Thursday, January 22, 2009

Battle Lines

Sorry to be gone so long, I know you worry. Life has been thrown into full panic mode recently and I haven't had much time to regroup. My life is accelerating into the light at the end of the tunnel: and I'm pretty sure it's an oncoming train. My program has decided that I am not progressing into becoming a doctor at a sufficient pace. Apparently I am distracted at work. I am letting my personal life compete with my job as a doctor and like a spoiled mistress, work is having a temper tantrum. They're not willing to ask what they could have done to contribute to the complete and utter destruction of my personal life. Nope. I have a problem as they see it and I'd better fix it. I'm sure it had nothing to do with being allowed to get septic for a month. Nothing to do with the fact that the people who should have been there for me were no where to be found and the people they disdain were the ones risking their licences pumping me full of meds to keep me going. Interestingly, we didn't discuss that.
I also seem to have a chip on my shoulder lately. Again no huge mystery there. Let's see I've given medicine and my residency my marriage, my youth, my health, and the first three years of the only shot of motherhood I'll probably ever take. Sorry if I think it's somebody else's turn to feed the bitch. I got nothing left.
Regardless, I am not developing the right attitude to be a physician. I am more interested in hanging out with the nurses and clerical staff then I am bullshitting with my fellow physicians and engaging in the grand circle jerk called literature review. It seems I think that the people on that side of the window understand more of what it's like to live in the real world then those on my side. On any one shift I can talk to at least one or two nurses who are single parents or are going through a divorce. One my side of the window there are thirty year olds who are still living with their parents. There is not one resident in my program who is divorced (very few who are even married), and there is not one woman with a child. I don't know why we haven't really bonded like were supposed to. It can't be that aside from medicine we have nothing in common.
Apparently I am also not aggressive enough in getting procedure and ICU players. I do however have the highest conversion rate of turning ICU patients into DNI/DNR's. Instead of convincing my patients families to go all out on their 95 y/o grandma and do everything I tell them the truth as I've seen it a hundred times, tell them that it is time and stand with them after I've pulled the tube. You get points for intubating and CPR but not for pulling the tube and seeing the patient gently to the other side. I knew this was coming. I got in a fight with one of my attendings a few months back about a similar thing. We had a young GSW to the chest arrive and not two seconds later his mother burst through the double doors screaming and sobbing. And I grabbed her in my arms as she 's losing it and push her against the wall and down it. Just far enough out of the way where she can't see the action but I can hear it and it's not going well. The police arrive to drag her out by her arms and legs and I shoo them away, because she has every right to be in this state. Her only son is dying steps away from her, if there is any time to be hysterical, it is now. So you have this huge black lady whose world has come completely unraveled being held in the arms of this little white girl with glasses, while someone is cracking her child's chest. And I have to hold her in my arms because I know that they are going to come charging past our area, like a runaway locomotive. And if I don't block her view she will see him flayed open, blood streaming down the gurney rails, with 20 people wrapped in yellow gowns and splattered with crimson stains looking terrified as they run for the elevator. When she remembers her son (because I know he's not going to make it) every memory will be forever intruded on by this last horrible vision. And I'm not going to let her see it, so I'm on the floor with her, my body blocking her view as I hear them readying to make the mad dash to the OR. And as they start to run past, I tell her I don't think he will survive, so that she will collapse into me just as they make there way past us. She never saw them, was so engulfed in her sorrow that she never knew he was inches away from her dying. And she will never have a memory of her son bloodied and ripped open and dead. I go back to the big room and my attending tells me I missed a chance to put in a femoral line. A bullshit central line. I missed a procedure I could have gotten credit for. I remember thinking, I don't want to be that person. The one who sees people as procedures and diseases instead of mothers and sons. I don't want to be a doctor if that's what it means. Sometimes it feels like a battle for my soul in that room and I have clearly chosen the wrong side as far as their concerned. You can either be a person whose a doctor or a doctor whose a person. The job of residency is turn me into a doctor and I'm failing at that. And I don't see that as a problem.
So I have five months left to try to pass. To pretend like medicine is the wonderful all consuming process that they think it should be. To make it the central figure in my life and my first and only love even though I see it as corrupted and immoral. To pretend like the people on my side of the glass have all the answers and are morally superior just because they went to medical school. When I know that the people on the other side are my true friends. They have experiencing picking their friends off the floor and holding them until they can stand again. They were there when I finally started to ask for help, handing me their numbers for the nights I struggle being alone, keeping me going when my colleagues just cared about who was going to cover my shifts. I know who my friends are and they don't have MD behind their names. I've dusted off my long white coat, they one I've never worn at work except to give death notifications. And I will wear it everyday now, just to wrap myself in the moral superiority that is expected of me. I am sending my child to live with my parents, even though she is the only thing that keeps me grounded, because I have been told I have to focus. Despite three years of seeing her be my only joy, my job sees my daughter only as a distraction and not as my salvation. She is competition to them. I am going deeper in debt to get an apartment for my mentally disturbed husband, because I will not abandon him to the streets. After fourteen years, after all the horrors he's put us through, I still meant my marriage vows and I will take care of him until he dies. I'm okay with that, even if no one else is. My apartment is empty, medical books and journals strewn about, white coat pressed and clean. I am readying for battle these days. Because after everything I have lost I will not lose my soul, I will not become what I hate, and I'm not staying in residency one second longer than I have to. There is big bright world waiting for me, a light at the end of the tunnel. And I am ready to leave all this darkness behind.


shadowfax said...

"They can do what they want to me, but they can't stop time."

That was my mantra in residency. Sounds like you've got the right approach. Good luck with the last five months and nine days (but who's counting?)

FridaWrites said...

I have faith in you. Five months--you can make that push. You will do well and you'll have more time with your daughter soon. When I almost gave up an academic program, my daughter was in tears. She'll admire your strength in the long run.

For your husband I hope there is some kind of treatment or counseling that he can get.

We need doctors like you.

Anonymous said...

It breaks my heart to read this. I'm in nursing school. Are you sure being a doctor is what you want? I hope things get easier for you.

Anonymous said...

You are exactly the kind of person I would choose to not only care along side me but also care FOR me.You can put your shoulder to the storm and endure til the worst of it passes.
I used to mutter"If what does't kill me makes me stronger,then why aren't I superhuman?" Believe me ,you may not notice it now but you ARE superhuman and later it will come to visit in the most astonishing times and will steel your spine and propel you forward.
I beleieve in YOU
Yvonne ED RN

Ninja Medic said...

Illegitimi non carborundum, chickie.

You are EXACTLY the kind of physician I would want treating me and EXACTLY the kind of physician I want to work with and for. Don't lose sight of yourself, please.....

Anonymous said...

We don't have any right to ask it of you, but if you could continue you are what medicine needs. Please do what you can, so that you will have the power to make changes in the system.