Happy Halloween, 2019

Confession: I’m not a big Halloween person.

I haven’t worn a costume since my freshman year of college, and that was only to be able to use a fake I.D. to get into a bar.

But others around here do not share my indifference to October 31.

Even the dog gets into the game:

And a wig on a pumpkin, why not?

Spouse still swears by his regimen of offering Fireball shots to weary parents.

And this flashback is just ALL THE FEELS. Sniff.

My Evolution as Physician

I graduated from medical school in 2001.

It feels like yesterday and a million years ago.

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.

With my darling co-fellow, circa 2005. Babies!

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. 

I stay curious.  

I am always learning.  

I remain a work in progress.  

Six Years

Whoa.

I realized yesterday that I started this blog six years ago.

I didn’t know it at the time, but I was about to become deeply unhappy.

In the midst of impending turmoil, this was a creative outlet that gave me buoyancy when I was otherwise slowly drowning.

I was so cautious about not revealing too much about myself, lest my Big Brother Employer disapprove.

Now, I don’t give a s*it.

Figuratively and almost literally naked. Authentically Me!

In retrospect, it was physician burnout, the product of a toxic work environment that ultimately led me to take a risk, leave the perceived security of my “safe” job and venture into private practice.

It was the best decision I’ve ever made.

Six years later, I’m happier and more successful than ever.

I have autonomy. I have partners I love and trust. I work harder but mostly better. I’m a Kick Ass Doctor Lady Boss to nearly 60 people.

And I remain Fancy.

I strolled down Memory Lane for posts that resonated with me.

If you’re new here or curious, my personal Hits List includes:

https://fancyladydoctor.com/2013/10/06/we-really-need-to-solve-this-nanny-situation/

 
Why Do I Save Good Things?
 
Life Constantly Humbles Me
 
Raw discussion of my job transition.
 
Seriously great advice on How to Quit Your Job
 
Summiting.
This is still quite funny to me. Check out Courtney Love, aka my daughter.

Murray1

Thank you for your love and support. I appreciate it more than you know.

2018 *Must* Be Better

Last night – a few hours before the calendar turned – I posted the following on Facebook:

2017 was a shitshow. 2018 *must* be better.

Over 40 people instantly agreed. 

2017 was such a hard, hard year.

In the end, I am here and so are the people I love, and that is the most important thing.

But it took a lot to make it so.

Screen Shot 2018-01-01 at 8.55.51 AM

I don’t think I handled 2017 with particular grace, but there were some wins, particularly professionally. Personally, I have a long way to go.

My goals for 2018, in no particular order:

  • Train for and successfully complete races. I’m leaving the exact races and distances vague, but I want 2018 to be a better running year. I only did one race in 2017 (a half marathon) and while it turned out ok in the end, I was woefully undertrained and the whole thing did not feel good. I also set a goal to get a PR in a fall marathon and dropped out of training two months before the planned race. That felt like a failure. By “successfully complete races” I mean that I want to confidently step up to the starting line and finish strong.
  • Appreciate and encourage the unique qualities of MGM (10) and Trixie (8).
  • Be well. Eat healthy food. Exercise. Spend time outdoors. Take some time off.
  • Get taxes done prior to April 15th.
  • Find a suitable new home for all of us. Move. 
  • Celebrate 20th anniversary with Spouse. I tend to downplay birthdays and anniversaries, sometimes nearly forgetting them. I know. Bad. Our 20th anniversary is in early June, and I plan to celebrate all summer long. I already have two trips planned (one for just the two of us, one for our whole family) to bookend the summer. Considering that my wedding ring took an accidental spin in the garbage disposal over a year ago, a new ring would also be icing on the cake.
  • Continue to grow our medical practice. Practice medicine to the best of my ability.
  • Cultivate friendships, old and new.

Cheers, 2018.

My Worlds Collide: NPR + Hallmark Christmas Movies

NPR’s “Weekend Edition” ran a funny story over the weekend about Hallmark Christmas movies, one of my guilty holiday pleasures.

Apparently I’m not alone.

Screen Shot 2017-12-18 at 2.53.13 AM.png

My favorite part was where guest Linda Holmes – who hosts a pop culture podcast – describes the general plot lines of the Hallmark movies to Weekend Edition host Lulu Garcia Navarro. Here’s an excerpt of the interview:

Screen Shot 2017-12-18 at 2.47.42 AM

Nailed it!

First Snow of the Year

IMG_2384

It snowed last Friday.

I’m not sure why it always takes me by surprise, but winter’s on its way.

I’d planned to go for a medium-ish long run that morning but after peeking out the window, I reconsidered that decision.

Coffee seemed appealing.

Howling winds and blowing snow did not.

I surprised myself by going, particularly since my comfort zone is approximately 71-73 degrees Fahrenheit (Spouse corrected me when I told him this, saying it’s not a zone when it’s really more of a singular point, specifically 72 degrees F).

Not every moment of this run was pleasant, but I ticked past one, two and then three miles. Four and five came next, and by mile six I had turned a corner into a tailwind that took me the last half mile home.

As part of my running group, Fellow Flowers, I had planned to use this run to complete a virtual challenge called the Joy Run.

IMG_2386

Mission accomplished.

 

 

School Break

Last week the kids had two days off of school, the famous MEA weekend in Minnesota, where public schools ostensibly give teachers two days off to attend an educational conference.

But basically this is a Mini Spring Break in the Fall, and many families take copious advantage of this to escape town for a long weekend.

Per my usual state, I didn’t prepare well in advance and for Day 1 of break, both MGM and Trixie found themselves back at school for an all-day Kids’ Club session.

Miraculously, I’d had foresight back in the summer to take off work for Day 2 of the break, so we had a whole day to spend together. It was a perfect fall day – warm and sunny – and we decided to do something fall-y, which was to go to a corn maze.

Everyone else in the Metro Area had the same idea. This place was a zoo, figuratively and literally since there was a petting zoo area. 

After paying for entrance fees, face painting, some strange food for the animals at the petting zoo, overpriced drinks and for camel (!) rides, I was suddenly $100 poorer for the effort.

IMG_2332

But the kids had a blast, especially in an area that was like a ball or sand pit, except completely filled with corn.

IMG_2336

On the con side, I’ve been digging corn kernels out of the washing machine for a week.

The weekend held one more perfect day and this time, I decided we were going to get some culture. Off the the Minneapolis Sculpture Garden!

If you’ve ever seen pictures of Minneapolis, there’s a fair chance you’ve seen the most iconic work in the garden, Spoonbridge and Cherry.

images-1

The kids appreciated the art about as much as I predicted, which was approximately a 2 on a scale of 1 to 10.

IMG_2369

This “snowman” sculpture was a hit with the late afternoon sun providing a perfect angle for the shadows:

IMG_2365 2

The giant blue chicken also did not disappoint:

IMG_2359

In the end we spent about an hour and a half enjoying the sculptures and running up and down the hill behind the Walker Art Center (them, not me).

Perfect way to cap off fall break!