I've been out of residency 2 years, passed my boards, and my hands no longer tremble when I have to intubate someone. My heart doesn't skip beats (as often) when I hear the MICN on the box taking a full arrest run. And, I'm more-or-less comfortable sending well babies home without worrying (too much) about whether or not they'll develop meningitis in the next week or two...
I've developed a (usually) polite, yet firm, way about me and my practice...in order to get things done. Both patients and ancillary staff typically respond better to a physician who is decisive and confident. But, I know how to listen and take advice (i.e. hear the subtle, or not so subtle, inflections in the voices of family and nurses when I should consider rethinking my disposition). I know how to ask for help without feeling incompetent. I can explain myself to the second-guessers...and feel even more validated in doing so. And, interestingly, I'm not at all shy about admitting what I don't know.
I'm actually enjoying myself most of the time.
Of course I still have times where I'm nervous, overwhelmed, or simply just not feeling up to the task. Since it's difficult to take 'a sick day'...we doctors (and nurses) often come to work regardless of how we're feeling - and probably when we shouldn't. But I digress....
The biggest thing however is my new-found *balance*. I have found the perfect number of shifts...types of shifts...and places to do said shifts. This, my friend is key. I believe that being rich means having choices, period. Money certainly allows for more choices (to a point), and is therefore a necessary part of the equation. But, choosing how you spend your time, where you spend your time, who you spend your time with, etc...for me actually defines "rich." If I'm working 25 shifts/month, I may have a $30,000+ bring home salary/month, but really, I'm not rich if I have to go to work frikin 25 days/month!!
I realize that working about 10 shifts/month allows me to bring home more than enough money to cover our expenses plus savings...AND I get to spend the rest of my time (get this)...doing other things!! Additionally, I realize that I actually enjoy working at 2 different EDs, each with their own flavor. Working in two different EDs allows me to not get all caught up with the politics of a place. My residency program was the *most* political program ever (I'm sure). Every word, every action...political. Very stressful.
I also realize that I actually *enjoy* working at an urgent care center/walk-in clinic. It offers a completely different perspective. It's nice to have time to sit here and update my blog (finally), and see patients intermittently while doing so. It's nice to take a lunch break (imagine that, a lunch break!!)...and its nice to visit the toilet from time to time when necessary.
Also, it's nice to refer patients that you don't wanna see (for whatever reason) to the ER. Shortness of breath? Hmmm...you need to go to the ER. Pregnant vag bleed...yep, ER for you. I see why so many clinic docs
Sometimes I get asked by folks when I tell 'em I only work 10-12 days a month:...what else do you do with all your time?"
You know what I do? I cook healthy meals because this non-organic/fast food shit is killing us. I read for pleasure (for the first time since college). I keep my babies out of daycare from time to time so I can take them to the park, then to the ice-cream shop...and maybe even to the mall. I manage the business that is a household (which is a full-time job). I make sure the bills are paid on time; I negotiate online payments, allocate funds for various usages, manage half of our accounts, and basically (since it is my strength) manage the finances. I am the historian of our family - blogging, documenting, video-taping, photographing, and scrapbooking our lives...so we won't forget, and so the children will have a sense of what their childhood was like.
If not me, who will go thru my kids drawers and determine what fits and what doesn't, what I adore and will save for them vs. give to a shelter? If not me, who will decide where I want things to go in my home...how to decorate...and how to organize? If not me, who will take inventory of what we have, and what we need as a family? There are some things a house-keeper can help you with...other things, I'd rather do myself. If I don't change my own kids diapers, how will I be able to tell the pediatrician that their poop is consistent with prior poops? If I don't bathe them, how will I know that my little guy likes to play submarine with his Thomas the Tank Engine train set? Or even more importantly, how long would it take me to notice an injury or a rash if someone else (or various someone elses) are doing the parental tasks? If I don't read to my kindergartener, how will I know she's progressing as she should in school...and in life? If I don't find time to really talk to her, how will I know who her friends are, and what they're like? I wonder if my colleague knows how much fun she's missing when she leaves the house before having had the opportunity to dress up her cute little girl in almost-as-cute clothing...and spend time fixing her hair just so? Isn't this why we dream of having daughters? Why would you want to delegate all the fun stuff? And...if I don't have sex with my husband, and listen to his hopes and dreams, how can we stay connected in this partnership that is raising our family...and enhancing our lives? I waited almost 30 years to be 'mommy/wife'...and I want to be intimately involved!!
You know what I do? I walk my (often neglected, despite all my "free time") dogs, and train them to obey me. I do yoga so my back won't be sore after my shifts. I get massages and facials...and my eyebrows threaded. I do my hair, my nails, and read fashion magazines. I have like 4 blogs in progress...and enjoy being 'in the world' in this way. I'm (still planning to) write a great book (but there isn't quite enough time).
I've discovered that I actually love photography...and it is not my style to do things half-assed so I actually devote a bit of time to this hobby. I am in a Sorority, and like many sororities, our membership doesn't end upon college graduation...and there are time commitments involved as we serve as mentors, organizers, advocates, and community activists in my Sorority as a graduate. I plan awesome trips for our family (that we have time to take because I don't work all the time). And not huge extravagant/over-compensatory (i.e. I work all the time so when we go 'on vacation' it has to be big so our friends will be impressed, and my working all the time seems justified) 3 week European-type trips...but rather Disneyland Resort trips...Legoland trips...Vegas trips...Tahoe trips. Frequent trips. Easy trips.
You know what I do? I can attend school field trips with my daughter. I can keep the laundry done (most of the time). I can be mentally and physically available and present for my husband. I can unwind and tend to my needs so I can be patient and understanding with my kindergartener and toddler without yelling all the time over spilled milk, literally. And without sitting them in front of TiVo'ed Little Einsteins cartoon for days on end (hours? maybe. days? no).
I can have 2 hour conversations on the phone with my parents...and/or my girlfriends. And I have the time/energy to spend a weekend or two a month (or at least every other month) socializing with good friends as a family (their kids, our kids, red wine, good food, background jazz playing, with the BBQ grill going, or tandori chicken and naan waiting for us in the family room...OR maybe an exciting night out at the bowling alley - the one with bumper guards to keep the bowling ball in the middle of the lane). And I have flexibility, and enough 'extra' time off that I can actually pick up shifts quite easily from other partners who need/want days off...but the schedule is already printed.
Above all...I just have time to think. You know, be bored...like a child in the summer, back in the day ('cause these days, kids are overextended and never have the pure luxury of just being bored). To just think. Think about investments, think about purchasing property, think about our next trip...and just let the creative energy flow. Think about ways to be more fully involved and engaged in this life I've been blessed with. Think about life. Think about my purpose...expanding my spirituality.
And, of course...time to *not* think...and just be.
There are so many things to do when not cooped up at work...running around crazy, neglecting your own needs. There are so many places I'd rather be, despite the fact I love being a doctor. Actually, I love being a doctor *because* I have plenty of time to *not* be a doctor.
I've said it before...and Dr. Leap repeated it here:
It's so important to realize that we are so much more than doctors. We are mothers, wives, daughters, spiritual beings, individuals, pet-owners, aunties, girlfriends, sisters, mentors, community activists, here to serve a Divine purpose. We have other loves and interests. And life marches forward.
Balance is so important...
...hopefully new doctors will realize that - and find their groove.