Sunday, October 8, 2017

On Endings and Beginnings

Hello....hello....hello. 

Wow. Um. Not really sure where to start.

I quit my job. I am no longer a rural GP-Surgeon. So, there's that. I moved. Enrolled in a Dermatology Diploma through Cardiff University, got a new full time job, a part-time locum. Oh and a full time LIFE again.

I bought a new house, adopted a second dog, moved. Is that everything? I guess that is the big stuff.

It's awkward as I have so much back tracking and so many half written half cocked stories and posts and its overwhelming. And were does one pick up the thread?

I will start by saying that physician burnout is a real thing. I read somewhere recently that around 80% of physicians in their first year of practice report feelings of burnout. It made me feel reassured. I haven't really sat down and dissected the past 15 months since finishing to see if the diagnosis would be burnout but I can certainly see that there were moments, really long moments that lasted weeks or months at a time where the over arching theme could be described as "burnout". Sure.

And I cycled through the emotions of feeling guilty for being overwhelmed when I should have actually felt good that I was acknowledging that too much was being asked of me. Feeling I was weak instead of seeing that the load was too heavy, and all of that.

So now I'm staring at all these books in my basement. Do I get rid of the stacks of emergency medicine books? ECG guides, Operative Obstetrics, Mastery of Surgery, Palliative Medicine? I have Care of the Newborn and PALS guides strewn beside Colorectal Disease atlases and AIME study manuals. It's nearly comical. I am letting go of some of my skills, some of my training but I am weirdly clinging onto these books. I am not a nostalgic person. Ever since I Marie Kondo'ed the shit out of my house 2 moves ago I have paired down and donated, sold, and dumped a lot of my belongings. These books feel like haunting reminders of the person I thought I wanted to be or the person I thought I'd become.

When people would ask me, "How are you?" at work my response was always "living the dream!" And this was an intentional response (for me) even though it may have sounded flippant. I said that because if you go back, all the way back to even before this blog started, I wanted to be a rural physician. A rural emerg or rural gp-surgeon or full scope rural GP. I turned my life upside down. I left my house in the mountains, all my friends, all my family. I left my financial security and traded it for crushing debt. I left the freedom to chose where I got to live. I left my hobbies, my boyfriend, my favourite recreation. I left my country! I traded all of that in to become a doctor. I came back to Canada and was lucky enough to land a residency in a fantastic rural program. Then landed another residency in enhanced surgical skills. Then I was offered a full time job in a full scope GP service practice in a place that I had spent 6 months as a resident. And everything was just finally lining up perfectly and I was reaching the end goal of 8 years of moving, studying, exam writing, wondering, hoping, and guessing.

And my "dream" finally came true.

And then it all went to shit.

So I purposefully reminded myself every single time someone asked me how I was doing, that I was in fact, living my dream. It's so easy to remain in this goal oriented, delayed gratification, head down, life will be great when....mentality. "At the coal face" as my husband describes it. You are in survival mode, you don't look up you just grind grind grind. You will one day live your dream, you tell yourself.

Then you arrive and the unicorns aren't sliding down rainbows to greet you. I can't even go back and read the post I wrote when I finished medical school because I may actually punch myself if I do. I was taught this lesson before but I suppose I never learned it.

I wanted to remind myself so I could stay in the moment. So I could find that thing and see the beauty in where I was even when it felt like it was crushing me. Something had drawn me to this exact place in the world so I had find those rewards and acknowledge them. Even when it felt really really hard.

I'm sure there are many, many people who chase certain goals in medicine, and achieve those goals and the rainbows and unicorns are there to greet them when they do. And to those I say, "you're so lucky". But to anyone reading this who felt weird and sad and stressed and unfulfilled when you finally got to live your dream I say, "you are not alone, dude".

So I finally gathered up the courage to admit all these things to myself and those around me. And here I am. Trying to focus on how I am going to make this whole medicine thing work for me, instead of the other way around.

To be continued.







25 comments:

Solitary Diner said...

Welcome back. I am sorry that the dream of medicine wasn't what you had hoped for. I feel that way on many days - like I am working harder than I want to for far less reward than I had expected. I am still trying to figure out how best to carve out a life for myself in this difficult, post-training world. I hope that your next venture will be much better suited to you.

Lisa said...

Welcome back - you've been missed. I've followed you since before you went to medical school, while you were working as a nurse. I wish you happiness and success in your new endeavor.

Albinoblackbear said...

@Solitary Diner - thanks lady! Yes, you seem like an old friend. :D Your description is apt and if you figure out the answer let me know! My new employers appear to have a much better grasp of work/life balance (they just got back from 6 weeks cycling in France, take 12 weeks holiday a year including 2 weeks at Christmas! Neither of them work full time when they are here!) For me it was about the difficulty in setting boundaries and carving out time for myself, saying "no". But, in small communities it is hard as everyone is stretched to the max and working working working too much. Thanks again, will keep you posted. xx

@Lisa - Wow, yeoza yes that is a long time! Thank you for still reading !! And also, thank you for your kind wishes. I hope to find those things too - or that they find me. :) Worst case scenario I am back in the mountains and that in itself feels like happiness and success ! xx

n said...

Wow. I've been following your blog for a while. I'm a nurse practitioner in a kind of isolated community in the NW US. I've often wondered what would have happened if I had gone the physician route rather than the NP route after being an ICU nurse for several years. I've done a lot of soul searching and had some regrets for sure. Ultimately I really like my job but still wonder "what if?" sometimes. I'm glad you chose to have some better work/life balance over trying to make the dream work. I'm happy for you!

Anne said...

Thanks for posting, and all best wishes as you make your decisions.

Tom Bridgeland said...

I'm a cardiac nurse. Just want you to know how much we appreciate having folks like you around. I always try to be kind to the student docs who float through the unit, knowing how much they are in for.

Mary said...

I am proud of you for recognizing that you didn't want to do "this" and stepping away from it. That takes guts. You will find your self again and it will be obvious that this is the right decision. Well done.

rakal said...

So glad to see you back! You're blog got me through my waitlist to get into nursing school, through nursing school, and now I'm a nurse! My goal was always to be an ER nurse. And after doing a residency in a Level 1 Trauma ED I wound up landing a new grad residency in the same unit. I was so ecstatic, I felt like my dreams were finally being realized. But the realities of being an RN in the unit vs being a student were harsh, and working nights were not kind to me. It was 6 months of insane insomnia, anxiety, and every day trying to remind myself, "this is my dream job" before I decided I had had enough, and it was okay for ER nursing to not be for me. Since quitting I've found something way more my speed, and I 100% feel like I have gotten my life back. I still fight with feelings of shame for quitting this highly desired specialty, but when I look at my quality of life now versus then its all worth it. Definitely not trying to say our struggles our the same, only that I recognize a bit of that feeling, and thank you for writing about it, it makes me feel less alone and crazy! <3

Just Me said...

CLAP! CLAP! CLAP!

Good for YOU!! Seriously - good for being good for yourself! We aren't taught to do this as physicians. I had a old friend tell me that he realized that he was living life like it was really long, but in fact, life is short. Too short to not be happy. So, good for getting a life back. Don't put it off. And seriously (believe me I hung on too long) ditch the books. Everything is online anyways :)

Albinoblackbear said...

@rakal Thanks for your comment. It's hard for me to believe that my blog was "with you" that whole time ! It's so cool for me to hear that! I Nursing school was a nightmare, I came so close to dropping out in year three due to a completely sociopathic prof. It is such a tough degree - in many ways I found my BScN harder than my MD.
I started out in the ER and remember those first six months very clearly - I was also in a panic most days and couldn't sleep the night before ANY of my shifts.
Of course our struggles are the same ! We both worked hard and ended up in jobs that didn't work for us and we struggled with the decision to leave. I'm glad you found a better fit for yourself - that is one of the fantastic things about nursing - there are so many options to change your practice and try different areas! You're not crazy!

Albinoblackbear said...

@Just Me Absolutely agree. I shudder already at how rapidly the last 10 years have zoomed by! I will ditch the books - even though I love them like old friends!

Albinoblackbear said...

@Tom - thanks for that, and know how much we appreciate having folks like YOU around as well ! :-) (can't count how many times an ICU, CCU or ER nurse saved my butt in a tough situation)

@N - Thank you! Yes, that was a big push for me - always wondering 'what if'. But, I realize now that medicine is just like everything else, there are good things and awful things about it. The main thing I hate is that medicine crushes so many aspects of your life into the ground whereas I felt nursing enabled me to have an amazing life (traveling to so many amazing places and working casually allowing me to work as much or as little as I wanted). A big part of it for me was also ego, I can see that more clearly hahah, and one should never make a life decision based on that motivation. ;-)

Albinoblackbear said...

Hi Anne! Thanks for the boost! I'm back in the interior now - come visit sometime!! xx

PAS1 said...

Someone once told me "don't let the golden ring become the golden handcuffs".

It's so so true.

Quality of life with love and happiness matters most at the end of the day.

skyjockbill said...

Just wondered if you'd seen this already?

https://onbeing.org/programs/atul-gawande-what-matters-in-the-end-oct2017/

Canuck said...

Wow, and welcome back! I've missed your blog!
I can't imagine the emotional rollercoaster this has been, but I'm glad you were able to recognize what was not working for you. I hope your new path will be more what you want out of life. Wishing you all the best! And selfishly hoping for more of your amazing writing :)

Ryan said...

Hey, wow, funny to happen by here and see a recent update! I was just strolling through old blog posts looking for photos and there you are, back up for air it seems. I hear you're in the 'hood again, and it would be great to catch up!

Shash said...

Tough decision. I made a similar one and am sure it was far more difficult for you than for me. Luckily, I was able to find a field where I can use most of the skills learned and still curl up on the couch with a good book and and the phone silenced. Take a deep breath. Relax. Say goodbye and move on. Life isn't waiting for anyone so enjoy it now.

Old FoolRN said...

Enlightened youngsters like your self have so much more wisdom than doctors and nurses from my generation. We kept our nose to the grindstone until personal demons, addictions or illness dropped us in our tracks.

I put up with middle of the night call ins, flying surgical instruments flung by agitated surgeons, and lots cussing for things totally out of my control. I lasted 20 years before Crohn's Disease brought me to my knees.

Save a couple of your books and bring them out again in 40 years. I guarantee they will bring a smile to your face as you sit back and reflect.

Oh and well I have this rash on my...never mind. All the happiness to you in your new adventure.

David Chin Shong said...

Really have enjoyed reading your blog especially when medicine wasn't delivering it's hoped for promises to me. Your time at medical school reminded me of the privilege it was to be part of something so special. There is a tendency amongst doctors to feel they have failed if it doesn't all go to plan but the reality is that you wouldn't have made it this far if you weren't able to keep going and the truth is that you have simply reached a different part of your life where your earlier dreams and ambitions are just not as relevant. I definitely think the most successful doctors are the ones who get the work life balance correct. As mentioned by Stephen Covey - nobody ever on their deathbed laments not getting to spend one more day in the office. You have a huge amount of experience on your way to ultimate mastery and most of them can be made relevant to whatever area you chose to go into. It will never have been for nothing you just need the right plan. You will know you have the right plan because you will be happy again like you were in Ireland. You have the insight and skills to figure this out so the future is bright and that discovery is near. Please don't look back cynically at your time in med school or when you finished. If you can't be optimistic then when can you be? And if you have been optimistic before you know you can be again. You just need to recharge (and we all do from time to time - I schedule at least a week every year for some navel gaziing and I know I'm not the only one of my colleagues to do this). Medicine doesn't define you but it is and always will be a part of you - My heartfelt best wishes and good luck with your decisions.

Jono said...

How you see yourself and how you really are aren't necessarily the same thing. I have done a similar thing twice, but not on as grand a scale. One thing that drew me to your blog years ago was the same thing in which I have always found comfort in. Music. Not much I can add to all the others comments, but since I am in my mid 60s all I can say is that life is short. Keep seeking the things that make you happiest. Promise I'll check back more often.

l berg said...

Thank you for your blog and sharing your story. I really appreciate your honesty. I think you are remarkable; for all you have achieved, experienced, as well as to recognize when something is not right, or no longer right. Also, an earlier post of facing debt was most welcome.

I have learned so much by following you. Thank you for being you!

Mama D said...

Three cheers for you, your courage and your honesty!

V said...

Remove the books from your life without guilt. Medical texts are continuously updated to teach the most recent "best practice" knowledge, so a five year old text may lead you down the wrong path. Lay them out from first to last, take arty pictures, print out and make a very personal montage for your office wall (or guest bathroom).

Albinoblackbear said...

@V I love that idea!! Totally doing it. And yes, I hadn't even thought about how outdated things will be. You're right, they're gone. Thanks for that. :)