I am in my pajamas, on my couch in Toronto. Despite this, I am counting today as the first day of my ER fellowship. I have been watching videos of rapid diagnostic ultrasound all morning, preparing for our crash course next week. I have been letting the first flickers of excitement sneak past my wall of apprehensions.
Now that Family Medicine is over, (passed, attained, whatever) I do feel some regret about moving on. There were patients that cried when I told them I was leaving. Colleagues who I will miss. A lifestyle of 9-5, Monday to Friday that I got comfortable with. ER will be more challenging, with no room for error, terrible hours and less flexibility. I know this, but I am still getting excited.
I am hoping that the ER fellowship will give me lots to write about; the people who choose to work ER tend to have strong personalities, and the patients are generally bat-shit crazy. I will also be teaching residents and medical students, which has great potential for hilarity. (First win: I will be supervising my grade 9 ex-boyfriend, the most misogynistic man on the planet. I will be his boss during August. I will carry the memory of his realization face through the rest of my life.) I will also be working weird hours, alone a lot of the time, and attempting to study huge amounts of material in a small amount of time. There is a strong possibility that my husband will leave me.
All this is just to say; I will be blogging more in the future. I look forward to it.
Finally, whenever I am leaving a city, ending a program or just making a life change, I always seem to get nostalgic for the past. If you have any desire to sit down and hash out the when, why and how of the past, now's the time to do it. I've got lots of room on the couch.
Friday, June 28, 2013
Thursday, June 6, 2013
Kokomo...
Late at night, lying in a single bed and listening to frogs chirping outside your window, you might start to relax. You can feel your sunburn radiating into the cool cotton sheets. Aching muscles remind you that you chased a pack, or flock, or rumble?... of goslings around the lake in the canoe. You stretch out, settling into a deep and untroubled sleep. Big picture happiness.
Medicine is a permanent hierarchy. Regardless of how far you've come, you will always be looking up to someone, looking down on someone else.
Friends of mine have mocked my choices; Australia, family medicine, the non-academic path. These same friends come to me now with sunken eyes and pale complexions. They need to know that their sacrifice is worth it, so they try to convince me they're having more fun than me. They talk about the work they're doing; seeing interesting cases, learning interesting medicine.
Their girlfriends ask me, "How can I get him to do what you're doing? I never see him". The answer is easy, but very hard for those who need the hierarchy to maintain their sense of self.
In family medicine, the work is not glamorous. You see the same patients. You say the same things over and over again.
- It's a virus, you don't need antibiotics.
- It's gonorrhea, you need antibiotics.
- You have got to start eating right and exercising.
- You have got to lose some weight.
Your patients will tell you you're stupid. They will counter your every suggestion with WebMD printouts. They will book an appointment to have you fill out their tax exemption forms, then shout at you when their application is denied. They will threaten to sue you whenever they're unhappy, and ignore you when you do things right. You have to be able to let go of your ego and try to see the big picture.
My big picture involves working reasonable hours for reasonable money. I need to feel that I've made a positive difference in at least one person's life every day. I need time to exercise, to cook (a political action now, according to Michael Pollan) and to wrap myself around my giant man. I need time to read for pleasure. I need time for Pender.
Family Medicine gives you big picture happiness. Emergency medicine will be icing (or gravy) on top. I used to feel defensive when I talked to my Internal Medicine colleagues. Now I look at them with sympathy and say, "When you're ready to let go, come find me".
Medicine is a permanent hierarchy. Regardless of how far you've come, you will always be looking up to someone, looking down on someone else.
Friends of mine have mocked my choices; Australia, family medicine, the non-academic path. These same friends come to me now with sunken eyes and pale complexions. They need to know that their sacrifice is worth it, so they try to convince me they're having more fun than me. They talk about the work they're doing; seeing interesting cases, learning interesting medicine.
Their girlfriends ask me, "How can I get him to do what you're doing? I never see him". The answer is easy, but very hard for those who need the hierarchy to maintain their sense of self.
In family medicine, the work is not glamorous. You see the same patients. You say the same things over and over again.
- It's a virus, you don't need antibiotics.
- It's gonorrhea, you need antibiotics.
- You have got to start eating right and exercising.
- You have got to lose some weight.
Your patients will tell you you're stupid. They will counter your every suggestion with WebMD printouts. They will book an appointment to have you fill out their tax exemption forms, then shout at you when their application is denied. They will threaten to sue you whenever they're unhappy, and ignore you when you do things right. You have to be able to let go of your ego and try to see the big picture.
My big picture involves working reasonable hours for reasonable money. I need to feel that I've made a positive difference in at least one person's life every day. I need time to exercise, to cook (a political action now, according to Michael Pollan) and to wrap myself around my giant man. I need time to read for pleasure. I need time for Pender.
Family Medicine gives you big picture happiness. Emergency medicine will be icing (or gravy) on top. I used to feel defensive when I talked to my Internal Medicine colleagues. Now I look at them with sympathy and say, "When you're ready to let go, come find me".
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