Not glamorous

This week I deeply felt whatever it is that fundamentally altruistic people who go into medicine but end up not practicing altruistically feel that makes them not do so. I’m tired, physically, existentially. I’m sick of delaying gratification and waiting for the time I can do the things I want to do. I want to travel, read books, do crafts, travel, fix up a house (just a little, not like Money Pit style), walk my dog, oh and travel. I can see why private practice life has such a siren song to those folks who started med school thinking they’d end up on a reservation or in the inner city or rural hospital or at an FQHC. I don’t think it is going to fundamentally change my plans, but I can see why we have a crisis of distribution in medicine.

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Today I was reminded that days of constant pain are exhausting and emotionally stressful. And that pain relief brings with it the sleep of the innocent. I mean, I knew those things before, but today I experienced them again. I got a steroid shot in my L knee. Long standing issues, my L knee has. Missing a part, kind of unstable, makes trouble for the neighbor joints. In the 30 years I have struggled with this knee, I have developed solid strategies for dealing with the pain & injury when it comes up (off the top of my head, I thought of 7 times but there are probably more that weren’t as emotionally charged and therefore memorable). Unfortunately those strategies involve rest, proper exercise, regular pain meds (hold on, forgot my nightly ibuprofen…), icing & probably physical therapy. I cannot rest, I don’t have time or access to a pool for swimming, time or extra cash for PT, regular pain meds & icing are the best I can accomplish. Unfortunately dosing q6h is a bit challenging to my memory, even if I carry ibuprofen everywhere with me.

So, steroid shot. With lidocaine. Which has worn off by now but still it feels so much better. But more full of fluid than I’ve ever had it. Residency is a very deconditioning event, especially in middle age. If residency were designed for 40 year olds, it would take longer but be less time consuming from moment to moment. People in their 40s are not is the same hurry that people in their 20s are in. There is a sort of existential urgency that slows over time. Like the escape velocity from childhood is still driving them forward. Telling a person in their 20s that it is okay to take a year off, go a little slower, don’t worry about getting there just yet, is like speaking to them in a way they literally cannot understand. “Why the old lady suddenly talkin’ in word salad?” they think to themselves.

I don’t begrudge them the urgency at all. I had it when I was their age. I remember feeling absolutely justified in the decisions that my urgency inspired: marriage, graduate school, home purchase, childbearing, job changes, religious pursuits. I **needed** to do those things RIGHT NOW. I don’t regret those decisions, I just realize that I’m making my plans with a different background velocity these days and it is hard for me to muster the same sense of urgency that many of my peers show about life.

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Parenting teens subjects One to a regular whiplash. I have gone from feeling horribly desperate on Tuesday to feeling a bit more put together and calm on Thursday. Feeling like my children were suffering, I was not fixing it, I had no idea how to fix it and dear sweet ever loving Honey God, how was I ever going to find the time to deal with All. These. Things.

Turns out that my kids were having a hard time, but it was mostly transient (I need to reflect on how they spend their vacations and how it impacts their overall well being going forward). The things I was doing WERE helping, and I thought of some new stuff and got that on board as well. But I still don’t know either who this Honey God is I’ve suddenly discovered or how I’m going to find time to deal with everything. One bite at a time, I suppose. And I was instructed to pursue treatment for my stupid knee by someone I trust and respect. And she was right. Because being in pain makes everything harder. Now I will just try to do the next right thing, and the next right thing and the next.

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I’m now 1 week post-steroid shot in my knee and 3 days into some simple PT rehab exercises. I’m a highly adherent PT patient. They hurt so bad the first day, I could only do 4 of the 10+ exercises in the regimen. And the second day I honestly considered skipping bc I was worried the pain would be too bad. But it was better, and today was even better. Ainsley & I have joined a kickboxing gym (called 9 Rounds, it’s like Curves but with punching & kicking. I’m very excited). She’s gone twice now and I haven’t been able to work out yet (the registration was a really good deal so I just went for it, even though I know it will be a couple more weeks until I can workout).