Paradox

When I was in medical school and considering my specialty, someone said to me: “You can train anyone to be a good obgyn.  What you can’t do is train someone to be a caring, kind, and compassionate human being.  People will see that about you and above all, that will stand out.”

Last week I had coffee with one of my current preceptors.  This man interviewed me when I applied to residency.  When I was accepted into this program, he told me that I was his favourite applicant that he’s ever interviewed.  He said I had a passion for life and a light about me that made him know instantly that I would make a great obgyn.  At our little coffee date last week he said to me: “Aggie, I have noticed that you are not the same person today that you were when I interviewed you.  I am so disheartened to see that our program has stripped away the best parts of you in an attempt to make you a good surgeon.  I don’t know why we do this to our residents.”  He continued, “I just wanted to tell you to not let residency win.  This is finite and when it is over, I hope that you will go back to being that person I remember from your interview.”

Both of these people, people I’ve respected and considered mentors, have spoken such true  yet conflicting statements.  In training to become the type of physician I want to be, I have lost the aspects of myself that would make me the kind, caring, and compassionate physician I imagined becoming.  Within this paradox lies my problem.  Can I ever come back from this?  Do I turn around now and work on nurturing myself back into the person I used to be, or do I risk continuing down this path I’m on and perhaps never recovering what I’ve lost?

Is there a right answer?

A Break From Authenticity

Last night I picked up my copy of Brené Brown’s Daring Greatly. This book has been sitting on my shelf, unread, for almost three years.  My mandate to begin “Living Authentically” started shortly after I read Brené’s earlier published book, The Gifts of Imperfection. Since moving, starting residency, and having another baby, my goal to read Daring Greatly kept getting pushed to the bottom of my list.  Within the midst of my current existential life crisis, I decided it was time to pick up the book and stare Wholeheartedness right in the face.

I didn’t even get through the prologue before realizing that I no longer live, or even embody, the qualities of wholeheartedness and authenticity.  Maybe I used to, but in the struggle to keep up and keep going, I’ve let these important aspects of my life fall to the side.

Our willingness to own and engage with our vulnerability determines the depth of our courage and the clarity of our purpose; the level to which we protect ourselves from being vulnerable is a measure of our fear and disconnection

~Brené Brown, Daring Greatly

The one thing I know for sure is that right now, I have no clarity of my purpose.  I am filled with fear and disconnection from my life and my purpose.  I feel confused and I lack direction because my viewpoint on life is clouded by outside expectations, judgement, and comparison.  My internal dialogue is lost and disguised by everything that defines fear and vulnerability.  These definitions were very well delineated by Brené Brown in The Gifts of Imperfection and I know that reading that book changed my life.  I blogged about that change on the old blog and I will find that post to re-post here in the coming days.

Ironically, The introduction to Daring Greatly literally reminded me of these imperfections and what needs to be shed from my life:
1. Letting go of what people think
2. Letting go of perfectionism
3. Letting go of numbing and powerlessness
4. Letting go of scarcity and fear of the dark
5. Letting go of the need for certainty
6. Letting go of comparison
7. Letting go of exhaustion of a status symbol and productivity as self-worth
8. Letting go of anxiety as a lifestyle
9. Letting go of self-doubt and “supposed to”
10. Letting go of being cool and “always in control”

Each of these ten imperfections, every single one of them, comprise the mental roadblocks that I am struggling with right now.  These imperfections are preventing me from committing to the decisions I am faced with in my life today.  I need to lean-in to my fears and rediscover my vulnerabilities.  I need to embrace them and re-discover my own authenticity

 

Queens Don’t Fail

 

 

Last week a friend of mine from medical school send me this snapshot from a book she’s reading: Constance Halls, “Like A Queen.”  She felt that this sentence embodied me.  Just the day before I told her that I was considering a specialty change.  I confessed that one of the feelings holding me back was that of failure.  In my mind, switching means failure.

The past few weeks have been a challenging time for me.  For years now, I have thrown around the idea of changing specialties in medicine.  Initially, the idea started because I struggled greatly with my work life balance: there is no room for family life in a surgical residency.  When A. was diagnosed with ASD, I took some time off and realized that I needed to give more to my family.  Despite that, I tried for a long time to convince myself that as long as I loved my job and enjoyed what I did while I was at work, the sacrifices at home would be worth it.  I honestly believe that, even now.  However, as more time goes by, I wonder if I really do enjoy my job as much as I tell myself I do.

Lately I find that I haven’t been as interested and engaged in my work.  I do my work and I take care of my patients, but I haven’t really been enjoying myself.  I wake up in the mornings dragging my feet and I spend a large proportion of the day waiting for it to come to an end so I can get home to my family.  Surgery is technically challenging and pleasurable, but I don’t feel passion when I am in the OR – Just a sense of obligation.  My call shifts are becoming more and more onerous, especially as they stack on top of each other: all I want to do is sleep.  When I think ahead to the heavy rotations, the year of being chief resident, and the studying that is going to have to happen, I cringe.  I know that not too far from now, I will have to neglect my family even more than I do now for an entire year if I want to pass my board exams.  And, I just don’t think I’m willing to make that sacrifice.

So, does that mean I need to change my goals?  Or am I just experiencing a bad case of burnout?  Maybe a little bit of both?  Is this really a good time to make a change in career paths?

I feel dissatisfied at work and I feel like I am falling short as a caring and engaged mother when I am at home.  I know, for certain, that these two feeling are not exclusive of one another.  Together these feelings play into a vicious negative-feedback cycle: I dislike my job because of how it affects my family life, and I feel guilty about what happens to my family because of how much I commit to my job.  Inadequacy in all aspects of life make for an unhappy life.  Despite all of this dissatisfaction, I feel frozen and unable to make a decision on how to move forward.  Staying in the same place, expecting things to get better feels like the wrong decision.  Yet, committing to change, admitting that I’m not happy, and taking a new path is frightening and feels like failure in disguise.

All these thoughts, ideas, and stressors have caused havoc in my mind.  Just a few weeks ago, after decideding to move ahead with the change, I felt empowered and giddy with excitement that I was taking control of my life.  That excitement has now completely dwindled away to leave only more anxiety and fear over the decision.  I fear that I am making this decision for the wrong reasons and that one day I will regret not “sticking it out.”  But I also fear the perception of failure.

I know I could finish this if I tried (and if I wanted to).  But is it what I really want?

 

Impressive Has No Value

“There is no value in being impressive,” I said to her while gazing at the baby in my arms. “I used to care about impressing people, about being the person that people would take a second look at. But, people don’t care about impressive. They care about themselves.”I punctuated the last thought by starting right into her eyes. I have never said something more true in front of her. It was the first time I said it aloud; the first time I actually believed it to be a real truth.

“You’re right.” She smiled back at me.  

I looked back at my baby, who was holding my hands while tentatively attempting to explore the world around her. El had been to every appointment in this office since she was born. I sat on this very couch while I was pregnant, agonizing over how a third baby was going to fit into my already hectic and hard to manage lifestyle. And before that, I sat on this same couch weighing the pros and cons about the decision to even have a third pregnancy. Over the years, these conversations with my therapist have been plentiful, yet none have been more revealing to me than this one.

My gaze became out of focus as I explored this new truth that spilled from my lips. I thought back over the past few years and over the decisions I made that brought me to where I am today. I felt a sense of sadness and anger come over me. The desire to impress had taken over my whole life. It had distracted me from the aspects of my life that were most important to me. I lost track of what I should have cared most about, and instead, I moved to impress other people. I never, however, impressed myself.  

The past few years of my life have been a whirlwind of stress, anxiety, unhappiness, and discontent. And, I can’t take that back. Maybe people were impressed with me at some point: “I really don’t know how you do it all…” they’d say. But that moment only lasts for a second before they go back to caring about their own lives.

Caring about their own life: Something I should have been doing this whole time. I looked at baby El and realized that she and her brothers are the only ones who deserve my efforts to impress. And ironically, they don’t need to be impressed by me to love me and want me, and for me to the he most important person in their world. 

I regret the years I’ve wasted trying to impress other people. I know where the desire came from and that it was something engrained early and deep in my childhood insecurities. This epiphany – the sudden absence of my desire to impress – is a sign that those longstanding, deeply seeded issues are slowly being resolved. I walked away from the appointment with a renewed sense of clarity and purpose about how to move forward in my life. I stepped over the threshold from treatment room to a new world with a completely different approach to living my life. 

That simple sentence. One simple thought. An enormous truth that has remained hidden from my reality for far too long. My acceptance and belief in that one thing has already affected change in my life that I never thought would happen. I already feel happier. 

Tales of Tired

I could start off the New Year on my blog by saying that I’m going to blog more often.  Or perhaps, it might be more appropriate to apologize for disappearing and not blogging for an inordinate amount of time.

I am sorry that I haven’t been around.  I am sorry that I haven’t been reading everyone’s blogs.  I know how it feels sometimes when bloggers “disappear” and you never really know why.

I’d like to think that this year I will get back to blogging more regularly.  The truth is that I do really miss it.  I think often, usually daily, about what I would write on my blog if I just had the time to make it here… If I just wasn’t so tired.  My phone is filled with notes containing one line thoughts and ideas that would make for good blog topics.  I have pictures and interesting nuggets that I imagine sharing.  But I also miss writing – and being a good writer, at that.  I used to be an amazing writer and I used to have profound things to say.  Now I don’t know where that all went.  I want my blog to mean something, even if it only means something to me.

The real truth, though, is that I’ve been so tired.

Since I started back at work, it’s been a inordinate effort to ensure I am giving off the right message of interest, commitment, and hard work.  I can’t afford for even one person to think I could do better, and that is exhausting.

Three kids is a whole lot of tired, too.  It’s been an exciting ride, and little El is already 8 months old.  I’m not sure how that amount of time has flown by, but it has and I am still managing.  I find it a challenge to really give each of my children the time they deserve.  I especially feel bad for E, my middle child, who is at that horrible age of 4-5… he’s straddling the line between toddler and kid and he embodies the worst characteristics of each one.  It is not my favourite age; I did not like it when A was that age and I suspect I will not like it when El is that age either.  And so I feel that I fall short as a loving, attentive mother to E.  Feeling like I need to do better is tiring.

Breastfeeding while working an 80 hour week with call shifts… now that is a whole new level of exhaustion.  I love breastfeeding.  I am already sad thinking about the possibility of it ending.  I still exclusively breastfeed El when I am home and I pump all the milk she drinks while I am away.  Finding time to pump between clinic patients and OR cases is like trying to solve an impossible puzzle.  Amazingly though, I leave each shift with enough milk to fill El’s bottles for the next day.  It is fulfilling, even though I loathe being attached to a breast pump each and every day.

Not having time for myself is also… just tiring.  I haven’t been running.  I haven’t been reliably going to Taekwondo. I haven’t been getting pedicures, or going for massages, or blogging, or doing anything other than working, mothering, and pumping milk.  I want to do better and hopefully (paradoxically) this will lead to less “feeling tired.”

I will set some goals for this year, like I did the past two years.  I’m optimistic that this will help with getting me back where I want to be.  I was extremely successful with this endeavour in 2015 (which was documented on my old blog, before I had to close it down), but looking back at the goals for 2016, I was very far off the mark.  I still need some time for reflection on what these goals will be, but I know they will follow a similar pattern of fitness goals, wellness goals, and personal life goals.

Maybe the first goal will be: “To be less Tired.”

And to achieve that, I should probably get to bed.

A Different Decision

We face decisions everyday.  Some are those types of decisions that are made without even thinking: Starbucks coffee? Pants or shorts? Dinner in or dinner out?

But what about those decisions that feel impossible to make?  Those decisions that seem to have no right and no wrong choice? Each choice is equally good and equally bad… So the decision becomes an impossible one to make.

Or maybe there is a clear right and a clear wrong to the decision, but you are just unable to elucidate which is which.  There are those times when the wrong decision feels like the right decision and you get fooled into making the wrong choice.

Has this happened to you?

My maternity leave is coming to an end.  I specifically chose to only take 5 months of my full year leave because I didn’t want to put myself too far behind in my training.  I don’t want my surgical skills to wane, I want to write my exam on time, I want to stay with my cohort of colleagues, and part of me misses work.

The trade-off: I could spend a whole 7 more months at home with my kids.

I don’t feel ready to go back.  The time I have had off feels like it has been stolen from me because I’ve had to deal with work problems while I’ve been off.  We are losing our nanny and my husband doesn’t want a new one; therefore, our childcare situation going forward is rather precarious.  I feel, deep down inside of my soul, that going back to work in two weeks is going to cause my home/family life to spin out of control.

Lately I have been thinking more about extending my leave and taking off my full year.  The reasons I made the initial decision haven’t changed, but I feel like priorities have shifted.  Despite this shift, I find this decision is still impossible to make.  There is no clear right or wrong, and the advice I get from everyone I talk to is the same: Do what’s best for you and your family.

Unfortunately, I feel like what’s best for me and my family is not very clear right now.

The Assault

I almost didn’t go.

He threw punches hard – right at my face.  I kept my hands up to protect myself, but it took all my strength to stop the blows.  I focused every ounce of my attention on blocking his fists as they came barreling towards me.  He hit hard – he was the same height as me, but at least 50 pounds heavier – all muscle.  And I was still weak, recovering from the recent birth.

I wasn’t ready. The roast chicken was just finished and straight out of the oven.  The kids weren’t even fed yet and Husband was still at work.  There was no way I could go, even if I wanted to.   My phone buzzed – A message from Husband: Are you going?  I’ll meet you there to pick up the kids… Don’t worry, I’ll feed them later… I don’t want you to miss it because of me.

It was my turn now.  I finally got my opportunity to hit him.  I used all my strength, but there wasn’t much.  I wasn’t very coordinated either: punching someone’s face is just not something that comes naturally.  Left fist jab, right fist power… those were the instructions, I remembered.  All my power was barely enough to make him flinch.  He took them though. He let me hit him and I gained confidence in my ability.  I didn’t stop for a full minute.

I rushed up the stairs to change, leaving the golden chicken, half carved on the cutting board.  I yelled down the stairs for the kids to get ready to leave.  I packed up the baby and into the van we piled.  I was going to be late, but that’s better than missing it entirely.

I’ve met him before; a polite, older gentleman… it seemed.  He used to come with his son, but it’s been a while since I’ve seen the teenage kid.  We’ve exchanged polite pleasantries in the past, but we’ve never really spoken more than that.  Nevertheless, it was obvious that he was strong and that I would never stand a chance.

Husband arrived shortly after I did.  He ushered the kids out and left me there for my class, alone.  It was glorious to finally have my time to myself.  After a day of hashing out work issues and my recent discriminatory evaluation, I was deflated, exhausted, and feeling defeated.  I wasn’t really in the mood for conditioning, but I figured the physical activity would be good for me.

After I finished my round of punches, he started at me again.  This time he added in the elbow strike to the face.  Here was my chance!  He was stronger than me, but in his older age, he lacked the coordination to properly execute the move.  He was slowing down with each change of motion.  The blows were not as hard.  If I wanted to, I could have overpowered him in this weakness. But I didn’t.  I let him finish.

The conditioning circuit was a challenge, even after being back for almost two months.  Fifteen stations, one minute each, with a fifteen second break in between.  My heart was racing but I was starting to feel better.  I’m glad Husband forced me to go… this is what I needed.

Another minute was over.  I had gained confidence after seeing my opponent’s weakness.  It was my turn.  The elbow strike to the face was challenging, but I adapted quickly.  Now it was him who almost couldn’t keep up with me.  Left jab, right power, left elbow to the face.  Harder and Harder each time.  More speed.  More power.  I didn’t even see my opponent anymore.  Instead, I imagined hitting the face of the person responsible for all the stress and anguish I’ve been through.  It felt good… No, it felt exhilarating!  One minute was not long enough.

When the circuit was over, it was time for some partner work.  My usual partner is another woman similar in age to me.  We met up to start the drill.  However, we were separated because she was much shorter than me.  For this drill we needed to be similar heights. I was matched up with the older gentleman.  I worried that I wouldn’t be able to match his strength well.   The instructor then handed out the hand pads and explained the drill.

One last drill: him first, then me.  Left fist jab, right fist power, left elbow to the face, right elbow straight up under the chin.  Yes!  One more power blow to really drive it home.  I held the pads for my opponent while he struggled with the coordination of the drill.  I spoke the moves aloud to help him with his concentration.  I wasn’t vulnerable anymore.  I had the power.  I gave him the pads after his minute was over.  Now it was my turn.  With each successive drill I gained power and confidence.  That jerk, with that smug, “I have power over you” look on his face stood no chance.  With each impact my body made with the pads I imagined him struggling and reeling in pain.  YOU HAVE NO POWER OVER ME.  I AM STRONGER THAN YOU.  My minute was over.  My fists were sore, my elbows raw.  But in my head I saw his face, dejected, battered, and bruised.  I had won the fight.

The punching drills were challenging, leaving my arms tired and sore by the end.  Regardless, I felt great.  I dropped the pads to the floor and faced my older, male partner.  We shook hands and bowed towards each other.  I thanked him, and him me.  “You’ve got quite the power and coordination,” he said to me.  “Great Job.”  I felt a small amount of guilt imagining beating someone else to the ground, but I quickly shook it off. He deserves it, even if it’s only in my imagination.  I was thankful that I scrambled to come to class.

And in my victory, I went home to eat my cold roast chicken.  It was delicious.

Unravelling

She sat at my kitchen table with her foot resting on the chair and her knee pulled up to her chin.  Her blond hair perfectly placed in a messy bun, juxtaposed against my un-purposed messy morning hair.  We planned a coffee date for first thing in the morning, after she dropped her kids off at daycare.  We picked my house because the baby likes to sleep late.  She had a lunch date with another friend later that day: she was trying to fit in as many visits as she could.

“What can I get you to drink?” I asked as I instinctively placed a mug under the coffee maker. “Coffee?”
“No thanks, just water,” She replied. “I’m changing the way I eat.  No coffee, nothing processed.  I want to make my body as strong as I can.  I’m getting ready to fight this.”
I wasn’t sure if she wanted to talk about it.  I said I was going to take her lead.

We met the year before at Taekwondo.  Her oldest son was in my youngest son’s class.  For weeks we would sit and talk about the superficial realities of life: Work, kids, husbands, weather… Slowly, our friendship developed and we would occasionally meet up outside of the gym.  I’m always happy to make new friends.

“So, when did this all start?”
“Remember back in February, when I had pneumonia?”

She was gone for weeks from Taekwondo, I remembered.  She came back and it seemed to take ages for her to fully recover.  When the snow started to melt, I ran into her in the neighborhood, walking with her husband and two boys – it was the first time I had ever met her younger son, who wasn’t more than three.  We vowed to have a playdate with the kids once the weather was a little nicer.

“The chest pain never went away, so they did an x-ray and they found two spots.  I had a biopsy.  Then I had a CT scan.  Then they wanted a PET scan.”
I listened intently, trying not to ask too many questions.

A few months ago we all went out together for a friend’s birthday party.  Our friend was turning 33.  Just like me… and just like her.  We joked that 33 would be the best year; it had to definitely be better than 32! And we toasted to that, them with their wine glasses and me with my diet pepsi (since I was pregnant and all).  We vowed to have more get-togethers after that – but we didn’t

“They found a few spots in my hip bones and in my leg bones.  I’m going for my first appointment with the oncologist on Wednesday.”

Wednesday was my birthday.  There would be not be another toast to 33 on my birthday.  No this time.

“I’m going to tell her that I don’t want timelines and I don’t want numbers.  I’m going to beat this.  I know I will!”

I painted a reassuring smile on my face and placed my hand over hers.
“Of course.”

I waited until she left to feel the sadness and the heartache – for her and for me.

I don’t think I could ever be so strong if I was diagnosed with Stage 4 Lung Cancer.

 

Tempered Expectations

Every year I dread the arrival of my birthday. It is such an anti-climactic day and for years it always felt like something was missing. 

Maybe it’s because when I was a kid, my birthday was a big and special day – and now there is nothing special about it. 

Maybe it’s because my husband is not the kind of guy who celebrates anything, my special occasions included. 

Maybe it’s because I have this idea that everyone around me has more exciting birthday experiences than I do.

Maybe I’m just getting old. 

Whatever it is, I always feel like it could be more. 

Today was different, though. I had no expectations. In fact, I expected that it would be nothing special and nothing more than any other day. And because of this tempered expectation, I was not disappointed when there were no big hugs and kisses and home-made cards from my kids. I was happy to spend the morning getting some exercise and getting to know a new friend. We had a nice family dinner at my favourite restaurant,  and I was pleasantly surprised when my husband gave me a birthday card with some thoughtful words written on it.  The only birthday gift I got today was a free birthday drink from Starbucks. 

It wasn’t exciting and it wasn’t spectacular, but I wasn’t disappointed – and that’s better than most birthdays. 

Finding Myself

“One of the greatest tragedies in life is to lose your own sense of self and accept the version of you that is expected by everyone else.”
K.L. Toth

lollipop

Image Credit: Google Images

How do we know when we are on the right path in life?
How do we know that we made all the right decisions for all the right reasons?

I have come to a crossroads, perhaps a crossing of paths like the one famously described by Robert Frost’s most quoted poem.

I’m acutely aware of a dissonance in my life – the two largest parts of my life suddenly seem to clash with each other.  I am not a happy mother because I know that when it comes to my kids, I have sacrificed more of what they need of me than makes me comfortable.  I am not a happy resident because I’ve come to realize that perhaps the amalgamation of my parts – the very aspects of my life that make me the person I am – does not completely fit the criteria of what my superiors want to see.

I cannot take more away from my life at home – from my children; from me – and force myself to become someone who isn’t really the person I am meant to be.  If I continue down this path, I know that at the end I will be more unhappy than I am right now.

Unfortunately, the other path is scary, unknown, and not what I ever imagined in my life.  I don’t know what the end will look like or what I have to traverse to get to that end.

What I do know is this:
I am a mother to three beautiful children, and that should be celebrated.
I am a physician who is caring and compassionate, and that should be valued.
I work hard to bring balance to my life, and that should be what matters most.

I love my job, but do I love my job enough to let the other pieces of myself wither away?