Boiled Frogs and Finding Balance

Have you ever heard that old adage about a frog in boiling water? The one that says if you put a frog into a pot of boiling water it will jump out as fast as it can, but if you put it in cool water and slowly bring it to boiling, degree by degree, it won't move and allow itself to be cooked... can't help but think about that right now.

I have noticed in the last few days how cool the world seems now that I am on radiology and past the last big hurdles in medical school. I realize now how hot it was getting in that pot of water!! It is not just because of my somewhat relaxed radiology rotation, but the culmination of several aspects of medical training which is now in the last half of my 4th year. The first half of the year was spent putting my nose to the grindstone (as if we ever are not doing that) in my field of choice, Emergency Medicine. I did 3 total rotations on Emergency Medicine, one at my home institution and two "away" rotations at other programs that I was considering for residency. On those you have to try hard to be on your game because your scores and evaluations go a long way towards impressing residency programs come application time. In addition, I filled in some free time with Anesthesiology and devoted free time to evaluating and choosing EM Residency programs to apply to. I finished the last set of medical boards required in medical school, the Step-2 CS & CK (hands-on clinical skills and multiple choice clinical knowledge). Then came interview offers during which time you spend all the money you have left in the bank flying all over the country, interviewing at the various residency programs that you open to be accepted into. Sounds easy but your are always "on". Trying to put your best foot forward, dress well in a nice suit (which is totally unnatural for me) and dealing with the stress of canceled flights, long nights in bad hotels, missing your own bed and watching your bank account shrink and your debt increase. All in all, I think I spent about $8000 during that 7 week period of interviews! The final hurdle was my "Triple-I" paper, a research requirement here at my medical school. I had chosen a rather challenging version early in medical school thinking it would be fun, but later realized what an albatross around my neck it had become. A few weeks ago my paper was finished and submitted and that last requirement satisfied. I checked with our registrar one last time to review my transcripts and assure me that all requirements for my M.D. had been met and she agreed.

Now I am on the last of my clerkships, all electives that I thought would be useful, fun and educational for my upcoming Emergency Medicine residency. Now I am on Radiology, half days only and almost all the material really practical and useful for the ED, where we spend a LOT of time reading x-rays, CT scans and ultrasounds of various anatomy. Next, I will be on a hard but exciting sub-internship (Sub-I) in the Trauma and Surgery Intensive Care Unit at our local Level-1 trauma center, Harborview. This is a clerkship where you are supposed to act like a resident, get treated like a resident and manage the sickest patients the healthcare system can generate. Central lines, sepsis, heart failure, who knows.... pretty much scares me to death and at the same time excites me, because I know we have good faculty there and I will learn a lot about managing sick people. Finally, I finish my elective time with Pediatric Emergency Medicine at Children's Hospital in Seattle. My last day is May 8th and residency does not technically start until July 1st, so I will have a little time off for a vacation and to pack and move across the country to whatever program decides I am worthy enough. I have a list certified and submitted, so now I wait until March 16th to find out....

So, what does this have to do with a boiling frog? Well, in the last week I realize that the pressures and stress of the last 4-5 years is now mostly vanished. I still am learning, still taking care of patients, all that you know. What many of us realize now though is that the external evaluations, the hoops and hurdles we are constantly jumping, the feeling of always "being on" is suddenly gone! In the mornings now I wake up early, do some minor chores around my house, sit in the chair near the window with sunlight streaming in with a cup of tea and read a chapter in my latest leisure book, I go to the gym for an hour and ride my bike for half an hour. I come home, shower and go to the medical center for Radiology lectures all afternoon. After that I come home, relax, cook a nice meal of real food from the farmer's market (which I had time to go to) and relax with a glass of wine and a good DVD. Other nights I go out with friends for a dinner party or a beer call at a favorite pub. Suddenly I remember what being human feels like, feeding my mind, my soul, my body... all the parts of my life I have shoved to the side to make room for more brain, more facts, more hoops. I even have been getting my cello out and practicing my scales and even trying an old tune. All this brings back a smile to my face, happiness.... I have more to give, I feel more generous... I feel more like a doctor funny enough where before I was starting to feel angry, a little bitter even. I smile at people on the street rather than trying to avoid them. I offer my free time to help my friends with projects or just to chat. All this allows me to see how tiny I had become, how small my world was and how empty I was feeling... funny, do it step by step over 4 years and you don't even notice the amputation of so much of your life. Well.... perhaps you do notice, but you accept it.

I plan on taking this time before residency to focus on returning my life to a healthy state in all manners before I make my big move. I know residency will challenge me again in many ways, but I will be learning now not to satisfy some administrator or some external hoop... I will be getting paid for my work and I will be striving to learn and excel for my patients and myself. For my own self-respect and the satisfaction at the end of the day that I did well by the people that needed me and my co-workers. This is a big change and a much more powerful and motive force for learning and I can't wait!!!