A week from today I will be on vacation. We get 2 weeks vacation (one in each half of the year) plus time at the winter holidays. Because of my rotation schedule and the kids’ school schedule, I won’t have a vacation when the kids are off of school except for winter break this year. This was a bummer but also a reality of the logistical challenges of organizing resident schedules. We are going to work to coordinate my schedule with the kids’ next year so that I can have some vacation time with them in 2nd year. (I’m profoundly grateful for the lengths my coworkers were willing to explore to try to find a way to get me a vacation during Spring Break. This program is so supportive) This vacation is going to be a stay-cation. I’m going to unpack my office and have a housewarming party. I’m really looking forward to being able to finish that last room that is filled with boxes. I have a whole wall of built-in bookshelves waiting to be filled. A meditation corner that is itching to be set up. A storage closet that is currently empty while its potential contents clutter my space. I’m going to hang art and go for hikes with my dog. It’s going to be awesome.
The L&D rotation was intense, repetitive and high volume. I got to do many things over and over again. In the midst of it, unsurprisingly, I was feeling overwhelmed. I comforted myself by acknowledging that this was not reality - this was not what my eventual career would look like. This was a training environment. One of the differences between L&D and GYN is that, I think, GYN looks a little bit more like a real world job. Mixed responsibilities, some days clinic, some days OR, some days a combination of both. Not a lot of repetition. It is less exhausting and overwhelming but as a learner, that repetition is important for building skills. I improved significantly on post-partum tubal ligations because I did 7 or 8 of them in the 4 weeks I was on L&D. I participated in over a dozen surgical births, either as primary surgeon or as first assist. I started to gain some muscle memory and automaticity in my technique and generally became less terrified in the OR. (Less, not none) The good news about being an intern is that there is so much to learn that even in a less intense, less repetitive environment like the GYN rotation, I have no doubt that I will learn things - from nurses & scrub techs, from listening to attendings & upper levels do the complex cases that are not appropriate for my level of training, from having time to read practice bulletins and committee opinions and textbooks and Up To Date.
Yesterday I made an off-hand comment about the difference between a 401k and a 403b and one of my colleagues said, “You’re a real adult, aren’t you?” I forget how many things I’ve learned about the world in the years between when I was a young professional and today.
I just finished a week of the benign GYN rotation. This rotation has a much lighter patient load in the hospital, which has meant later starts in the morning. It also has me in clinic most afternoons instead of in the OR or working on an inpatient team, meaning earlier release times as well. The flip side of the extra time is being cast about to different locations (outpatient & hospital-based surgery as well as clinic time) and not having a base ops like the L&D unit. BUT, my chief introduced me to the OB Intern call room - a space that is not convenient to the floor (so a bad place to go when you are monitoring patients in labor for example) but is very cozy and complete unto itself.
I’m really bad at letting go. I guess I prefer the sting of painful confrontation over the emptiness of the unknown. Right now I’m struggling with the very modern problem of navigating a social media relationship with my ex-husband and would be co-parent. I am trying to be my best self, to retain empathy, to remember that the person we show on social media is never the whole of our lived experience. But juxtaposing his quasi-introspective public posts about enjoying life in SoCal against the harsh private realities of my and the children’s lives just makes me too angry. I’m too tempted to write snarky comments about issues that do not belong on social media platforms. I’ve tried to unfollow in an effort not to expose myself to triggers that will cause me to think bitter and angry thoughts about the fact that he is behaving entirely consistently with the sort of person he was before we separated (and then dealing with the subsequent anger at myself for entertaining the delusion that he would behave differently after I left him). But as I mentioned I’m bad at letting go. I may have to escalate my digital separation if I can’t muster the willpower.
I'm learning, through this my training, to take things less personally. Many aspects of my work are easier if I can manage some honest detachment. Feedback isn't Personal, Pervasive or Permanent. We need, I mean NEED that feedback if we are going to be able to do our jobs. But it isn’t just the feedback, I’m also working to practice a certain amount of detachment from the patient experiences. We do things to patients, often to improve their health or to manage a dynamic birth process that is not going well. Sometimes the things we do bring about a desirable outcome - a baby is born before the distress is debilitating or a woman successfully VBACs. But sometimes we do things and less good things happen - more bleeding than usual, an injury to tissue that needs to be repaired or a surgical birth becomes necessary. Giving one’s self credit for the desirable outcomes is just as misplaced as beating one’s self up for the adverse ones. I’m working on letting go of ego and holding on to the evidence and Not. Taking. Things. Personally.
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