I suspect that I'm not the only person in medicine who is a people pleaser. Since elementary school, I've always been very academically successful, and the resultant praise from teachers and relatives has given me a lot of pleasure and personal satisfaction. Going to medical school and becoming a doctor took this to the next level, as suddenly patients and even strangers were regularly praising me for the work I did.
The big problem with getting so much validation externally is that you start to be dependent upon it. You need people to tell you how important you are and how no one else can do what you're doing. And so you constantly seek ways to keep that validation coming. You say yes to giving one more presentation or fitting another patient into your clinic or teaching one more tutorial. Even when you don't really want to be doing any of those things.
Over the past few months, I've been feeling depleted, as I keep telling my partner. I've been feeling overwhelmed by work; I've been having difficulty sleeping; and I've been hit with a bone-weary exhaustion that reminds me of my residency days. I had hoped that a recent trip to a cabin would fix things, but four days away just wasn't enough. I'm tired.
And despite this, people keep asking for more. Start a research project. Do more training. Teach another academic half day. More, more, more, when all I want to do is stay in bed with my cats. It has reached the point where I feel anxious not only when my pager goes off, but also when my inbox pings, signalling the arrival of another email asking for my time and energy.
So this year, I'm going to learn to say no. Thank you for the opportunity, but that isn't my priority. My priority needs to be finding balance, a level of work and engagement that I can happily sustain for the next 20 years, not saying yes to every single request that comes my way. I need downtime and sleep and yoga classes and running and home-cooked food and time with the people I love, not another item on my to-do list.
No.
It sounds straightforward, but it goes against the very essence of medical culture. Physicians pride themselves on being able to work a 28-hour shift and then go climb a mountain on their post-call day. Medicine is the North American worship of busyness and achievement taken to the extreme. Saying no means being inadequate and not measuring up to the standard.
And Medicine doesn't always listen to no. A few weeks ago, I was emailed a request to help someone out with a presentation. My stomach sunk when I read the email, because it was something that I really didn't want to do, even if I had had an abundance of time in which to do it. So I sat on the email for weeks, debating the merits of saying yes versus no, until I finally got up the guts to sent a polite email declining the request.
The response? Within seconds, a return email that basically said "Can you do part of the work for me?".
No!
I'm still completely flabbergasted by the response. Why is my attempt to protect my happiness and my time not respected? Why am I expected to say yes to every request that comes into my inbox?
Learning to say no isn't going to be easy. It's going to mean letting go of the need for other people to tell me how wonderful I am and what a good job I'm doing. It's going to mean letting go of the belief that if I were just better, just like every other physician, that I would be able to say yes to everything. It's going to mean ignoring the blogs of the overachievers, who have a medical practice and children and exercise daily and cook healthy food, and setting my own standards for achievement. Because ultimately no one cares about my happiness as much as I do. And no one else in Medicine is looking out for my well-being as much as I am.
Showing posts with label Being Less than the Person I Want To Be. Show all posts
Showing posts with label Being Less than the Person I Want To Be. Show all posts
Sunday, January 8, 2017
Saturday, January 9, 2016
Testing a Theory
I have a strong and somewhat irrational dislike of people who drive fancy cars. I hate when people think that having money makes them special, and I particularly hate it when they prance around displaying their money to others*. This is a somewhat unfortunate attitude to have as a physician, as many of my colleagues own fancy cars, and I can't help but judge them unfavourably when they park next to my grungy Corolla in a freshly washed BMD with a vanity plate that reads "DOC MD".
I've always maintained that all I need from my car is to get me from point A to point B, preferably without contributing too much to the nightmare of global warming. When asked if I would be buying a new car when I finished medical training (because buying a new car is so much more important than paying off my six-figure debt), I would reply smuggly "I don't want a fancy car. I'm going to drive my car into its grave."
Well.
Yesterday, while picking my girlfriend up from work, I started backing up my car while asking her about how her day at work was going. I was clearly distracted by the conversation, because I drove my car straight into a dumpster. It wasn't a case of seeing the dumpster and misjudging how far it was from my car, but rather a case of completely not noticing that the dumpster was there. I was so oblivious to its presence that it took a moment before I realized that the loud crunching sound was somehow being caused by my actions. Horrified, I got out of the car to discover that my left bumper was completely bent inwards. In a 90 degree angle kind of way.
Amazingly, the damage was purely cosmetic. The rear light was scratched a bit, but the plastic didn't break, and it's still fully functional. And the bumper is plastic, so it won't rust despite the surface being horribly and irreparably damaged.
So, this is my test. I said I didn't want a fancy car and I only needed it to get me from point A to point B; I guess we'll find out whether I really meant it.
*Not to mention the people with fancy cars who do not actually have money and are fools in addition to being snobs.
I've always maintained that all I need from my car is to get me from point A to point B, preferably without contributing too much to the nightmare of global warming. When asked if I would be buying a new car when I finished medical training (because buying a new car is so much more important than paying off my six-figure debt), I would reply smuggly "I don't want a fancy car. I'm going to drive my car into its grave."
Well.
Yesterday, while picking my girlfriend up from work, I started backing up my car while asking her about how her day at work was going. I was clearly distracted by the conversation, because I drove my car straight into a dumpster. It wasn't a case of seeing the dumpster and misjudging how far it was from my car, but rather a case of completely not noticing that the dumpster was there. I was so oblivious to its presence that it took a moment before I realized that the loud crunching sound was somehow being caused by my actions. Horrified, I got out of the car to discover that my left bumper was completely bent inwards. In a 90 degree angle kind of way.
Amazingly, the damage was purely cosmetic. The rear light was scratched a bit, but the plastic didn't break, and it's still fully functional. And the bumper is plastic, so it won't rust despite the surface being horribly and irreparably damaged.
So, this is my test. I said I didn't want a fancy car and I only needed it to get me from point A to point B; I guess we'll find out whether I really meant it.
*Not to mention the people with fancy cars who do not actually have money and are fools in addition to being snobs.
Wednesday, August 26, 2015
Evening Routines
OMDG posted today about her challenge with evenings, which got me reflecting on my own evening routine since starting back at work. When I was on holidays, my plans for my work evenings were very ambitious - cook tasty dinners with my girlfriend, clean the kitchen, take care of housework/paperwork, exercise, and read stimulating and erudite books. Shockingly, the reality has been somewhat less impressive. Despite not actually working that hard yet (I'm only working about half-time at the moment), I've been coming home mentally exhausted every day, and I haven't been able to motivate myself to do most of the things I would like to.
Currently, my post-work schedule looks something like this:
1) Arrive home and dump all possessions (lunch bag, purse, backpack, jacket) in the front hallway. Ignore voice in the back of my head that tells me that I should be putting things in the spaces I created for them.
2) Cook dinner with my girlfriend. This varies from spending 2-3 hours making an elaborate dinner (we love cooking) to BBQing hot dogs and eating potato chips from the bag.
3) Spend way too much time on the computer. Facebook, blogs, news, repeat. I haven't mastered the art of turning off the computer when there is nothing good left to look at, so this eats up a lot of time. On a good day, I write a blog post of variable quality.
4) Watch something on Netflix with my girlfriend. Lately we've been watching Human Planet, which is actually a decent and not entirely mind-numbing show, so it could be worse.
5) Look at the stack of library books on my coffee table. Decide it isn't worth the effort. Possibly watch another Netflix show, usually of lower quality than Human Planet.
6) Feel progressively more exhausted. Resist the urge to go to bed like a reasonable human being. Repeat item #3.
7) Realize it's past my bedtime. Rush around trying to make a lunch, pack my work bag, feed the cats, and do anything else that needs to be done. (Feeding the cats is the only thing I consistently accomplish before bed, and that's only because they meow at me.)
8) Finally get to bed much later than I should. Realize that eight hours of restful sleep has become an impossible dream.
9) Lie awake staring at the ceiling, regretting all of the things I didn't do.
This is something I need to work on, because evenings make up a lot of the quality time I have for myself and my girlfriend outside of work. Looking back on this time of my life, I don't want Facebook and Netflix and a cluttered apartment to be my most vivid memories.
How happy are you with your evening routine?
Currently, my post-work schedule looks something like this:
1) Arrive home and dump all possessions (lunch bag, purse, backpack, jacket) in the front hallway. Ignore voice in the back of my head that tells me that I should be putting things in the spaces I created for them.
2) Cook dinner with my girlfriend. This varies from spending 2-3 hours making an elaborate dinner (we love cooking) to BBQing hot dogs and eating potato chips from the bag.
3) Spend way too much time on the computer. Facebook, blogs, news, repeat. I haven't mastered the art of turning off the computer when there is nothing good left to look at, so this eats up a lot of time. On a good day, I write a blog post of variable quality.
4) Watch something on Netflix with my girlfriend. Lately we've been watching Human Planet, which is actually a decent and not entirely mind-numbing show, so it could be worse.
5) Look at the stack of library books on my coffee table. Decide it isn't worth the effort. Possibly watch another Netflix show, usually of lower quality than Human Planet.
6) Feel progressively more exhausted. Resist the urge to go to bed like a reasonable human being. Repeat item #3.
7) Realize it's past my bedtime. Rush around trying to make a lunch, pack my work bag, feed the cats, and do anything else that needs to be done. (Feeding the cats is the only thing I consistently accomplish before bed, and that's only because they meow at me.)
8) Finally get to bed much later than I should. Realize that eight hours of restful sleep has become an impossible dream.
9) Lie awake staring at the ceiling, regretting all of the things I didn't do.
This is something I need to work on, because evenings make up a lot of the quality time I have for myself and my girlfriend outside of work. Looking back on this time of my life, I don't want Facebook and Netflix and a cluttered apartment to be my most vivid memories.
How happy are you with your evening routine?
Wednesday, August 19, 2015
It Only Took Two Days
As a resident, it used to drive me nuts when I would try to page my attending and he or she wouldn't respond to my page. It was particularly annoying when it was the middle of the night and all I wanted to do was review a case quickly so that I could get to my call room and possibly be horizontal for a few minutes. Whenever it happened to me, I would vow that I would never, ever fail to answer my pager as an attending.
Guess which attending woke up this morning to discover that she'd slept right through a middle of the night page?
Guess which attending woke up this morning to discover that she'd slept right through a middle of the night page?
Tuesday, August 4, 2015
Habits
As I've written about before, part of my motivation for taking so much time off this summer has been to catch up on all the things I've neglected over the past five years: finances, household organization, paperwork (why is there so much paperwork?), and cleaning BBQs, amongst other things. While I've been spending hours of my precious vacation time on these not so enjoyable tasks, I've been thinking a lot about how to keep up with these tasks on an ongoing basis, rather than waiting until things get desperate to play catch up. As part of my attempt to figure out how to do things better, I recently read Gretchen Rubin's book "Better Than Before: Mastering The Habits of Our Everday Lives".
This book explores the ways in which we adopt (or fail to adopt) new habits, with a focus on internal and external barriers to making positive changes. Included in it is a whole chapter on "loopholes", which basically describes what goes on in my mind whenever I try to change myself. (I'm an expert at coming up with reasons not to follow through on my goals.)
What I found most interesting about the book was Rubin's categorization of people into four groups - Upholders, Questioners, Obligers, and Rebels - based on how they respond to inner and outer expectations. I would really like to be an Upholder (one who meets both inner and outer expectations; Sarah from theshubox strikes me as a perfect example), but after reading the descriptions and doing the quiz at the end, I had to resign myself to the fact that I'm an Obliger (one who meets outer expectations but not inner). In the book, Rubin writes of Obligers that "Because Obligers resist inner expectations, it's difficult for them to self-motivate - to work on a Ph.D. thesis, to attend networking events, to get their car serviced. Obligers depend on external accountability, with consequences such as deadlines, late fees, or the fear of letting other people down."
Difficult to self-motivate. Yup. That's me. I could complete my 21 days of regular blogging just by giving examples of how I've had difficulty self-motivating throughout my life*. My Master's degree is the perfect example - it took me forever to get experiments done and papers written, to the point where I nearly drove my supervisor crazy. I actually told her once that if she wanted me to do something she just needed to give me a deadline. And it worked! When I had something external to motivate me, I got my work done without difficulty - even if the "deadline" was entirely arbitrary.
Which brings me to a dilemma. As an attending, I will decide everything that I do. I will decide how many patients to see and when to do dictations and whether or not to do research (etc, etc). There will be no external expectations, aside from some very minimal requirements for teaching and clinical duties, which will not be difficult to meet. How, as an Obliger, do I not allow my life to devolve into chaos in the absence of external expectations?
I still don't know the answer to this one. Maybe I need to re-read the book.
*And then no one would ever read my blog again.
This book explores the ways in which we adopt (or fail to adopt) new habits, with a focus on internal and external barriers to making positive changes. Included in it is a whole chapter on "loopholes", which basically describes what goes on in my mind whenever I try to change myself. (I'm an expert at coming up with reasons not to follow through on my goals.)
What I found most interesting about the book was Rubin's categorization of people into four groups - Upholders, Questioners, Obligers, and Rebels - based on how they respond to inner and outer expectations. I would really like to be an Upholder (one who meets both inner and outer expectations; Sarah from theshubox strikes me as a perfect example), but after reading the descriptions and doing the quiz at the end, I had to resign myself to the fact that I'm an Obliger (one who meets outer expectations but not inner). In the book, Rubin writes of Obligers that "Because Obligers resist inner expectations, it's difficult for them to self-motivate - to work on a Ph.D. thesis, to attend networking events, to get their car serviced. Obligers depend on external accountability, with consequences such as deadlines, late fees, or the fear of letting other people down."
Difficult to self-motivate. Yup. That's me. I could complete my 21 days of regular blogging just by giving examples of how I've had difficulty self-motivating throughout my life*. My Master's degree is the perfect example - it took me forever to get experiments done and papers written, to the point where I nearly drove my supervisor crazy. I actually told her once that if she wanted me to do something she just needed to give me a deadline. And it worked! When I had something external to motivate me, I got my work done without difficulty - even if the "deadline" was entirely arbitrary.
Which brings me to a dilemma. As an attending, I will decide everything that I do. I will decide how many patients to see and when to do dictations and whether or not to do research (etc, etc). There will be no external expectations, aside from some very minimal requirements for teaching and clinical duties, which will not be difficult to meet. How, as an Obliger, do I not allow my life to devolve into chaos in the absence of external expectations?
I still don't know the answer to this one. Maybe I need to re-read the book.
*And then no one would ever read my blog again.
Saturday, August 1, 2015
Dancing
It's 11:19, and I just arrived home from too many hours of wedding, and I'm exhausted. And I stink of bug spray. So this will be short.
The wedding was lovely - a big, spirited celebration of two young women who fell in love at (of all places) bible college. It was wonderful to see so many people from a fairly conservative religious community come together for a wedding that not everyone in their community supports. And the Indian buffet was fabulous.
What stands out most for me about the day, however, isn't something specific to a same-sex wedding. It's the dancing. After the ceremony and eating and many, many speeches, the backyard where the wedding was held was turned into one enormous dance floor, and almost everyone got up and danced. In the beginning, I managed to pass as someone who isn't terrible at dancing, but after a few songs, my energy level began to wane, and my awkwardness became apparent. I suck at dancing.
I wish I didn't. I wish I could be one of the uninhibited people who has a great time on the dance floor, instead of the all too self aware nerd who stands on the edge of the group looking uncomfortable. But that's always been me. And probably always will be.
The wedding was lovely - a big, spirited celebration of two young women who fell in love at (of all places) bible college. It was wonderful to see so many people from a fairly conservative religious community come together for a wedding that not everyone in their community supports. And the Indian buffet was fabulous.
What stands out most for me about the day, however, isn't something specific to a same-sex wedding. It's the dancing. After the ceremony and eating and many, many speeches, the backyard where the wedding was held was turned into one enormous dance floor, and almost everyone got up and danced. In the beginning, I managed to pass as someone who isn't terrible at dancing, but after a few songs, my energy level began to wane, and my awkwardness became apparent. I suck at dancing.
I wish I didn't. I wish I could be one of the uninhibited people who has a great time on the dance floor, instead of the all too self aware nerd who stands on the edge of the group looking uncomfortable. But that's always been me. And probably always will be.
Sunday, June 21, 2015
Screwing Up
There's a resident who is a few years younger than me with whom I've always enjoyed working and whom I would like to get to know outside of work. Her boyfriend is a huge fan of board games, as am I, so long ago she promised to invite me to her house the next time they hosted a games night. A few weeks ago the invitation finally came, and I was looking forward to meeting her boyfriend and bringing some tasty snacks.
This morning, I was driving home from dropping the girlfriend off at work, when I saw a sign advertising monthly games nights. My first thought was "Oooh! I love games nights!". My second thought, accompanied by the horrible feeling that I might spontaneously vomit all over the inside of my car, was "OMFG. Games night was last night."
Yes, after waiting for months, I had managed to completely forget about games night. It was in my calendar; I had reminded the girlfriend about it earlier in the week; I had even thought about what to bring on Friday night. But when the day actually arrived, I'd gotten lost in dreading the multiple presentations that I have scheduled for this week and dreaming about my last day of work*, and all thoughts of games night completely slipped my mind.
This, sadly, isn't the first time I've done something like this. As a teenager, I twice (TWICE) forgot to go to my regularly scheduled after-school babysitting job. In my working life, I've more than once forgotten to go important meetings, usually involving the boss and a collection of bigwigs. A year ago, I forgot to attend morning case conference, where I was scheduled to present one of the patients.
Sigh.
It's not that I'm an idiot. It's not that I don't put these things into my calendar or check my calendar regularly. It's that I get caught up with something else and completely lose track of where I'm supposed to be. And I hate it. After writing a very long apology to the resident, I've spent my day today feeling like a total shit who can't do anything right.
Guess it's time to start setting reminders on my iPhone.
*Thursday. Exactly 95 hours at the time of writing this (check the counter below the Blog Archive for the most recent update.)
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