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?

 

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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.

I AM The Milk

“Why are you so worried about your milk? He asked, after I broke into tears.

It was 7am and I couldn’t help but let the pooling tears run down my cheeks.  I had been awake most of the night feeding El, who just never seemed to be satisfied.  The day before had seemed a pointless day to wear a shirt and bra, because my breasts were out all day, on demand to her.  She was finally asleep, my breasts were empty and deflated, like they had been all night, yet the mere thought of feeding her left me leaking more than just tears.

Maybe I have been obsessed lately.  I know El has a small tongue tie, and I know what that could mean for our breastfeeding relationship.  I have mentioned it to everyone from the postpartum nurse in the hospital, to the pediatrician who looked after her there, to the home care nurses drawing her bilirubin, to my own family doctor.  Everyone just keeps telling me not to worry about it because she’s feeding and growing well.  But her latch is shallow.  I know it could be a lot better, and I fear that while she gets enough milk now, she might not get enough in the future.  I love breastfeeding my babies, and she is the last one.  I want to breastfeed her for a long time.

So, why shouldn’t I obsess?  This beautiful baby was part of me – she came from my own body and flesh.  Now that she is born, she is still part of me; everything that provides for her, nourishes her, and keeps her happy and alive is from me.  She knows my voice and she knows it means comfort, fulfillment, closeness, and love.  I am the only person in her world who can give her all of that by simply holding her in my arms and offering her my body.

It is not just milk.  That milk is me.  I AM the milk.
My beautiful baby drinks me in and for those minutes – those hours – we are one again.
I am not ready for that to end, so I can’t help but worry about my milk.

The Real Struggle

I woke up this morning feeling like today would be a struggle.  I have these days every so often, and it is always the same thoughts and issues that plague me.  I feel lost and lonely – like I haven’t navigated my way through life very well at all.

I am days-to-weeks away from having a third baby.  For this whole pregnancy, and even the months leading up to it, I have questioned whether this is a reasonable step to take in my life.  I obviously can’t go back and change things now, but it doesn’t make me feel any less stressed about how everything is going to fit together in the coming years.

I know I should be looking forward to my maternity leave, and I *kind of* am.  But I am nervous about what I’m going to do with all that time at home!  I know I’ll be taking care of my baby and for the first weeks I will be so exhausted that I won’t know night from day (can you tell I’m looking forward to this?), but sometimes I find that my home is not the peaceful, relaxing place where I imagine spending my down time.  There is so much to be done around my house: teach my nanny how to cook, deal with the clutter that has accumulated over the time that I’ve been neglecting housework (and letting my nanny do a sub-parr job of keeping up), figure out how to discipline my children, decide if I need to hire a new nanny (since the one I have seems to have difficulty with all the above things that I have to remediate)… That just part of the home list.

Then there is my anxiety about work.  Failing my exam has certainly not made me feel any better about my position and my performance at work.  I know that I likely didn’t prioritize studying as much as I would have it I actually had to pass the exam.  However, I feel like it reflects poorly on my ability to balance my work like and my home life, and in the coming weeks that struggle is only going to get worse.  Add in the fact that I am going to be taking 5 months off work and will be that much behind – I feel like I am going to have a target on my back, setting me out as “the weak one.” Any why am I the weak one?  Because I have kids and a family, and I can’t make my work my top priority all the time – especially when something in my work world doesn’t really matter (like a test that I don’t need to pass).

I struggle with finding people to connect with in my life.  All of my good mommy-in-medicine friends are back in the place I left behind when I moved here for residency.  I have yet to find some good friends here.  I marginally succeeded in finding some out-of-work friends, but since work has gotten so much busier in the last year, those relationships haven’t been well maintained.  Not to mention, I can’t really talk about most of my difficult struggles with them… I mean, when someone tells you they had a bad day because their kid’s school bus was late so they missed their aerobics class, how do you respond when your bad day was doing a STAT c-section on a full-term baby who didn’t survive?  And there is the opposite situation with friends from work.  All my co-residents are wonderful people, but most of them don’t have kids and that makes it very difficult to commiserate with them.  Who can I talk to about my feelings of inadequacy as a mother, or about my decisions to prioritize my life differently because my kids and my family are an important (arguably the MOST important) part of my life.  Mostly, I feel like this position is a very lonely place to be and I don’t know how to make it better.

I’m sure that in a few days I will be feeling better than I am today.  For today, though, I have to push through the discomfort of the struggle.

 

Nearing the End

This afternoon I will be writing the first part of a two-part surgical exam.  This exam is the reason I haven’t been around blogging and reading other blogs much in the last few weeks.  I just want this exam to be over.  The saddest part about this exam is that I don’t even need to pass it – it is the biggest waste of money and time away from my kids and my life ever.  However, when is a Type A personality like me ever going to be okay with failing a test?

Don’t ask me too much about the reasons why I need to write an exam that I don’t actually have to pass – it’s all “politics” within my residency program.  Let’s just say that after tomorrow, it will be over and I can stop feeling guilty about being poorly prepared for it and for spending time away from my kids to prepare so poorly.

I am also nearing the end of pregnancy.  I have, though, reached that point where I wish the end was here now.  I have begun suffering from the “pregnancy insomnia,” to help round off the extreme fatigue I had before that. My poor pubic symphysis is ready to tear apart and my left SI joint is in collaboration with the pubic symphysis to make all daily activities a living, painful nightmare.  My physiologic dyspnea is getting worse and I am starting to have tachycardic, bordering on pre-syncopal episodes every day.  However, I don’t want to start medication for this because I am so close to the end, and I remember from my last pregnancy that the medications just made me more tired.  Plus there is all the other non-pleasantries that go along with the end of pregnancy.  Almost 35 weeks!  The end is close!

I am stressing out about the end of work, as well.  I am still having a hard time accepting the idea that I am taking off the next 5 months of my training – and postposing the completion of my program by as much.  I feel lost with the idea that I will fall behind my cohort of residents, but that i won’t actually be part of the new cohort – I will be floating in this in-between, neverland space, like I already feel I do in most of my life.  I know I am taking this time to be with my baby and with my family, and I will never get it back, but I can’t seem to get over that right now.  I am also supposed to be starting a new, 4-week rotation next week and I am uncertain as to how it will go.  Will I be able to finish enough of the rotation that it will be considered complete?  Will I be able to stand all day in the OR?  Will people just wonder why the heck I decided to try and work right up until I go into labour, instead of taking time off to relax and prepare for the baby’s arrival?  I just don’t know!  I am motivated to finish this rotation because it means that I don’t have to do it when I come back from my maternity leave (and I don’t have to do call right now, so that makes it more pleasant).  However, I just want my pregnancy to be over and the change over from one rotation to the next seems like a good time for this baby to come!

Despite wanting this pregnancy to be over, I am actually really nervous and scared about the changes that come along with bringing home a new baby.  Like most people, I hate change.  I fear change.  I feel like I am in a holding pattern, waiting for this monumentous change to happen so that I can stop fearing it.  I am beginning to feel sad that the life as I know it, with my two boys, will be over soon.  I remember feeling this way before E was born, but he came only such a short time after A and there wasn’t much of a family routine at that point.  But this baby… she’s coming after 4 years of us being a family of 4.  We have family vacations, traditions, memories, and a large family portrait of the four of us over our mantle.  This is a really big change and I’m not sure I’m ready for it.  I feel very out-of-touch with the reasons why I wanted a third baby; now that she is almost here, I fear that having three kids won’t be what I expected it to be.  Obviously, there is nothing I can do to change this now, which leads me back to the beginning of my circle: I just want it to be over so that I can stop worrying and fretting and just live!

 

Distressing Dreams

The past has been coming back to haunt me.

Over the past few weeks I have been having a series of distressing and upsetting dreams about people and events from the past.  I have spent an inordinate amount of time trying to process and accept the misfortunes that serve as the basis for these dreams, but clearly, they are still stirring around in my subconscious, waiting to haunt me at the least opportune times.

It is coming up on that time of year again: the residency matching saga where medical students scramble to apply to, interview, and eventually get offered (hopefully) a residency position where they want.  If you followed my old blog, you will know how distressing of a time this is for me.  If you are new to my blog, I’m sorry that this post will make less sense to you – I will try to find a way to explain the terror that this time of year was for me when I went through it a few years back (perhaps in another blog post).

Intertwined in the match saga is the surge and then eventual demise of my relationship with my old friend and mentor, Kay.

Unfortunately the dreams that have been occurring lately have all involved Kay or other people that elicit the painful and undesirable memories that this time of year holds for me.  I know that my current levels of dissatisfaction and confusion about my career choices makes these memories and events even more difficult to tolerate.  After all, if I was very happy in my current situation it would be easy to say that “this was the best thing that could have happened to me.”  But, I can’t say that.  So, my subconscious continues to dwell on the “what if” and “if only” byproducts of my past misfortunes.

One dream that is recurrent, but seems to be more prominent now, involves the resurgence and reconnection of my friendship with Kay.  It plays out exactly how I wish it would have long ago.  It is a beautiful dream filled with honesty, forgiveness, understanding, and starting anew.  However, too much time has passed now and having this dream only causes pain because I know it will never come to be.  I end up asking myself why I still dream of having her back in my life as a valued friend, after everything that’s happened.  I want to believe that she is a good person who either did what she needed to do at the time, or realized she made a mistake with how she treated me.  Unfortunately, as more time passes, I come to believe more and more that she feels that she made the right decision by removing me from her life.

I have “recollection dreams” about how important Kay was at this time in my life, those few years ago.  I recall her supportive words and her sympathy and empathy over the catastrophic events.  I re-experience all the good and wonderful times we had in our friendship and I wake up to the sorrow of knowing that something so wonderful no longer exists.  And to make it worse, that sorrow is filled with feelings of guilt and anger towards myself – reminding me that I am at fault for the absence of this beauty in my life.

Last night my sleep was riddled with variations of the same dream: This one involved interactions and observations of the people who didn’t experience my same misfortunes.  These people are, in essence, living the career life that I had imagined for myself… The life that was shattered for me with little explanation, but that was given to them as they expected.  I watched them as they expressed satisfaction and happiness with where their lives are going, all while I am lost in the confusion and distress of my own life.  The variations involved them coming into my world, and me going into their world, and regardless of where we were, I felt resentment and anger towards them and the system that allowed this to happen.

It is not helpful for me to experience these types of dreams while I am in the midst of trying to overcome negativity in my day to day life.  It is difficult for me to get out of bed after a night of distressing dreams and say to myself, “today is going to be a great day!”  It is next to impossible to keep looking forward and push through my day -to-day challenges when my subconscious continues to drag my back into the past I am trying to overcome.  I can’t control what I think about when I sleep, and I have no solution to overcome this problem.

Rampant Guilt

When my kids are sick, I am usually the one to push through the sleepless nights, make my husband mostly deal with them, and leave them home with the Nanny while I go to work.  I don’t have a lot of flexibility at my job to take days off (I get 5 sick days a year and 4 EDOs which need to be scheduled in advance).  This makes the decision when it comes to caring for my sick kids very difficult.  I almost always go to work when the kids are sick and spend the whole day worrying about them and feeling guilty for not putting them before my work.

I already have a significant amount of mommy guilt when it comes to dealing with my vomiting kids.  I have extreme emetophobia (fear or vomit/vomiting) and usually can’t be near my kids when they are vomiting or I think they will vomit.  I also fear that by being next to them, I will “catch” whatever bug they have and then I will get sock too.  I hate myself for it, but I can barely put my fear/anxiety aside to comfort my kids when they are sick.

Yesterday my son developed a horrible bout of gastroenteritis.  At least I figured it was gastro, until he could not stop vomiting (no matter what medications we tried to give him) his entire stomach contents, then bile, then just poor retching.  Even a sip of water to wet his mouth would lead to more retching.  Through this all he was complaining about a really bad stomach ache and the pain seemed to be  getting worse as the night progressed.  After already being awake all night and finally overcoming my vomit fear to lay down with him and rub his back (at this point he was barely even retching anymore), I began to worry more about his abdominal pain.  He wasn’t sleeping, I wasn’t sleeping, and he was obviously dehydrated.  I felt like he needed to be seen in the urgent care centre, at least to check out his abdominal pain, and to possibly give him some stronger medication and rehydrate him.  Making the decision to do this meant that I for certain wouldn’t be able to go to work today.  So after weighting which guilt would be worse – that of not taking care of my sick son or that of calling in sick to work for the second time in the span of a week – I opted to take him in.

I put his cool little feet into his socks and piled him into the car with his blanket, giraffe, and a little puke bowl.  I drove across the city at 2:30am and listened to him moan in pain from the back seat.  I checked him in to the urgent care and waited for the nurse, then the doctor, then the medication, and finally the rehydration.  My 5:30am alarm rang and I made the call to my chief resident.  I felt horrible for that.  Eventually my son’s lips started looking less dry and his face less pale.  He was more talkative again, and we got the go ahead to leave.  We drove home and got into bed and slept most of the morning,  However, when I woke up, I felt an extreme amount of guilt for not being at work.

It feels like I can never win the battle against Guilt.  For every “good decision” that is made, there seems to be an equal and opposite “bad decision.”  I feel like I am always trying to decide which decision is actually the good one…

 

Reflections for a New Year

 Many of these types of inspirational pictures and messages have been floating around on my Facebook feed over the past few days. Given that I’ve been in a rather introspective mindset and contemplating changes in my life, they have really been hitting a chord for me. I know that I’ve been rather absent from the blogosphere lately and I think that has actually been a bad thing. This is a great place for me to come and let out my thoughts, fears, questions, and frustrations. While I’ve been very busy with work and home, I feel like the winter blues have been making me lazy and unmotivated to blog. The truth is,  though, I really miss it and I think my mental health is suffering because of it.  I really need o work harder on making blogging a priority – not because I want to promote my blog or anything, but because I know it contributes to my mental sanity. 

On a similar note, I have been reflecting on some goals for the new year. Last year on the old blog, I set 11 goals for myself over the year. I met most of them by half way through the year, and a few of them fell to the wayside. In July, right before I closed down the old blog and started anew, I revised and reset some goals but with the blogging fiasco, I never kept up with them. I really want to start some new goals for 2016 here on this blog, much like I did last year. I have been reflecting on  some reasonable goals given that I’m struggling with decisions surrounding my career, I am 4.5 months pregnant, and I feel like I am starting from “zero” most days.  I’m hoping that by the end of this weekend I will have delineated some reasonable goals and will have posted them here for accountability. 

In the meanime, in will make a shot-term “pseudo goal” to get back into the blogging world.   
    
 

Ready For Christmas

December has been a whirlwind month. I feel bad for not blogging in almost a whole month. However, it’s been tough keeping my head up over the past few weeks. Today we are on our way out of town in preparation for Christmas. It is going to be another crazy 5 days, but at least I’m off work and spending time with my family. I’m hoping to get a few more blog posts in over the next few days. But here is a quick summary of the last few weeks:
I had a week of vacation where I managed to get a significant amount of baking and reading done. Hopefully in the next few days I will get a chance to post about my reading adventures. I managed to read 3 books in December, thanks to my week of vacation, which means I accomplished my goal of reading 12 books in 2015!
I went back to work and, again, struggled with the challenge of feeling like I’m not quite in the right place in life. Work is so busy, demanding, and tiring, and it makes me really question if I’m doing the right things with my life. 
Pregnancy has continued to be exhausting. I am almost 20 weeks pregnant now, which means that I am getting bigger, gaining more weight, and feeling more uncomfortable. The first few days back after my vacation I was feeling a lot of cramping and that was stressful. Thankfully it was only that – no bleeding, no contractions, no broken water. I think that the worst part of my job these days is seeing all the bad and unfortunate pregnancy outcomes. This week alone I think I dealt with at least 4 or 5 peri-viable (22-23 week) broken waters or deliveries. It’s been hard to see that happening. 
After all those difficult outcomes at work, the worst thing an anxious, pregnant mom of two boys could do is plan an anatomy ultrasound for the morning that her Christmas Vacation starts. After a tense hour of having a stranger smear gel over my swollen belly and take hundreds of pictures of my unborn baby without saying a single word, it turnes out that everything looks okay! Normal anatomy (including heart, spine, and palate), high anterior placenta, long, closed cervix… And, it’s a Girl! 

 

Feeling Overwhelmed

I am sad to report that over the weekend I just felt too tired and overwhelmed to finish the Nano Poblano challenge.  It makes me a little sad to think that I was so close and didn’t do it. But even now, it’s taken a lot of time for me to feel anything like a normal person and get back to blogging. I think this feeling started about half way through November, but I had been pre-scheduling so many of my posts that it didn’t matter. Some of you may have noticed, though, that I haven’t been around reading and commenting like I normally do. 

I just feeling very… Overwhelmed. Very tired. Very misunderstood. Very alone. 

I do remember this being the lowest point of my year last year, so I hope this is just a phase and that it will get better. In the meantime, I feel like I am losing the ability to cope well. Thankfully, today is my last day of work for the next 12 days. I am off to an out-of-town conference tomorrow for the weekend, and then on vacation until Dec 15. Hopefully in that time I will be able to recover some of my mental and emotional reserve.

I need some words of wisdom and encouragement, please!