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 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*).

Patience and Forgiveness

Because nothing says vacation like dealing with your finances, I spent most of my morning today figuring out a strategy for getting myself to a positive net worth*.  Ever since I started budgeting, I've been haunted by the negative on my balance sheet and desperate to get back into the black.

The good news about my strategy session is that I figured out that I can be back to a positive net worth in just 16 months, thanks to having lots of room to invest in an RRSP (Registered Retirement Savings Plan, the Canadian equivalent of a 401(k)).  The bad news is, it's going to take me 16 months.  Which literally feels like forever.

It's hard at times to forgive myself for the financial mistakes that I've made in the past.  There is absolutely no way that I could have made it to this point debt-free, but I know that my burden of debt could have been much less if I'd been more careful with my spending.  And it's even harder to be patient, to refrain from adding more call shifts and more patients to each clinic just to bring my bank balance up.

I have to remind myself, on pretty much a daily basis, that it took me eight years to get to this point.  16 months is entirely doable for getting rid of it.  I just need to breathe.

*My goal is to increase my assets beyond the level of my debt, rather than to pay off the debt itself, because interest rates are currently so low.

Moments When I Love My Job

It has been an absolutely perfect weekend here, which of course means that I have been on home call and working on a presentation that I have to give on Wednesday.  (Grumble, grumble)  To make sure that I didn't completely miss out on the beautiful weather, I made plans to take a break from work this morning to meet my Mom for breakfast and a walk through the largest park in my city.  Unfortunately, while I was showering in preparation for my outing, my pager went off.

"Hi, this is (Surgery Resident who is surprisingly cheerful despite working at least twice as hard as a Hepatology Fellow).  We just admitted (Very Medically Complicated Liver Patient), who is going for emergency surgery today.  We need you to come see him."

(Grumble, grumble)

After phoning my Mom and telling her to delay our plans, my empty belly and I drove to the hospital, staring glumly out the windows at all of the happy people frolicking in the sunny, 25 C weather.  Arriving at the hospital, I went into my best doctor mode, pretending that there was nowhere in the world that I would rather be on a beautiful day than inside a dimly lit hospital ward that smelled of harsh disinfectant mixed with bodily fluids.

When I walked into the patient's room, prepared to re-introduce myself with my standard line of "You may not remember me, but I'm Doctor Solitary Diner", I was met unexpectedly by the most enthusiastic of greetings.

"Solitary!  So good to see you!"

What followed was part medical interview, part in-depth discussion about our respective plans for an upcoming music festival.  Despite not having seen the patient in a number of months, he remembered that I was planning to attend the same music festival as him, and he was eager to confirm that I'd purchased my advance tickets.  (I'm actually volunteering at the festival, so it's free!)

It seems like such a small thing, but this brief interaction was a major bright spot in an otherwise tiring weekend.  It was so nice to feel like I'm not just another random face in a patient's medical team, but that I'm seen as a real human being with my own interests outside of medicine.  And it was important for me to be reminded that the patients for whom I care are distinct people with lives outside of the hospital, not just a collection of lab reports and physical exam findings.  This is why I do what I do.

Not bad for an early Sunday morning page.

Gifts

My birthday was yesterday, which means that I have recently gone through another round of my annual ritual of telling the people who love me "No, seriously, I don't want you to buy me anything".  As soon as I became an adult, with a job and the ability to buy myself the things I want, I stopped enjoying getting gifts.  The reasons for this are many.  I hate getting things that I don't like and having to pretend that I do.  I hate having more things to store in my apartment, which was already full when my girlfriend (who is a hoarder less of a minimalist than I am) moved in.  I hate knowing that the people I love have spent time, which they usually don't have enough of, in a shopping mall instead of with me.  And I particularly hate that gift giving perpetuates our debt-fueled, environmentally destructive consumer culture.

"Surprise! I love you! Here’s a part of the planet I wrecked for you, Hooray!!"*

A few weeks ago, when my Mom asked me what I wanted for my birthday, I tried again to tell her that I didn't want any gifts.  Unfortunately, any time I suggest that she not buy me a present, she looks at me as if I have suggested we go out and murder babies.  The gift-giving mentality is very strong with her.  So I tried to suggest a) alternatives to gifts and b) practical gifts that I would actually use.  I suggested that she give me a certain amount of her time, which she could use hanging pictures and putting up blinds and doing other things in my apartment that are outside of my skill set.  I suggested that she make me a nice dinner at her place and we spend a few hours catching up on each others' lives.  I suggested that she get my medical degree framed, so that I can take it out of the cupboard where it's been collecting dust for the past five years and display it in my fancy-pants new office.  None of these things was acceptable to her. 

So what did I get?  A cheque.  My widowed mother, who is on a fixed income, gave money to me, who will soon be earning ridiculous sums of money as a physician**.  How does this make sense?  How is this better than her hanging the pictures from my trip to Cuba that have been taking up space behind my couch since I moved in five years ago?

Gift giving is insane. 

I encountered another example of this insanity when I was talking to my Mom about my cousin's upcoming wedding.  I am spending money that I don't have to fly halfway across the country for the wedding, so I feel like I am justified in being a bit cheap frugal with the gift.  I suggested to my Mom that I was going to get a $50 gift card to the store where my cousin is registered, and she once again looked at me like I was heading out to murder babies.  She thought I should be spending closer to $200 on the gift!  What?  Why should I, who am trying to dig myself out from a giant pit of student debt, be spending ridiculous sums of money on a gift for my cousin (who has a job) and her soon-to-be husband (who also has a job)?  Why is this the expectation?

Rant over.  Thankfully it's another seven months until I have to deal with Christmas.

 *I've been obsessively reading Mr. Money Mustache for the past month or so, and it is transforming my approach to spending and debt.  The article that I linked to is one of my personal favourites and describes my feelings about gift giving much more eloquently than I can.

**Admittedly, I will be using these ridiculous sums of money to pay off my equally ridiculous debt...but that's not the point.

Shopping Woes

Earlier this week, the girlfriend and I were watching a documentary about people who are transgendered, and we got to discussing whether either of us had ever wanted to be male.  While neither of us has ever felt any particular desire to be a man, we both recognized that being part of the opposite sex would bring a few advantages.  For me, I would love to never, ever again be mistaken for a nurse.  Not having periods would be awesome.  And today, as I was wriggling into and out of ill-fitting work clothes at the mall, I was reminded of how much easier men have it when it comes to clothing.

Men's work clothes are simple:  dress pants, dress shirt, tie (if a bit formal), and jacket (if more formal).  Done.  My male colleagues can spend 20 minutes in a store and walk out with enough clothing for a year. 

Not so much for women. 

Instead of a classic suit that fits everyone, women get to contend with multiple styles of pants, skirts, and dresses, none of which seem to have been designed to look good on a real live woman who actually consumes food.  And then there are the ridiculous tops, which are one or more of too see-through, too low-cut, too gaudy, or too difficult and time-consuming to wash to be worn in a professional setting.  Seriously - what resident wants to spend their limited time off hand washing their work clothes?

Not this resident.

Can we just agree to let all doctors wear scrubs?