silent on this blog for awhile.. Not only was I feeling stuck in a topic-rut, but I was plugging away on the editing work pretty much every day. While I enjoyed (and still do enjoy) that work, I had a wonderful opportunity come up to make a shift (again with the change!) into clinical informatics. What now, you say? Clinical informatics is basically the effort to disseminate medical information in a meaningful way. In the case of my current project, it is making electronic medical records make sense by standardizing terminology. (You can't imagine how many ways people come up with to say the same thing!) Anyway, I got out of the habit of writing, even as my new job freed up some time to write. This has been a very positive change, exposing me to a field I didn't really know existed. And I still have time to do some freelance editing, keeping a toe in that pool and maintaining some variety in my work week.

And so I am embracing the change. My path away from my previous career track has led me here, and I couldn't be more thrilled! They say that nobody expects the Spanish Inquisition... well, when I was in medical school and residency, I never expected to be working from home at a job that makes me happy and making enough money to cover the mortgage! It is completely different from my previous life, and that suits me just fine. What will I be doing in 10 years? Or even 5 years? Who knows! That's the exciting part. Life's too short to do anything other than what makes you happy... and apparently change makes me happy. So stay tuned... and expect the unexpected...

image credit: gretachristina.typepad.com