Fast forward another 2 years and I'm back in Chicago. It seems that one post every few years is all I'm capable of these days. Perhaps it takes at least 2 years before the valve in my brain needs to vent all the pent up crap that accumulates while being a doctor.
I went for the trifecta of change this time: new job, new city, new baby. Well I wouldn't advise it, I'm not sure that this change was avoidable given the training/fellowship 3 year cycle. I officially moved back to the suburbs where I grew up; it has taken some getting used to be surrounded by family again. There was something comforting about being hundreds of miles away; you had no obligation to attend the random family outings and it was always more of a big deal when you came back into town. Now the pop-ins are abound and every weekend involves a family obligation. It is nice to have regular social contact, Lord knows it wasn't always present in the ATL, but it can be overwhelming when you don't feel like you have time and space to yourself.
And really that leads into the next biggest part about living in the suburbs: homeownership. Condo life was easier. We had a loft which was more or less a large concrete box. It was idiot proof when it came to repairs and fairly easy to maintain and clean. There was no fear of some hidden lead pipe as all the pipes were exposed. No worry about rickety stairs, plaster walls or outmoded electrical. Now enter the 1930s home. Behind every fixture is a time capsule of electricity in eras gone by. Pipes in the basement are wrapped in newspaper to prevent freezing. We appear to be supporting a small ecosystem of drain flies, silver fish and spiders. Lawns need to be mowed. Outdoor lights turned on and off nightly. Lead pain concerns. Window replacement. You name it - it's on the list. In attempting to have our stairs refinished and handrail secured we have to get quotes from no less than 3 contractors: a wood floor refinisher, a handrail refinisher and a stair carpenter. FYI it's ridiculously expensive to get these things fixed.
Don't get me wrong, owning your own home where you can make all the noise you want and not have to share any common walls with neighbors has been great. I now have a place for all my tools in the basement and don't have to shove anything into a closet. While I might not have a neighbor 6 inches behind a common wall, actual home-owning neighbors has been a whole new interesting experience. When you live in the city, especially in a condo, the age range of other owners tends to be pretty narrow. Moreover people largely keep to themselves. There may not have been a welcome committee when we moved in, but there also wasn't anyone going all Rear Window and watching our every move. Many of my neighbors are now separated in age from me and my wife by decades. Many are also retired or work from home. They have all been incredibly friendly and helpful but you find that you can't really be outside your house without someone else taking note. Sprinkler on too long? You'll get a message from the neighbors. Stroller left outside? Neighbors remind you to take it in. Want to sit on your sun porch? Neighbors will pop over to chat. They watch all the service people come into the house. They comment on the products you carry in and out of the house. Should a service person step off your lawn onto theirs? You'll probably hear something about it. I miss the anonymity that comes along with city living. You could be sitting 2 feet away from someone at the pool and not say a word; glorious.
I started a new job which was really the main reason for moving back to Chicago. And I use 'Chicago' loosely as I'm firmly live in the suburbs and work in a further away suburb. Overall I think my choice to leave academia to join a private practice was a good one. Gone are the silly demands for research and the idiotic hierarchy. It's replaced by RVUs and networking. My practice had tasked me with setting up a new office in a new suburb. It has huge potential but it has become increasingly isolating. We have had a lot of challenges in terms of getting another physician to join me this far away from the city. It turns out people in their 30s aren't ready to commit to moving away from River North quite yet. As a result I drive 30 minutes to a windowless office only to hang out with PCPs all of whom are at least 20 years my senior. Work is still slowly ramping up so I have a lot of downtime, but I still have had a lot of trouble being productive. It's almost like a failure to mentally commit to where I am. I haven't hung up any diplomas, certifications or awards. Frankly I don't feel comfortable with all my important documents being stored 30 minutes away in an unlocked office. But part of it is that it still all doesn't feel real. There's some hardcore imposter syndrome going on every time my paycheck is deposited. When you work for peanuts at the bottom of the totem pole for 10 years moving up a rung feels unreal.
Fatherhood, I am learning, is something you cannot prepare for. There are ups and downs. It is all time consuming. When my baby cries and I can't seem to comfort him I feel helpless, scared, and frustrated all at the same time. I feel equally concerned on a regular basis that I'm not doing enough to stimulate his mental growth. That somehow he will suffer because I'm not around enough or I'm not doing more. I don't know how my parents did it without going insane with three of us.
Overall I'm starting to ask myself questions that I though were only reserved for mid-life crises. What is my purpose? How can I feel fulfilled in life? I always thought that the pitting sense of unease I had in the depths of my stomach were related to constantly being stuck in the gears of training. That once I had a career, home, family I would feel settled. Instead it has been the exact opposite. Maybe it's just the way I'm wired. While sometimes I wonder if being a stay at home dad, or having a less stressful career would wash away these worries I know deep down inside that they would just be replaced by other concerns. Ugh. I sum it up with the conclusion that adulthood is hard and the adage that youth is wasted on the young.
And with that I conclude this three year update. Who knows, will it happen again in 2019, 2020?
Tuesday, September 12, 2017
Tuesday, September 1, 2015
Fellowship 6:08 PM
Hello blog, it's been awhile.
Three years to be exact. Sometimes it's a little surreal to look back on posts from 2007 when I started medical school, 2011 when I graduated and then when I started residency. I'm glad that what I wrote is comprehensible knowing that it is indexed on google.
Fast forward and I'm 600 miles from Chicago sitting in downtown Atlanta as a pulmonary critical care fellow. That's right. The guy who spent most of 2010 complaining about long hours and type A personalities during the M3 surgical clerkship now works long hours with type A personalities in the medical ICU. There's a word for this behavior...masochism.
Transitioning from the role of a resident to that of a fellow has been rife with challenges. The most obvious being that you spend 3 years training to be an internist, pass the boards and officially become a "real doctor" only to end up as low man on the totem pole once again. It's been just over a year and I think only one attending even acknowledged the fact that I'm a board certified internist and that it constitutes some kind of achievement. How depressing. Hearing about what my hospitalist friends are earning is even more depressing.
The other challenge revolves around expectations. There are a lot of them and everyone above me has a different one. For the first time we do "360" reviews where I get to hear the opinion of everyone from the nurse to the resident to the attendings. To date I am both "ready to run an ICU" and "not assertive enough." Depending on who you ask I'm a competent teacher or someone who doesn't teach enough. There's a joke in here somewhere but I'll settle on the idea that too much feedback is actually a bad thing and just a reflection of the many personalities you work with.
And also that I need to do research (endearingly referred to as a "project"). Based on the way it's discussed you would think that doctors only do research. If there wasn't a hospital attached to the research building I wouldn't even believe that patients were being seen on a daily basis. It's not that I don't think there's a vital role for medical research - I'm thrilled that people want to do it. It's just not for me. From the first time I had to decapitate a lizard to do EP research to the countless hours chart reviewing to the tedious review article editing I just know deep in my brain that I derive little pleasure from such academic pursuits. Try articulating that to your program director, it's not easy. You mainly come off sounding like a lazy bum without any aspirations. After my year end review he told me that my two future job options would revolve around working in an ICU either in the daytime or during the night. Thanks for the insight.
But enough self deprecating. There are some unbelievable changes since my last post that I hope to read about with wonderment in 2018 when I rediscover this blog (let's face it, no one else is reading this blog). I managed to get (and remain) married, buy a condo, not kill a house pet, buy life insurance and have an actual honest-to-god retirement account. Less unbelievable is that I've gone almost completely bald and chose to buy a Ford because it was the "responsible thing to do." Being an adult has proven to be challenging because of all the intensely boring things that you need to do on a day to day basis. There was a point this year that I worried about getting audited because I deducted my moving expenses. Read that sentence again. It is likely the most boring thing to provoke worry on the face of the planet, yet it was a thought that I had as an adult member of society.
So there you have it.
Three years in a nutshell: I'm more an adult, much more bald, probably not a research scientist but definitely capable of putting a dialysis catheter in your internal jugular vein.
Three years to be exact. Sometimes it's a little surreal to look back on posts from 2007 when I started medical school, 2011 when I graduated and then when I started residency. I'm glad that what I wrote is comprehensible knowing that it is indexed on google.
Fast forward and I'm 600 miles from Chicago sitting in downtown Atlanta as a pulmonary critical care fellow. That's right. The guy who spent most of 2010 complaining about long hours and type A personalities during the M3 surgical clerkship now works long hours with type A personalities in the medical ICU. There's a word for this behavior...masochism.
Transitioning from the role of a resident to that of a fellow has been rife with challenges. The most obvious being that you spend 3 years training to be an internist, pass the boards and officially become a "real doctor" only to end up as low man on the totem pole once again. It's been just over a year and I think only one attending even acknowledged the fact that I'm a board certified internist and that it constitutes some kind of achievement. How depressing. Hearing about what my hospitalist friends are earning is even more depressing.
The other challenge revolves around expectations. There are a lot of them and everyone above me has a different one. For the first time we do "360" reviews where I get to hear the opinion of everyone from the nurse to the resident to the attendings. To date I am both "ready to run an ICU" and "not assertive enough." Depending on who you ask I'm a competent teacher or someone who doesn't teach enough. There's a joke in here somewhere but I'll settle on the idea that too much feedback is actually a bad thing and just a reflection of the many personalities you work with.
And also that I need to do research (endearingly referred to as a "project"). Based on the way it's discussed you would think that doctors only do research. If there wasn't a hospital attached to the research building I wouldn't even believe that patients were being seen on a daily basis. It's not that I don't think there's a vital role for medical research - I'm thrilled that people want to do it. It's just not for me. From the first time I had to decapitate a lizard to do EP research to the countless hours chart reviewing to the tedious review article editing I just know deep in my brain that I derive little pleasure from such academic pursuits. Try articulating that to your program director, it's not easy. You mainly come off sounding like a lazy bum without any aspirations. After my year end review he told me that my two future job options would revolve around working in an ICU either in the daytime or during the night. Thanks for the insight.
But enough self deprecating. There are some unbelievable changes since my last post that I hope to read about with wonderment in 2018 when I rediscover this blog (let's face it, no one else is reading this blog). I managed to get (and remain) married, buy a condo, not kill a house pet, buy life insurance and have an actual honest-to-god retirement account. Less unbelievable is that I've gone almost completely bald and chose to buy a Ford because it was the "responsible thing to do." Being an adult has proven to be challenging because of all the intensely boring things that you need to do on a day to day basis. There was a point this year that I worried about getting audited because I deducted my moving expenses. Read that sentence again. It is likely the most boring thing to provoke worry on the face of the planet, yet it was a thought that I had as an adult member of society.
So there you have it.
Three years in a nutshell: I'm more an adult, much more bald, probably not a research scientist but definitely capable of putting a dialysis catheter in your internal jugular vein.
