Today’s inane image of the day:
Oh, hi!
It has been a while since I updated here [woah, almost a year?!]. I kept telling myself it was time to write something or record something but the passion just hasn’t been there. A couple weeks back, I actually recorded a video, but I wasn’t excited to edit it. Either way, I’ve wanted to explore writing regularly again as a way to stay true to myself and practice articulating things that are important to me. Someday, I’d love to write a book [yup, I’m writing it here so that all two of you reading this entry can hold me accountable].
Anyway, for my first entry of 2023, I thought I’d start with a big one.
For those of you who follow along on YouTube or my social media channels, I’ve been very open about the fact that I enjoy my job. Sure, I can come up with reasons to hate it, but there is no such thing as the perfect job/career/anything. In general, I think I’m the type of person who would try to see the best in any job I’m in, or figure out how to make the most of it. But there was actually a time after I finished fellowship when I wondered if my current job was the right fit.
I actually went as far as reaching out to someone I knew in a private practice group to ask if they would hire me[!].
Setting the scene
Let’s back up for a moment and set the scene. Imagine this: I’m a brand new attending critical care anesthesiologist in a major academic medical center and in an effort to make up for the opportunity costs of becoming a doctor, I willingly take on a very aggressive clinical schedule. Truly, there is no better time to work hard than right after residency/fellowship; you haven’t gotten used to what it’s like to have more balance and time… so why not work hard and make money?
When I first start with this busy clinical schedule [like at least ~60 hour weeks including ICU time which was 70+ hours], it doesn’t seem so bad. It feels like I am growing and learning and finding my footing. Almost a decade of training has culminated in the ability to do this work. It feels gratifying. And each time I work with learners, I am reminded just how much knowledge I’ve accumulated over the years. I guess I actually know a few things!
But part of being a junior attending is saying “yes” to some very challenging cases. Cases that most hospitals would not dare to touch. Cases where there is a mutual understanding that the risk of life-threatening complications is higher than usual. When these cases go well, it’s immensely gratifying. But when they do not, it’s hard to separate my personal role in the outcome.
At some point during my first year as an attending, I had to ask myself if my heart could take it. I think I have a “soft and squishy” type of heart. I cry easily during movies. I cry when I have a tough family meeting in the ICU. I basically cry at any major emotional moment – both happy and sad. There was a time when I numbed these emotions and feelings, but it felt wrong. I personally think that this ability to feel emotions makes me a better physician.
The problem is that if I’m investing all of my emotional energy into patient care, it takes away from putting that energy toward other things in my life.
Why I stayed
It’s not a surprise to any of you that can read my profile to the right of the page that I stayed in my job. The promised land of private practice wasn’t enough to lure me away. The challenges I encountered in my first year as an attending weren’t enough to push me out the door. But why?
And how did it get better?
Perspective
Only after I finished my first year of practice as an attending did I get the perspective of just how tough it was. I tell all graduating residents/fellows that the first year as an attending is the toughest one in all of my medical journey. There’s nothing that compares to the gripping fear that comes with whether you’ll make the right decisions or create the right plan. There’s nothing like the first negative outcome and how it haunts you for the rest of your career. It takes perspective to acknowledge that being a physician is tough and the first year is about figuring out how to fit into a brand new role for the first time without someone else automatically double-checking your work.
Community
During my first month as an attending, I worked exclusively in an operating room area that I had very little experience with as a resident. I have zero shame in saying that I texted one of my colleagues almost every night to confirm that I understood the type of anesthetic that was expected and to gain insight into what my surgical colleague would be doing for their case. One of the advantages of staying on as an attending at the same place where you trained is that you know who you can turn to for questions. And who you can call for an extra set of hands.
When I encountered a complication for the first time, I struggled with my role in that outcome. I cannot even describe how incredibly demoralizing and disheartening it is to feel even a modicum of responsibility for a complication. How do you pick yourself up after encountering this? Ultimately, it was the community of mentors, colleagues, and friends that helped me see the big picture. It was this community that helped me reflect, process, and learn.
Addressing burnout and work-life [im]balance
I don’t actually believe work-life balance is a thing. Life changes. Jobs evolve. We are constantly juggling things to make stuff work. It’s never actually “balanced.” But I do believe that when I realized I was crispy with burnout and found ways to take ownership of my time… things got better. For a while, it felt like I just had a vice grip on my head that kept me in one place and prevented exploration and reflection on my life. That vice grip was burnout. It has taken a lot of time away from work to loosen the hold. It has taken a lot of introspection to find the right path that aligns with my vision for the future.
In conclusion…
I semi-recently got a promotion that has made job even more gratifying [I didn’t think this was possible]… so I’m really glad I didn’t quit.