Wednesday, March 30, 2016


For weeks (months? years?) I've been feeling overwhelmed by work.  My desk has been covered with charts and lab results, my dictation inbox has been overflowing with letters to edit, and I've been weeks behind on my to do list.  No matter how much effort I put in, it seemed like I was never doing any better than keeping the piles from growing larger.  And I hated it.

About two weeks ago, I had finally had enough of all of the things that loomed over me, so I made it my goal to get caught up on everything.  Everything.  Whenever I had a spare minute, I tackled the things that needed to be done.  I went into work early and stayed late.  I worked through lunch.  I logged on from home when I had extra time in the evenings or on weekends.  I worked my butt off, and I got shit done.  And now?  I'm caught up.  There are zero charts on my desk and zero dictations to sign off on.

All done.

It feels amazing.  I no longer want to scream at my administrative assistant* when she brings a pile of lab results into my office.  I have actual time to do the big picture things, like read journal articles and prepare presentations and (maybe someday) finish the article on my fellowship research.  By getting caught up, it is now possible to keep up with the things that come in every day and to stay caught up. 

Best.  Feeling.  Ever.

The only problem?  I'm so used to existing in a state of chaos and panic that I don't know how to function with the stress gone.  With nothing screaming at me to pay attention to it, it's hard to pay attention to anything.  How is a procrastinator to function once they stop procrastinating?

*I have never done this, because I'm not a jerkface.  Any physician who yells at people in his or her workplace (or anyone else, for that matter) is a jerkface.

Friday, March 25, 2016

Notes Towards a Poem That Can Never Be Written

"The facts of this world seen clearly
are seen through tears;
why tell me then
there is something wrong with my eyes?

To see clearly and without flinching,
without turning away,
this is agony, the eyes taped open
two inches from the sun." - Margaret Atwood

Part of my girlfriend's job involves resettling Syrian refugees.  After experiencing almost unspeakable horrors in their home country, these people have now traveled halfway across the world to a foreign city searching for something better.  Which they don't always find.  The cold and the grey of a Canadian winter, even as it begins to melt into spring, isn't always inviting.  The residents of my city too aren't always welcoming towards more people who will need government support (more taxes on the already overtaxed) to establish themselves.  The low-income housing into which people are placed doesn't always match with the image of an affluent Canadian city.  Life here can be hard.

And so they talk.  They talk about many of the sad things from their pasts and about the disappointment that they don't leave the sadness behind when they physically leave their country.  They talk to my girlfriend, and she listens because she's a good person and can feel these people's need to unburden themselves, if only a little.  With each story, each heartbreaking story, some of the weight of their experience transfers from them to her.  Their loads lighten, hers becomes heavier.

And I see it in her.  I see it in how she laughs a little bit less and seems a little bit more distracted when we talk.  I see it when I awaken in the night, and she is already awake, her mind unable to rest.  And I know what it is like, to bear witness to the suffering of others, and to feel powerless.

And I wonder, how do we - the doctors, the nurses, the social workers, the myriad of helpers - stay intact?  How do we witness these things and not be destroyed by them?  How do we keep coming back, day after day, offering what little we have to offer, when all we see is the neverending need?

Sunday, March 20, 2016

Why I Continue to Live the Frugal(ish) Life

One of the best people I met during my fellowship training was our Educational Coordinator, S*.  S is slightly older than I am** and married later in life, so she could empathize with me during both the single-career-woman-looking-for-love and the single-career-woman-falling-in-love stages of my training.  She was also a huge advocate for me and the other fellow, which was invaluable in dealing with a system that was often indifferent and occasionally blatantly hostile to its trainees.  When I finally finished my training, one of the few things that made me sad was no longer working with her on an almost daily basis.  (Everything else was bliss.)

While I liked S from the very beginning, I really bonded with her after I abandoned my spendy ways and started living more frugally.  She would stop at my desk to chat fairly regularly, and one day we got talking about money after she caught me binge reading the great Mr. Money Mustache.  It turned out that she had learned to be frugal while living as a single person, and she'd carried that approach into married life, such that she and her husband currently live off a single income and bank the second one for retirement.  Over the remaining months of my fellowship, we talked regularly about the freedom that comes from living well below your means and about all the sources of happiness that don't require money.  In a financial sense, she and I clicked.

Which is why I was surprised the other day when I ran into her in the hallway, and she asked me "Are you getting used to living like an attending now?"  Her assumption, like everyone else's, was that I had abandoned frugal living as soon as my first fee-for-service patient entered my clinic.  In reality, for anyone who is curious, I'm living on almost exactly the same budget as I did during fellowship***, and every additional dollar I earn is either getting saved or applied to my debt.  Which makes many people (my accountant, my financial advisor, my spendthrift physician friends) ask me "Why?"  They point out, quite legitimately, that I could afford to be more liberal with my spending and to buy a house and a car that doesn't have a giant chunk out of its rear end.  They simply don't get why I keep living like a fellow despite my attending's salary.

For me, the answer is easy:  choice.  As long as I am in debt, as long as I am spending most or all of the money that I earn, then I have to keep working long hours as a physician.  If I buy the big house and the fancy car, then I'm always compelled to earn a high income to pay for them.  Which isn't so bad now, when I'm fresh from training and still somewhat keen, but who knows how I'll feel in 10 or 20 years.  Maybe I'll want to stop working full time and take three-day weekends every week.  Maybe I'll be sick of my subspecialty and want to retrain in another field.  Maybe I'll burn out altogether and want to move to the West Coast to smoke pot.  Who knows?  All that I know is that saving money now, and living on less, means that I can practice medicine because I choose to, not because I have to. 

Even in the short-term, frugality makes life better.  I can work at an inner city clinic, where I earn slightly less ridiculous amounts of money than I would at a tertiary care centre, because I don't have to maximize my salary at the expense of my happiness.  I can say no to extra weekends of call, even though I usually don't****.  I can sleep better at night knowing that I'm within a few months (maybe as little as two?) of having a legitimately positive net worth, even without counting my car.  All of this is way better than a $30 bottle of wine or a $200 dinner out. 

And let's be honest:  I'm really just pretending to be frugal.  I'm not living a Frugalwoods life of 10-cent rice and bean lunches over here.  I'm living off of more than the average family in my city.  I'm traveling to the Middle East in May, and I'm going out for Korean food tonight, and I'm buying weekend passes to our local music festival instead of volunteering.  As my accountant said recently, I'm living a "relatively modest" life.  It's only in comparison to the crazy excesses of many doctors that my life is in any way frugal.  And for that, I'm very lucky. 

*I'm so creative with the names.  You're welcome.

**5 years?  10?  15?  I'm terrible at guessing ages.

***I added $200 per month to my travel budget, because we love to travel and have some big trips planned this year, and I threw a bit of money at my budget to make up for the Great November Debacle so that I wouldn't have to spend a year recovering.

****That will happen once I hit a positive net worth.

Sunday, March 13, 2016

Goals - Looking Back at February and Ahead to (What's Left of) March

This post is a little late.  I've been scrambling a bit to catch up on everything that didn't get done while I was in Montreal, and I've been feeling a lot of end-of-winter blahs, so the blog has been a bit neglected.

I set three goals for myself for February:  Work out three days a week; go see the psychiatrist, and go out with friends/family twice a week.  How did it go, you ask?

Recycled February goal:  Go to the gym three days a week.

Nope.  Didn't happen.  I went a few times at the beginning of the month, and then sleeping in seemed more appealing than exercise (as it always does), and I stopped.  I think I've hit the dreaded point where I no longer believe that I can be successful at this goal, so I'm not even making an effort.  I'm not sure what it's going to take for me to get exercising again, but I do genuinely want to find a way to make this a regular part of my life.  I commented to my girlfriend yesterday that I'm happier and more relaxed when I exercise, and she looked at me as if I'd just said that the sky is blue and responded "Um.  Yes."

Second February goal:  Don't chicken out and skip the assessment with the psychiatrist.

With this, I was fully successful.  Not only did I go to the initial assessment, but I also went to three follow up appointments to convince him that there wasn't something seriously wrong with me and that I just wanted some help learning better coping skills.  (Aside:  I have never been asked about drinking, drug use, and suicidal thoughts as many times as I was in those four sessions with the psychiatrist.  Apparently physicians only seek help when things are terribly wrong, and I'm a bit of an anomaly for wanting some preventative mental health care.)  Having passed the psychiatrist's test, I'm now awaiting the availability of a psychologist who will do some cognitive-behavioural therapy with me.

At some point, I will write a whole post about my experiences with this and about physician mental health in general, but today is not that day.  For the thoughts of another soon-to-be physician on this subject, check out Kay's blog Premed Post-Mom.

Third February goal:  Spend time with people I love.  At least twice a week.  The girlfriend doesn't count.

Yes!  I did this*!  Apparently if I set fun goals for myself, like go out for dinner with my favourite people, I can achieve them.  Over the course of February, I did the following:
  • Took my nieces to see a play about Harriet Tubman
  • Organized a gathering of medical friends to try out a local restaurant promotion
  • Drove to the country to visit my bff from medical school
  • Went to my Mom's house for dinner and to help her move furniture
  • Went to dinner and the theatre with my Mom
  • Met up with a friend from grad school in Montreal 
  • Breakfast at a shitty new restaurant with my Mom 

This goal was a good one for me, as it reminded me that, as much as I love my girlfriend and her people, I get something unique from spending time with my people.  My family and my long-term friends know me and love me in a way that my girlfriend's people don't, and that connection and understanding are central to my happiness.  As an introvert, I am more than able to meet my need for time spent with other people through my girlfriend and her extroverted social life, but it is still important for me to maintain my own social contacts.

The main downside to this goal was that it completely wiped me out.  In addition to the activities that I did with my people, I also spent a lot of time with the girlfriend and her people, and it was simply more than this fragile introvert could handle.  By the end of the month, all I wanted was time in my pjs on the couch with my cats.  Which is pretty much how I've spent all my free time in March so far.  Also...all of the eating out was expensive.  My eating out budget is usually ridiculously high, but in February it was about 50% beyond what it usually is.

March's really vague, non-SMART goal:

For a while I was thinking of not setting a goal for March, as I'm mostly just feeling tired and in need of a break, but then I came up with something that I think I can do even in my tired state, which is kind of, but not really, a goal.

In March, I want to make more of an effort to recognize what I need and to meet those needs.

(See?  Vague.)

For essentially all of my medical training, I didn't think much about what I wanted or needed.  There was always a long list of things that I absolutely had to do, so I just focused on getting them done, regardless of how happy or unhappy I was doing them.  Thankfully, things are different now, and I have much more flexibility to do the things that are important and life-giving to me.  Or, on a smaller scale, to simply do the things that make me calmer and happier from moment to moment.

While I could've tried to make this a defined goal, I've intentionally left it nebulous because the things that I need vary from day to day.  Some days I need to retreat from the world and be with my cats, while other days I need to socialize and connect with the people I love.  Some days I need to be stingy with my budget and save for the future, while other days I need to be self-indulgent and enjoy the results of my hard work.  Some days I need to work less so that I can get enough rest and relaxation, while other days I need to work more so that I can get shit done and stop stressing about it.  Different days, different needs.

I'll let you know how it turns out.

*Technically I only did seven things instead of the eight that would be required to have gone out exactly twice per week, but I'm still counting this as a success.  In part because I achieved the spirit of the goal, and in part because one of my friends bailed on dinner plans at the last minute, so I can blame her for falling slightly short of eight.

Friday, March 11, 2016

Friday Night Purrs (No Hiss)

Oh, what a crabby person I've been this week.  I've allowed myself to be upset about the fact that I was on call and that my office is inaccessible due to a toilet that overflowed one floor above the power room*.  I could write another whiny post about all of the bad, but I'm getting really tired of hearing myself complain, so instead I'm going to talk about the good things (big and small) in my life at the moment.


1)  The girlfriend and I made an extra-large batch of tuna noodle casserole last night, so we got to come home to tasty comfort food that required zero effort.  And it isn't takeout sushi, so it's frugal to boot.

2)  The girlfriend convinced me to not watch Top Chef last night, so I get to enjoy my favourite show on Friday night.  Go Marjorie!

(I was going to insert a picture of Marjorie here, but I realized that I would most likely end up spoiling the episode for myself, so no visuals.)

3)  It is warm and sunny, and I can hear the sound of cars driving through melting snow through our open balcony door.

4)  New books from the library!  My reading goal for the year is to start** all of the books on the Canada Reads longlist, and I have three of them sitting on my coffee table.

5)  As I type this, my girlfriend is making homemade pizza dough for a dinner party on Sunday.  She is an incredible baker, and her pizza is better than most of what you can get in a restaurant. 

6)  Hagen Daas.

7)  Thanks to being on call, I've earned enough to cover all my expenses for the month, so every penny I earn for the rest of the month can go to debt repayment.

8)  If I use very generous calculations and include the value of my car, I'm almost at a net worth of zero.  For the first time in about nine years.

9)  I am only one week behind on paperwork.  After leaving a giant stack of paperwork behind to go to a conference, this is major progress.  Starting work early and leaving late pays off.

10)  Saturday morning brunch date.

What are your purrs for the week?

*Good design there, architect.

**I recently forced myself to finish reading a book that I absolutely hated, because I thought it was "good for me".  All that it really accomplished was that I stopped reading for a few weeks, because I couldn't stand the book.  I've now decided that if I am really not enjoying a book that I don't have to finish it.