Monday, February 29, 2016

How to Conference Better

I'm on my fourth (and thankfully last) day of my conference in Montreal, and I am way past ready to go home. The talks that excited me on day one are now barely interesting enough to keep me awake, and my stomach is unhappy from too many unhealthy meals out. I have 25 minutes until my next (and last) talk, so I thought I'd share a few of my thoughts on how to optimize a conference experience.  While they may not be interesting to anyone reading this, at the very least they might help me do better next time. advice:

1) Be selective:  Attention spans (especially mine) are limited.  Not even the calmest and least ADD person can be engaged for over 8 hours a day of lectures and poster sessions.  Pick only the sessions that are most interesting and useful, and use the remaining time to nap or exercise or explore a new city (if it isn't fricking cold, like it is here now).

2)  Consider going for only part of the conference:  As a lifelong keener, it's hard for me to not participate in something from the opening until the bitter end.  And as someone who is trying to live somewhat frugally, it feels like I'm only getting my money's worth if I stay for the entire conference.  But the reality is that the best talks are rarely on the first or last day.  In the end, I will have gone to only about two hours of talks on each of the first and last days, because there simply isn't that much of interest to me.  I could've saved two nights away from home (and two nights of hotel/food costs) if I'd come only for the most useful days. (Not to mention the fact that I could've avoided cancelling three half days of clinic.)

3)  Don't go to every conference:  Again, this is difficult for me, because I want to stay knowledgeable and current, and conferences are generally a good way of doing that. But, being in a small field, the research doesn't change all that much in the 3-4 months between conferences.  I think I'd actually be better off skipping some of the conferences and just dedicating a day to reading all the articles that are piling up in my "To Read" folder.

If you attend conferences, what other advice would you give?

Saturday, February 27, 2016


Since I read Cheryl Sandberg's book Lean In last summer, I have been hyper-aware of the ways in which men and women in medicine behave differently.  I've noticed how men speak up more during lectures and stay at the microphone even after they've been told that the question period is over.  I've seen how male residents give orders to nurses while female residents make requests.  I've witnessed the self doubt of smart and talented female medical students contrasted with the cockiness of some not as smart and talented male medical students*.  It saddens and frustrates me to see, time and time again, women reflexively and unconsciously making themselves smaller because they've internalized the message that they are somehow lesser.  (And men making themselves bigger because they believe that they're greater.)

This morning I went to an educational session in which these gendered behaviour patterns were on full display.  The session was led by one male physician and one female physician, both of whom are well-respected in their fields and have similarly impressive CVs.  Although they were supposed to be equal co-chairs, the man completely dominated the session.  He read not only his introductory slides, but also hers.  He answered all of the questions without even acknowledging that his co-chair might have an opinion that she wanted to add.  The few times that she managed to start answering the question before him, he interrupted her to finish the answer.  And then, partway through the session, he deviated from the planned presentation and, without asking permission from his co-chair, started showing his own set of slides on his area of research.

I was livid!  I couldn't believe how blatantly disrespectful he was to his colleague.  And the worst thing for me was, I suspect I was the only person in the room who noticed.  We're so accustomed to this pattern of male dominance and female submission that we don't even bat an eye at it.  Even though the voice of another smart and talented woman was completely silenced in the process.

I'm still livid.

*In case it needs to be stated, I don't think that female medical students are inherently smarter and/or more talented than male students.  I've simply observed that women in medicine tend to underestimate their abilities, while many men do the opposite.

Thursday, February 25, 2016


I'm sitting in a hotel room in Montreal, awaiting dinner with a friend (in 1 hour) and the start of a conference (tomorrow morning), and I am struggling to write one of the blog posts that has been floating around in my brain for the past few weeks.  I want to write about how it feels to be six months into my work as an attending, about my struggles to start up a research program, or about my recent two-year anniversary, but all my brain and body want to do is rest.  In the past two weeks, I've taken on three extra clinics and an extra weekend of call, and while my net worth is very happy about the additional work, the rest of me is not.  I'm exhausted.

This past weekend, my girlfriend and I had a long discussion about careers and life goals and what is important to us.  Both of us want to do work that is meaningful and that hopefully makes the world a slightly less miserable place, but we also want to have full lives outside of our work.  We want to sleep in on weekends and cook good homemade food and read books and knit*.  And maybe even do productive things like exercise and clean our messy apartment.  If we run out of fun things to do, that is.

At the moment, it feels like what I want to do is always in conflict with what I need to do (work).  I wish at times (always) that I could go back a decade and live more frugally so that I would have actual money now, instead of debt, and would feel like I could take more time to myself.  I keep hoping that hitting the zero net worth mark will bring about a major change in how I feel and how I approach work.  I'm hoping that it will make me feel okay with saying no to the extra clinic time and the extra weekends of call.  Because while I like my job, I love my life outside of it more.

*Well, I want to knit.  Specifically this, in a gorgeous grey yarn that is ridiculously expensive but will be worth it because it will undoubtedly take me at least six months to knit the scarf, thus keeping the cost per hour of knitting very, very low.

Saturday, February 13, 2016

Student Debt Identity

When I was in San Francisco two years ago, immediately before I met my girlfriend in person for the first time, I visited a small bookstore in the city's gay district (The Castro).  It was the kind of cozy, inviting bookstore that encouraged leisurely browsing, which is exactly what I did for my last few hours in the city.  I checked out the staff favourites; I discretely flipped through LGBTQ books that would make Dan Savage blush; and I somehow resisted the enormous selection of magnets and mugs and bookmarks that I'm usually suckered into buying.  In the end, despite finding a large collection of books that wanted to come home with me, I managed to leave with only one:  Tiny Beautiful Things, by Cheryl Strayed. 

If you have never read this book, you should go out and do so immediately.  And don't take it out from the library (although I love libraries):  buy it so that you can read it over and over and over again.  The book is a collection of articles from the "Dear Sugar" online advice column that Strayed used to write, and it is easily the best advice column I've ever read.  She addresses every topic from romance (of course) to friendship to finances to body image to life's purpose, and she does so in a way that is wise and frank and kind and simply amazing.  I loved the book so much that I finished it on the red-eye from San Francisco (instead of resting up for my date when I got home), and I have read it cover to cover two additional times.  When I picked it up to start writing this blog post, I had a hard time not reading it a fourth time.

Anyway...this is not supposed to be a post about the genius of Cheryl Strayed but rather a post inspired by one of her responses as "Dear Sugar".  In one of the letters she received, a young woman wrote about her desire to go to graduate school and her frustration about having to incur additional student debt to do so because her parents didn't have the means to put her through school.  In one line that stuck with me, the woman stated "[M]ore often than not, I am defined by my 'student loan identity'."  Strayed's response surprised me a bit.  She seemed to diminish the woman's concerns about debt, and she encouraged her to strongly consider graduate school despite the cost.  In addressing the woman's concerns about the psychological aspect of debt, she said "I don't even known what a student loan identity is.  Do you?  What is a student loan identity?"

As I sit here, months away from having a positive net worth for the first time in almost a decade, and another decade away from having my debts payed off, I know exactly what a student loan identity is.  A student loan identity is waking up every morning and thinking about how much you still owe.  It's feeling like every dollar you earn is already accounted for and that none of it is actually yours.  It's saying yes to extra clinics and extra weekends of call because you're bloody tired of being in the red.  It's feeling like every decision you make has to be based on the financial implications, rather than on what you most want to do in your heart.  No matter what my rational brain tells me about the wisdom of my decision to go to medical school or the long-term financial security that I will enjoy, my lizard brain keeps fixating on my student loan and the long road between me and debt repayment.

I wish I could be more Zen about my debt and just accept that it's there and will be for a long time, but I can't seem to get past the sensation of OH MY GOD, MY HAIR IS ON FIRE!  I can't seem to stop questioning every purchase, wondering if I can somehow live without $20 a bag cat litter and train my cats to use the toilet.  (The answer to that question is a resounding no.)  I can't seem to say no to any opportunity to make extra money, no matter how tired or stressed I may be making myself.

More than anything, I just want to be back in the black.

Friday, February 5, 2016

Friday Night

For the past few weeks, I have been taking on an extra half day clinic per week to address the seemingly never-ending list of people who need to be seen.  While I actually kind of enjoy the extra clinical work, I don't enjoy having more paperwork to do and less time in which to do it.  By the beginning of yesterday, my desk was piled high with charts to dictate and phone messages to return and labs to review.  I have no clinics on Thursdays, so I spent the entire day in my office slowly crossing things off my to-do list.

It still wasn't enough. 

After clinic today, I ate lunch while dictating charts, and then I left the hospital to go to the other clinic where I work once a week.  And did more paperwork there.

I'm still not done.

I'm really hoping that, with experience, I will get faster at dealing with paperwork, because it is currently taking up almost all of my non-clinical time.  Time that I should be spending developing a research program (*ha*) or preparing presentations or teaching.  Fun things.  Non paperwork things.  It also exhausts me in a way that no other aspect of my work does, because I need to focus carefully on what I'm doing despite how tedious and dull it is. 

Thankfully, it's Friday, and for the next two days I can forget about the 45 dictations* that are sitting in my inbox waiting to be signed off on.  Tomorrow the girlfriend and I are heading to an independent cinema in our pjs to watch Saturday morning cartoons and eat sugary cereal.  Then on Sunday, I'm doing social activity #2** for the week and taking my nieces to a play about Harriet Tubman.  After I go for a run in keeping with my goal to work out three times a week.  And there will be sleep.  Lots and lots of glorious sleep.

I need this weekend.

*Literally.  Shit.

**Social activity #1 was dinner with my mom and my brother for part of a week-long promotion in which restaurants serve three-course meals at a discount.  The conversation was good, but the food was really underwhelming (including inadequately cleaned shrimp *shudder*).