My mother-in-law is very kind and recently sent me a box of fancy chocolates.
The accompanying note:
“Here is my cure for just about anything. If you feel anxiety or frustration or whatever, take one or as many as it takes to make you feel good. Not to worry about calories. In fact you need extra calories to keep up your strength.”
Last week, Spouse mentioned that he made plans for us to go out to dinner on Saturday night.
My nephew and his fiancée were on board to watch the kids.
I thought that we’d just been out to dinner, but when I did the math, I realized it had been nearly six weeks (longer?) since we’d eaten a meal together, just us.
[And before that? NOVEMBER. Sigh. We have work to do].
But, Saturday got away from me.
I was feeling well and decided to take the dog for a walk. I went too far and became tired.
Next, I attended my daughter’s fifth grade orchestra concert. I was nodding off by the end.
And then I was done.
I contemplated telling Spouse that dinner was off. Rest was all I could muster.
An hour of napping later, though, and I was refreshed and ready to go.
We drove to the restaurant, Spouse gave his name at the host stand, and we were shown to our booth.
And seated there was one of my dearest friends in the world.
G. and I started as physicians at the same academic medical center within 3 weeks of each other in the summer of 2008.
We quickly figured out that our birthdays are within days of each other. We both had to do a Meyers Briggs personality test as part of our work orientation and discovered that we had the same profile, one of the rarest, ENTJ. Our friendship sparked from day one and grew to wildfire levels.
And then, eight years later, we went separate ways.
For different reasons, the academic center was no longer for us.
I went into private practice.
He became wildly successful as an executive physician at a pharmaceutical company.
I missed seeing him every day but we were able to maintain our friendship.
Our paths still crossed several times per year, but there was no event that had him scheduled to be sitting in that restaurant booth on Saturday night.
That was pure love.
Turns out, Spouse and G. had been crafting this plan for weeks, knowing it would cheer me up.
Big gestures are not required for friendship, but wow! This one was marvelous.
Everyone should be lucky enough to have a friend like this.
^^^ Not sure who’s the Babysitter and who’s the Babysittee, but this faithful buddy has constantly been by my side.
Even in these early days, I have been humbled by the outpouring of love and support from friends from every stage of my life.
And let’s be honest, after 47 years, I have cycled through quite a few stages: early life and high school, college, medical school, residency, fellowship, my first job post-training, my current iteration.
(And I’m not ready to call it quits yet!)
The nature of my life has been to put my head down and soldier on. One year I spent 135 nights in a hospital, working.
I know because I counted them. That was not a good year.
And I’ve said it before, but Time is now my most precious commodity.
It is scary to see it passing – I still have dreams where I am in college, facing a final I forgot to study for, then wake up remembering that I am solidly middle aged, Ugh – and the cancer diagnosis sharpens the focus that Time may not be on my side the way I’d assumed it was.
Time has also gotten in the way of cultivating my relationships. I am ashamed of this; I know so many wonderful people and I am furious with myself that I didn’t tell each and every one of them every day how I love them and what they mean to me.
And so, My Dear Friends, I Love You.
Thank you for being an important part of my life, whether you gave me a ride to school sophomore year when I didn’t have a driver’s license; when your friended me on Day 1 of Biocore while I was a perpetually floundering college student trying to find her way; when I was delivering a baby in the OR at 3 AM and you let me stand on the Good Side during a c-section; when I really didn’t need the calories but you made the Cookies You Know I Can’t Resist and brought them to work (they were delicious).
Above all, I hope I have (mostly) been the kind of Friend to you that you have been to me.
Yesterday I finished the last bit of holiday shopping and wrapping.
Well, at least until today.
Trixie and I hit the mall(s) early Sunday morning to avoid the worst of the crowds. It was *mostly* successful.
I heard on TV that Saturday had been dubbed “Panic Saturday” for holiday shoppers and was expected to ring up more retail sales than Black Friday or Cyber Monday. If that was Saturday, I’m not sure what moniker Sunday earned – perhaps “Last Chance Sunday?” “It’s-This-Or-Walgreen’s-Sunday?”
Hard to say.
In theory, I love Christmas.
I love the music.
I love the lights.
I love shopping and selecting the perfect gifts.
I love the holiday candy and treats.
I love the decor – as long as it’s not littering my house until March.
But the reality is that there are many things about the holidays I DO NOT love.
The endless wrapping.
The paper and tape that run out with four packages to go.
The post office. THE POST OFFICE!
Tripping over Amazon boxes.
Breaking down those Amazon boxes and deflating those awful plastic packing bubbles.
The puzzle-cramming operation that is fitting everything into our vehicle.
Driving back and forth to various family members’ homes, where we invariably are late and don’t stay long enough.
No one is happy in the end.
Of course it’s too late to follow through on my threat to spend Christmas in Hawaii, but a girl can dream, right?
What will happen:
Christmas will come and go. Too quickly.
There will be moments of joy.
There will not be enough sleep.
There will be laughter.
There will be at least one Can-You-Believe-That-Happened moment that we have to process later.
There will be one unbelievable gift that Everyone will be talking about.
We will make memories.
Someday I will wish I could reverse time and do it all again.
We will still struggle to fit everything in our vehicle for the trip home.
After that, I did 4 years of OBGYN residency and 3 more years of fellowship in Reproductive Endocrinology and Infertility.
That’s a lot.
Since then, I’ve been practicing medicine full time.
“Practicing medicine.” Think about that term. It implies that medicine always keeps us striving and learning, while never being perfected.
During my time as a physician, I’ve evolved. As I should.
These are my subjective observations after nearly two decades in medicine.
What is different for me:
I have experience under my belt. There are times in medicine where you can’t Fake It ‘til You Make It. I am Board Certified in OBGYN and my subspecialty, Reproductive Endocrinology and Infertility. I earned my stripes. More than 11 years into practicing my sub-specialty, I have seen a lot. When I quote you success rates about my practice, I am giving you facts about my practice. Mine. I have done thousands of egg retrievals and embryo transfers, not dozens or hundreds. Part of counseling patients is discussing the risks, benefits and alternatives to a procedure. We call this informed consent. Of course we do everything possible to minimize risks, recognize and treat any complications, but when you are doing something long enough and with sufficient volume, you will encounter complications and tough situations. I have. It’s humbling. But on the flip side, if you’re a patient, you want someone who can quickly and competently handle a problem, plus keep you out of trouble in the first place.
I work harder than ever to build relationships with patients. I am genuinely interested in where you grew up, how you met your partner (if you have one) and what your ideal family looks like. The reality is that while many patients will be successful, some will not. Investing in the relationship along the way pays multiple dividends. I have some patients who did not achieve pregnancy yet still express deep gratitude for their care and have transitioned from patients to friends.
I’ve aged into a new demographic. A whole generation of physicians has now come behind me. It is exciting to meet younger physicians or medical students who are the future of the field. They’re so bright and shiny! I love it. We’re in an age where women physicians get to be their authentic selves and I embrace it all. I love this army of Boss Lady Doctors.
I delegate more. I get it. Patients want access to their doctors, and we should be there for our patients. Should I personally answer every patient’s routine question or call with a non-urgent lab result? Maybe. But with a robust practice, it is impossible to sustain or scale this over the long term. When your patient load is building and time is less limited, I wholeheartedly agree that every patient would prefer to speak directly to her doctor with every question, problem or concern. As you get busier and time becomes your most precious resource, you *must* find a way to divide and conquer tasks. This is true for life at home, as well.
I am more skilled at having difficult conversations. My specialty requires a lot of them. Patients put their hopes, dreams and resources – emotional and financial – into our care and sometimes, it is not going to work out. It is never easy telling a patient that her eggs are not likely to create a baby. It is not easy telling a couple that none of their eggs fertilized in an IVF cycle and there are no embryos to transfer. While you should always bring your A Game to these conversations, I used to fear and dread them. Now I don’t. I might wish we were talking about something completely different, but I will be present for you and we will figure the next steps together.
I thank patients for letting me take care of them. This is something I have done for a long time, and I mean it. Thank you for letting me in. Being a physician is a unique profession; we care for others at their most vulnerable and in the end, it is mutually satisfying. A word about thanking patients: do not do this if you cannot be sincere. This isn’t a place for phonies. A healthcare provider I saw once for an acute issue with my daughter asked at the end of the visit what he could do to ensure a five star rating if we received a patient satisfaction survey. That left a bad taste in my mouth. Don’t be that guy.
I am better about recognizing when my tank is low. I’ve been burned out. Now I’m not. I’ve also come to think of my emotional reserve as a fuel tank: there are times when it is full and others where I am running on fumes. Now I’m better able to determine when I am down to my last quarter tank and then re-fueling prior to becoming completely dry. When I say “better,” I also do not mean perfect.
I remain a work in progress.
What is the same:
I will tell you “I’m sorry.” I’m sorry that your pregnancy test was negative. I’m sorry for your pregnancy loss. I’m sorry that you have to be my patient in the first place. I will acknowledge the Elephant in the Room. It isn’t a failing as a physician to say “I’m sorry.” Doctors aren’t gods, and I believe the “God Complex” stereotype is woefully outdated. I certainly don’t think of myself as anything other than deeply human, and part of being human is being honest and vulnerable with others. Saying “I’m sorry this happened to you” is often the humane thing to do.
I understand how much this matters to you. It matters to me, too. Every negative pregnancy test is hard. The one thing I have told myself over and over is that the day a negative pregnancy test stops being hard, I should quit the field. There isn’t room for ambivalence.
If you send me a birth announcement or a holiday card, I will save it. Not only will I keep it, I will look at it. Often. Especially on tough days.
If I ever get to meet your baby, I will cry. Probably ugly cry. They will be happy tears, though.