Tuesday, January 16, 2018

Life as a Highly Sensitive Physician - Part One

A little over a year ago, I stumbled across an article about highly sensitive people.  I had never heard the term before, but as I read the article, it resonated very strongly.

Feel more deeply?
Emotionally reactive?
Take longer to make decisions?
Detail oriented?
Cry more easily?

That's me!  After reading the article, I went on to do a self quiz, and the answer that came back was basically "You fit this profile so perfectly, why did you even need to take the quiz?"

So yeah.  I'm a highly sensitive person.  Meaning that I tend to respond very emotionally to things, that I am very sensitive to criticism, and that I can get overwhelmed easily.  These were all things that I knew before reading the article (and the subsequent articles/blogs/books on the subject that I have read), but the concept of a highly sensitive person was helpful to me for the way that it presented my individual traits as something bigger, some complete personality type that described me shockingly well.

It also helped me by explaining why some aspects of work were much harder for me than for other people.  All through medical training (and into my first years of practice), I would look at the high achievers around me and wonder how it was that they were able to accomplish so much more than I did.  How could they work a long day and then come home and raise a family and do research projects?  And without hating their lives? 

Identifying myself as an HSP has helped me to realize that things exhaust me more than they do other people.  I engage deeply with everything I do, and so I use up a lot of energy doing my work.  One challenging conversation can deplete a lot of my emotional reserves, so when I have a day with multiple tough patients, it isn't surprising that I have no energy for anything else in the evening.  I'm simply done.

This happened to me last week, when I had to tell a long-term patient that he was dying.  That interaction was difficult enough, but then it was followed by a number of really tough disclosures about personal trauma from other patients.  I did everything I could to be present for my patients and to help them get the resources they needed, but by the end of the day I had nothing left.  I spent my evening on my couch binge-watching Top Chef and eating leftovers from the fridge, physically and mentally unable to do anything else.

When I tell stories like this to some of my colleagues, they look at me like I'm crazy.  It's not that they're not empathetic or that they don't care about their patients*, it's just that they don't personalize things in the way that I do.  They can detach from their patients and move on quickly, whereas I struggle to not be too deeply affected by my patients' stories.

But it's something I'm working on.  I have zero desire to burn out early, so I'm constantly looking for ways to do my work well without giving so much of myself.

Which will be a subject for a future post, because for the moment it's time to read a book and recharge for work tomorrow.

*Well....for some of them it is.

Friday, January 12, 2018

Do I Need to Make Resolutions?

Since the end of 2017, I've been thinking a lot about writing a resolutions post.  I've been reading everyone else's posts, in which they talk about their goals of saving X dollars or losing Y pounds, and I've been thinking I should do that too.  But as I read these posts and think about writing my own, I find myself paralyzed by the fact that I have no idea what to resolve.

My challenge with resolutions is twofold.  First, I am not a person to make a resolution for the sake of doing so.  If I commit to doing something, it has to be because I believe that doing so is going to make me happier or is somehow going to make me a better person/make the world a better place.  Second, I am really, really bad at keeping resolutions.  Like my recurrent resolution to exercise.  A look at my last post about exercise shows that it starts with a paragraph bemoaning my failures:

"Oh exercise, how I struggle with you.  With just a quick look through the blog, it's easy to find multiple posts in which I'm either committing to exercising more or lamenting the fact that I've failed at exercising more (see here, here, here, here, and here for just a few examples).  It's not a habit that comes easily to me."

I worry that committing to anything, especially exercise, will inevitably lead to me writing a follow up post in a month or two talking about how miserably I've failed at my commitment.  Which makes me ask the question, why do I feel like I need to write a resolution post?

While part of this feeling is just the feeling that I should be doing what everyone else is doing, I think another part of it is a desire to create some sort of...shape in my life.  I feel like I'm in a phase in life in which I go to work, pay off debt, save for retirement, learn a few more words of French, and keep repeating ad nauseam.  I'm 7-10 years away from hitting FIRE, and I will likely keep working even when I reach FIRE, so this is not going to be a short phase.  There is an incredible monotony to this stage, and I wonder if I could somehow break up the monotony with a resolution.  2018 will be the year that I become a true minimalist/ban all shopping/run a marathon...something other than just the year in which I keep going to work every day and slowly trudge forward with life.

Hmmm.  This post is turning out much darker than I had expected.  Maybe because I'm alone on a Friday night and it's -26C outside and I drank a glass of Malbec before I started writing?  Maybe because I got word that a longtime patient of mine died yesterday, and I can't quite believe that he's gone, so the sadness that I haven't yet allowed myself to feel is coming out in other ways?

There is part of me that is longing desperately for a solution to this.  To be able to say that I am going to do X in 2018 and everything is going to be perfect.  But maybe life doesn't work that way.  Maybe it's harder than we all like to pretend it is, and we can't solve everything with a resolutions post.

Sunday, January 7, 2018

How I Like to Travel

The first time I ever traveled overseas, I was 22 years old, and I had just graduated from university.  Using my parents' travel miles, I flew to Europe with my good friend N, whom I'd known since I was five.  We had six weeks, ridiculously heavy backpacks, Eurail passes, and very little money.  It was going to be amazing.

Except, it kind of wasn't.  I mean...there were moments that were amazing.  Like the first day in London, when I walked around the city with my mouth hanging open saying things like "OMG...Alfred Russel Wallace lived here*.  OMG...MAHATMA GANDHI LIVED HERE!!!"  Or the beautiful day we spent on a boat on Loch Ness, before I discovered how badly I had burned my legs because I had decided to "let them tan".   But there was also a lot of hard stuff.


The biggest problem was that N and I wanted to have completely different trips.  I had planned for the trip obsessively, reading Let's Go Europe from cover to cover and marking things as "Must-See" or "Would-Like-To-See-If-We-Have-Time".  I had practiced saying Hello/Goodbye/Please/Thank You/I desperately need a bathroom now in the languages of every country we would visit.  And I had dreamed of all the nerdy historical places we would visit:  Westminster Abbey, Edinburgh Castle, Notre Dame Cathedral, the Roman Forum. 


N had packed her party clothes.  Unbeknownst to me, this trip for her represented an opportunity to escape from her somewhat overprotective parents and just have fun.  She had almost no desire to buy the discount passes that let you see all the historical sites in a city, but every desire to meet people at hostels and go dancing.  So for six weeks, we cramped each other's style, arguing constantly about whether to spend our time in a museum or a bar.  By the time we flew home, we were barely talking to each other.

I realized on that trip that I have some pretty specific desires when I travel, and they aren't necessarily the desires of others.  Which is completely okay.  I in no way judge the crazy people who want to be social and spend times in crowded spaces.  I simply don't want to travel with them.

Over the years, I have been very fortunate to have lots of opportunities to travel.  And with each trip, I've gotten even better at knowing what I will or will not enjoy.  Which is particularly relevant to me right now, as I just bought tickets for a conference and vacation in France this Spring.  FRANCE!  If you follow me on Twitter, you will know that I have been posting there frequently about my excitement about learning to speak French and planning my trip.  And to build on that excitement, I've decided to post about some of the things that make a great trip for me.

Really Nerdy Activities:
I love nerdy things, and the more I embrace this fact, the happier I become.  When traveling, I have no interest at all in the popular shopping district, but I absolutely do want to see the collection of 18th century dioramas/the site where a famous scientist was born/Galileo's middle finger.


When traveling, I seek out the oddities.  I look on Atlas Obscura to find places to visit (Oradour-Sur-Glane is high on my list for France).  I allocate entire days to medical and natural history museums.  And I love every minute of it.




Traveling Alone:
Shockingly there are few people in this world who want to spend hours with me in a natural history museum photographing a dodo bird (A DODO BIRD!) from every angle.  When I travel with another person, it is inevitable that at some point the other person will become impatient and/or I will feel rushed.  Which is quite easily overcome by me simply traveling alone.

While traveling with someone else isn't entirely negative (eating in restaurants tends to be better with another person), I do tend to prefer traveling on my own.  I like having complete control over where I go and what I see.  I like being able to commit a day of travel and four hours on a bus to visiting the seaside town from which the French explorers departed for Canada.  And I like never being dragged out in the evening to socialize with people I don't know.

Flexible Schedule:
Whenever I travel, I tend to alternate between days of "OMG I'm so excitied!  I'm going to see three museums and take a walking tour and take hundreds of photos!" and days of "Cobblestone hurts my feet and I don't like the food here and I want to stay in bed and Internet".  This pattern repeats itself on every trip I go on, and if I ignore my need for downtime and try to push on with the sightseeing, I will inevitably become miserable.  I've learned to build flexibility and extra time into my schedule so that, when needed, I can spend a day on the couch with a block of cheese and a good book and recharge my traveling energy.

Small Cities and Towns:
When N and I went to Europe, we gave ourselves four full days in Rome, recognizing that there was a lot to see.  And for four days we rode on the crowded subways and got catcalled by Roman men and saw site after site of broken columns.  For me, I was overwhelmed by the number of people and by the sense that no matter how much we rushed, we would never see everything.  I learned from my visit to Rome that I prefer the small places to the big.  Small places may not have as many things to see, but I enjoy the sense of being able to see everything, even when I go at a leisurely pace.  And I love the oddities that turn up in small places, which would never attract tourists in a big city, like the preserved two-headed pig in the farming town where my grandparents lived.

Packing Light:
On my first trip, I bought the biggest backpack I could find, and I filled it with everything that would fit in it.  And then I packed a second smaller backpack as a day pack.  Even though I was only 22 years old, I felt like an old woman thanks to the constant back and shoulder pain from carrying my things around.  When I watched the movie Wild, I couldn't stop laughing in recognition at Cheryl Strayed's pack (although, for the record, I did not pack 12 condoms for my trip to Europe).


Every time I travel, my suitcase gets lighter.  I simply don't need much stuff, and I hate hauling a heavy bag into airport bathrooms and onto trains.  On my most recent trip, which was to Quebec City, I took only my camera bag and a carry-on suitcase, and it was still more stuff than I needed.  I will probably need to take a larger bag to France, as I need to bring work-appropriate clothes with me, but you can bet that it will be packed as lightly as possible.  (Leaving room to bring home wine.)

So this is how I travel.  A solitary introvert with a tiny bag and a big camera, visiting the nerdiest places I can find.  My idea of a fun vacation would probably be a nightmare to a more outgoing person, but it works perfectly for me.  Which I think is a good guiding principle for life:  do what works perfectly for you.

*You know you're a nerd when you not only know who Alfred Russel Wallace was but also still feel angry that he didn't get the recognition he deserved for the theory of evolution.