The Fabulousity Roundup: October 26th Edition

A few things I think are just great.

When a female neuroscientist gets mansplained about her own research. I won’t spoil it for you. It’s brilliant.

I probably need this shirt.

Image via Evereve

The Notorious R.B.G. wins the $1M Berggruen prize for philosophy and culture and donates the money to charity. Class.

Speaking of R.B.G., Trixie’s Halloween costume from three years ago remains a favorite:

I could not make these mine fast enough:

Many other colors available at Nordstrom.

What an amazing, inspirational athlete. Jess Zaiss completed back-to-back Ironman competitions. That’s 281.2 miles in one weekend.

The lasting trauma of infertility. A well-written piece from the NY Times.

And finally, a quote from My Forever President about former Rep. Elijah Cummings:

Have a fabulous weekend.

Stuff That I Was Into: Summer ’19

Image via HBO

Renata Klein. “I will NOT NOT be rich!” She does not apologize for who she is. I loved her. #Bosslady

This.

Image via Amazon

Fleabag. Flawed, awful, delicious “Fleabag.”

I talked them into letting me sabrage. Again. #stregispuntamita

Platform Golden Goose sneaks.

Tacos. Always tacos.

Bose Soundsport earphones. I did not go into the Apple store expecting to buy these, but they came home with me and they are awesome. The case will charge them and the sound quality is excellent. Penny and I spent nearly every morning together, jogging at sunrise and rocking out.

Speaking of rocking out, we certainly loved Lizzo in Summer ’19. I just took a DNA test, found out I’m 100% Fancy.

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. 

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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.  

To The Next Generation of Fancy Lady Doctors

I earned the nickname “Fancy Lady Doctor” in medical school, even before getting the official MD letters behind my name in 2001.

Despite being tongue-in-cheek at its core, the concept of the Fancy Lady Doctor – or FLD – resonated with my classmates.

Several of them started developing their own mini-groups of FLDs in residency programs across the country, but nowhere did it take off like in my own OBGYN residency program at the University of Colorado.

Friends, they still give out a “Fancy Lady Doctor” award at the annual end of the year residency banquet. I die with pride!

When I attended medical school in the late 1990s, there were a few attending physicians who qualified as FLDs, but not many. Ditto residency.

Don’t get me wrong, there were countless wonderful, smart and kind women who educated me, but not many were wearing heels in the OR at 3 A.M.

I have done this.

The culture of medicine has changed since then, too. More women than ever are entering medicine, and now that we are more than half of medical students – and emerging physicians – we can own the space in a way that our foresisters could not. I recognize the debt.

Back to the FLD scarcity in my training: This all changed when I was a third year resident and attended the 2003 annual meeting of the American Society of Reproductive Medicine, known as ASRM.

In the fertility world, the ASRM meeting is a big deal. Nearly 10,000 fertility professionals – doctors, nurses, embryologists, psychologists, scientists and more – meet to learn about cutting edge research and new techniques, tools or devices. There are opportunities to connect with old friends and colleagues, as well as industry leaders.

And there are parties.

Some of this has changed since my inaugural ASRM (it’s toned down a lot), but back then, I was blown away.

Everywhere I turned there was someone with near rock-star status in our field, walking around like a mere mortal. There were parties every night with multiple live bands, cocktails and embarrassingly extravagant displays of sushi. One party had enough jumbo shrimp and lobster tails to fill a bathtub.

And there were many, many FLDs.

Not only were these women smart, well-spoken and professionally accomplished, they looked great. They wore suits or dresses that fit perfectly. They had designer – real designer – shoes and bags. No knock-offs here. They had rings with diamonds large enough to choke a horse.

I had found my tribe.

Fast forward to now: Last week marked the 75th ASRM meeting in Philadelphia, PA. I went.

One day I wore these:

Holy Grail: Fabulous and comfortable.

And I was delighted to connect with a whole new generation of FLDs in my field.

While it’s a surprising position to discover I’ve aged enough that a whole generation has come up behind me – How did I get here? – I really, really like these women.

It makes me happy for the future of our speciality and for women physicians in general.

And, so, a final message to my younger FLD colleagues: Keep it going.

Be smart.

Be fabulous.

Be kind.

Be amazing physicians.

And remember: diamonds are always the perfect accessory.

Especially with scrubs.

Fancy Pants

When I saw that J. Crew was selling these pants, I almost broke my finger clicking “Buy Now.”

Fancy hot pink velvet pants? Sign me up!

But then I looked at the other images.

Ok, when this does not even look amazing on a 22 year old model, I can reasonably project that the rear view on a 46.75 year old Boss Lady Doctor will be less favorable.

One more shot:

I passed.

The search continues.

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.