The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Saturday, July 21, 2007

What, Me Worry?

Things that are currently taking up valuable space in my brain:
  • Money (or more accurately, the lack thereof)
  • I'm lonely. I don't think I've ever moved anywhere where I literally do not know one person before.
  • The fact that I've managed to forget large amounts of emergency medicine in the year it's been since I've done any emerg-- I feel like an idiot at least 3 times a shift.
  • The balance on our VISA card. It has to be paid off before I start mat leave, or it will continue to eat away at me indefinitely.
  • I'm leaving for a month-long trauma rotation at the end of this week and don't even know where I'm staying (it's supposed to be arranged by my program)
  • I'm worried that I'm never going to figure out how to get a freaking OHIP billing number, and will never get paid for the hospitalist work I've already done.
  • The bases that my paramedic husband is working out of are anywhere from 1-2 hours away. I worry about him being on the road, particularly at the end of a night shift.
  • Due to his commute, my husband is often gone for 14-16 hours for his 12-hour shift. With me out of town, I am very stressed about how we're going to manage with the dogs.
  • The scrub tops at my new hospital fit funny-- the mediums don't fit over my expanding belly, and I swim in the larges. I always have to try on 5 or 6 of them on before I find the one random medium that is a big bigger. Gah.
  • I am worried that if I feel isolated now, my maternity leave will be hellish. Having a baby in late November in Canada is the worst timing ever-- my leave will end just as the weather starts improving.
  • As is always the case, as my anxiety rises, my appetite disappears. I'm having trouble eating (anything but freezies and popcicles anyway) which doesn't help the way I've been feeling. I'm not too worried about The Bean, since I've managed to gain nearly 10 lbs anyway.
  • I've had a few more pre-syncopal episodes at work. As long as I'm careful to eat every 3-4 hours I'm hanging in, but I live in fear of passing out in the ER.
  • I'm worrying about the fact that our last appliance is now nearly a month late. I want my freaking dishwasher. I've lived without one for two years, and I'm dying to have properly clean dishes again.
  • I am concerned that I will never find a good weekend to take ATLS. I can't believe I put it off this long.
  • I really want a vacation. Like, want one so badly I can taste it. The beach kind. Or the spa kind. Definitely not in the budget.
  • I am worried that I am going to mess up my job as a hospitalist. I'm not used to working without backup, and not having anyone checking my orders and treatment plans. I could kill people with this kind of responsibility.
  • Baby stuff costs money. Money we don't have.
  • I worry that I'm never going to feel 'at home' in our new town, and will be miserable the whole time we're here.
  • I'm worried that I'm never going to get a central line on the first try.
  • I worry that the dogs won't take well to the new baby
  • I'm very worried that I'm going to suddenly become a 'mom' when the baby comes. In the not-good way. In the high-waisted jeans, always smelling like baby vomit, out of shape, unable to talk about anything but my child's bowel movements kind of way.
  • I am worried that even after a year of emergency medicine, I still won't feel prepared for work in the emergency room.
  • I also worry about crying at work. I cry a lot. I know it's the pregnancy hormones, because I never cry. I don't even get PMS. But my coping skills are pretty much nonexistant at the moment.
  • We really need to fence in the yard, but... big surprise... we can't really afford it. But if we don't do it before the ground freezes, I'm faced with bundling up a newborn in the middle of a Canadian winter to walk the damn dogs.
  • I worry that I made the wrong decision to pursue emergency medicine when I could have joined a nice, safe family practice and started digging myself out of this financial hole.
  • I'm worried that I'm going to be miserable away from my husband for the next two months (after trauma, I have another out-of-town rotation). I am a horrible suck when it comes to him. The last time we had to do the long-distance thing I was on elective out west during medical school-- I missed him so much I ended up stacking my shifts and coming home early.
  • I'm worried that I'll never work up the motivation to unpack the rest of the house now that the important stuff is done. Let alone paint the colours we had already picked out.
  • I'm worried that my PDA will finally figure out that I've been unable to HotSync it for over a year, and will lock me out of my desperately needed Lexi-Drug and 5 Minute Clinical Consult programs.
  • I am worried that I will hate my post-baby body, and that no amount of diet an exercise will make things right again.
  • I am now down to my last pair of dress pants that still fit. If I'm going to be moonlighting until mat leave, I'm going to need to find some maternity work clothes-- NOT something I want to spend money on at this point.
  • I worry that our child will be born with some kind of severe disability and will be dependent on us for life.
  • I worry that my dogs will somehow escape my watchful eye and unfenced yard and find their way onto a nearby busy street where they will be hit by a car. I didn't say that all of my fears and worries were rational ones.
  • I can no longer see my own genitals. I worry that my feet won't be far behind.
  • I worry that my husband will never get on with the EMS in town, and will have to commute to out-of-town bases the whole time we live here.
  • I realized that next month's trauma rotation isn't an ER-trauma rotation... it's a general surgery rotation. My last general surgery rotation (as those of you who have read this blog since the beginning may remember) nearly killed me. And that was BEFORE I was pregnant. I can't do 10 hour days on my feet anymore, and I certainly can't handle assisting in the OR. I've applied for vacation to shorten the rotation by a week, but if it doesn't get approved I'm thinking of pleading sick leave on the basis of my inability to stay upright for long periods with my ongoing hypotension. And my rapidly developing anxiety disorder.
  • I am worried that my inlaws, whom I love, will begin to drive me nuts now that we're living relatively nearby.
  • I'm disappointed that Rebecca is Canada's Next Top Model. I was really rooting for Sinead.
Okay, enough bitching. More uplifting posts to come.


Blogger Adam said...

Hang in there!! Peaks and valleys.

12:24 AM

Anonymous Anonymous said...

You never get comfortable in the er. When you do, you get dangerous and miss things. Being uncomfortable is ok...full blown panic is not! The baby thing I can't help you with. Been trying for 2 years without success. Be glad you have The Bean. Just remember in Emergency Medicine, unlike family practice, you do not take call, you don't have to follow your patients. When you leave for the day, you are done. There is no overhead, don't have to worry about staffing...etc. etc...Hang in there. It'll be better soon!

7:22 AM

Blogger Nikki said...

It's amazing how worries snowball, isn't it? I can empathize with the "don't know anyone here, wish I had some friends" feeling. As for the rest - things will work out, you just have to slog through these next few months. There IS a light at the end of the tunnel - baby will arrive, you will be able to cope better, you will finish residency and make real money, Mr. Couz's work will work out. It's coming!

11:03 AM

Anonymous Anonymous said...

Emergency Medicine is a wonderful career. I have been practicing and teaching Emergency Medicine for the past 4 years and it's been fun. Yes, there are ups and downs and our patients are not always the nicest people in the world, but it's rewarding when you save a life. Remember when they ask, "Is there a doctor on the plane?", they are asking for the EM physician, not the chiropractor or podiatrist.

11:25 AM

Anonymous marble said...

Figure out which of your co-workers are the fit, on-the-ball moms and start going out for pie with them. People like to be sought out and asked for advice. Several problems solved in one whack.

Baby stuff - you don't need much - mainly a comfortable rocking chair. Think eBay for a wardrobe of stretchy suits. IKEA for a crib if one is near you.

Dogs - rope on a stake? (Or an eyebolt in the house siding, etc.)

Eating - keep a powerbar in your pocket? Dense calories.

Good luck!

11:42 AM

Blogger Dr. J. said...

Dr. C., You can always bail and join us here in the lovely north! They are always looking for locum flight medics too....hmmmm ;)

I remember the financial crunch at the end of my residency....I owed a house worth of money, but apparently didn't own a thing other than a few peices of paper that said MD and CCFP on them (where was my house!!). Crap, I thought, I'm broke and moving across the country. However, even my poorly paying job in Vancouver got my debt under fairly rapid control. If your willing to do a few locums in the north it's all the more rapid.

At any rate, try not to worry too much about the money angle, you'll be debt free within 5 years of finishing your R3 I suspect (or sooner if you come join us in Iqaluit!).

3:22 PM

Blogger Suzie said...

Well, that's a lot to worry about. I don't have advice on most of it, except this: having a baby might be the best cure for the new-town loneliness. IF you get out there and sign up for mommy/baby groups right out of the gate. A new moms' group saved my sanity, made me feel much less isolated during the toughest part of motherhood (the first 3 months), and I ended up making a few friends in the bargain too. See what public health has up there, as well as the local Ontario Early Years Centre. Dig around... I'm still discovering programs I wish I'd found at the start of my mat leave. It will help you feel part of your new community too.

4:26 PM

Blogger Couz said...

You guys have all made me feel a lot better. It's been a really rough three weeks since the move, but I think things are looking up. The only BIG concern right now is the dogs, and we're looking into a few possible (less than ideal, but temporarily acceptable) solutions.

Anon 7:22: You're right, and I've heard this before. A little fear keeps you on your toes, and the emerg dogs who aren't scared are dangerous. Thanks for reminding me!

Nik: I'm sure you can sympathize with a lot of what I'm going through. Hope your new town is growing on you-- is your husband with you there or back in the academic centre?

Anon 11:25: I'm not doubting my love of EM-- I really do think it's my calling, it's just that having to deal with the financial stuff for another year isn't seeming worth it anymore.

Marble: Solution-focused. I love it. Thanks for the great advice!

Dr. J: Nothing is out of the question, you may see me up north yet! But yeah, that's exactly how I felt when I graduated-- and now we're dealing with TWO mortgage payments (one for the house, one for the education). No wonder I'm stressed.

Suzie: There is a local YMCA that I'm going to join as soon as I'm in town full-time again (October). Hopefully I'll find more of the kind of groups you mention when the Bean is finally here!

I've also started spreading the word that I'm on the hunt for baby castoffs... hopefully, that will fill some of the needs!

Thanks to all for the encouragement. It really has made me feel better. :-)

6:33 PM

Blogger Couz said...

Um, in the above comment I hope that everyone knows I meant emerg DOCS and not emerg DOGS. You guys knew that, right? ;-)

6:34 PM

Blogger MY OWN WOMAN said...

I've been sitting here probably a good 10 minutes or more wondering if I should post my comment. The only thing I know about you is what I've read in your blog. All the other comments have been more of the "keep your chin" up comments and perhaps they know you more than I.

I don't mean to be out of line, and please accept this advice with the good intention with which it is given. Residency is rough, pregnancy is hormonally rough, and moving away from a support system can be pretty devastating. Perhaps you need to talk to your OB/GYN and see if you need something just a bit stronger than a pat on your back and to be told to keep your chin up. From your post, it sounds like things seem to be spiraling to fast for you right now. Sometimes we need a little help slowing things down.

Please Dr. C, I don't mean to offend you, but I don't want you to become sick either.

8:04 PM

Blogger Bohemian Road Nurse... said...

Everything will work out just's the hormones worrying.

8:54 PM

Blogger radioactive girl said...

You are awesome for sharing this! I think every woman has all these thoughts while pregnant. Deep breath and one thing at a time. You can do it, you are a strong woman!

12:30 PM

Anonymous Anonymous said...

Hang in there. I can totally emphathize. I cried all the time with both my pregnancies, and I too felt completely alone in my experiences, even though people were really being pretty supportive.

My advice: remember you're not really alone, talk to Mr C to help him understand how you're feeling, and then try to take care of the things you can take care of.

For example,

a) Look for a mother/baby group or another working mom to talk to. Ask the moms for help. Maybe you can borrow some baby clothes/gear from them. Babies grow quickly, so it's unlikely that the clothes have been worn out. Look around for second hand kids gear shops too. You can find some great deals there, and once they're washed, it's impossible to tell they were 'gently used.'

Remember also that you really don't need half as much as stuff as the baby magazines tell you you need. For example, a changing table is nice, yes, but the floor works perfectly well for changing and playing with Junior. If you don't have enough money for a changing table, don't sweat it. Backpacks work better than diaper bags, and generic diaper wipes are just fine.

b) the rope on a string for the dog would work--good idea. A fence would be ideal, but if you can't get one, you can't get one. Perhaps a neighbor teen could help you out with dog walks etc.

c) finances: will take a while, but budget ahead (and keep to the budget) to get ahead. Meanwhile, hang in there. The money will come, no?

d) the mommy/baby groups can work out really well; you don't have to be automatic best friends with them all, but you will likely meet some interesting, used to be working, people who may also have some great ideas on sharing resources. Look in the newspaper or at a church or gym noticeboard (or at work?) for news of such groups. My family is still friends with a families we met 8 years ago at one such group.

Like Anne Lamott wrote, though, just do this 'bird by bird.' Break the worries into small pieces, and start solving them one by one. Do the easy ones first, and remember you don't have to solve them all by tomorrow, and you don't have to solve them alone. Ask Mr C to help too. Good luck with it all.

7:52 PM

Blogger carley said...

Deep breaths couz, deep breaths!

11:39 PM

Blogger MY OWN WOMAN said...

Anonymous with the A. B. C. answers..... you did a great job of breaking things down. Sometimes it's hard to find the answer to the small things when all you can see is the big picture.

9:41 AM

Blogger Xavier Emmanuelle said...

Finances: have you considered taking in a student? You can rent out an extra room or a basement for $500 a month, and it's a nice bit of extra income.

1:03 PM

Blogger Christy said...

My 2 cents...having a baby in the winter is the BEST! I had my daughter in November, and am going to try and time my second for winter next year. You don't have to worry about being 9 months pregnant in the middle of a heat wave, you get to hide under a bulky sweater (especially that immediate post baby body).

2:06 PM

Anonymous jojomd said...

You'll be okay Couz.

I was in a similar position last this time last year-moved to a new city where I knew nobody in July, had my baby in October. It's scary. But having a baby is a great way to meet people actually. Join a baby-group. Everyone there will be a new mother, eager for some adult conversation. And your brain will not completely atrophy, I promise. Well, not permanently anyway. You may temporarily lose interest in other things, but it'll come back.

The money will sort itself out.

The billing number... I'm not sure what to say; the people at OHIP are indeed beyond incompetent in my experience... eventually that'll get sorted out as well.

Everyone feels like they look stupid when they start out, at least sometimes.

Hang in there!

8:39 PM

Blogger Double Headed said...

Dear Dr Couz, sorry you are feeling a "little" anxious. It is though to be in a new place, without well-established support network (even without being pregnant). It is stressful to be in debth. It is scary to have your first baby. And being in ED, trying to keep people alive is also not exactly a desk job. And you are, Dr Couz, doing all of the above at the same time... In my humble opinion, you are freakin amazing. And so if you are anxious about things... well, you do have a lot on your plate. You are going to be fine, I am sure of it. And after all this in the past and you have done an awsome job, you will have a story to tell AND a baby to show:)

But hey... doing surgery trauma may not be a good idea for you right now, eh? I think you should really really try to change it, if you can. And Rebecca? Hell... And, oh yeah... "Emerg Dogs"... that was pretty funny... I had to think about it for a second...
Hang in there.

2:58 AM

Blogger Amanzi Down Under said...

I read your blog and really ached for you! Moving/being in debt/being tanked up on pregnancy hormones/being away from Hubby are all difficult things - and you're doing it all at once! We admire your strength to persevere in the midst of adversity! I can't really offer much advice cos I think Anonymous (a,b,c,d) and jojomd pretty much covered it.
I always look to Psalm 146 when my burdens get too much to bear.

2:45 PM

Anonymous Anonymous said...

you will make it through this. mainly because there isn't an 'off' switch on life, and it's amazing how things can come together.

as for mat. pants...have you done the elastic band thing yet? a strong elastic band through the button hole of the pants and around the button can buy you a whole size of pants.

9:15 PM

Blogger Bohemian Road Nurse... said...

It's going to be alright. You're smart, motivated, and gifted---and so it will be alright. So try to stop the worry-cycle in your head and maybe pamper yourself a little...

9:59 PM

Blogger ERnursey said...

As the mother of four:
1. Babies do not need top of the line anything, they outgrow stuff so fast that it is ridiculous to buy stuff new. Look in the yellow pages and you will probably find several childrens consignment shops where you can find good quality stuff for little money.

2. Dogs - I had a yard with no fence so I set up a fifty foot dog run with an eyebolt outside the back door and another attached to a tree. Buy a baby snuggly and walk the dogs, even in the Canadian winter, the baby will fit under a roomy coat and be snug and happy. The exercise and fresh air will be good for you (and the post baby body.)I lived across the river from Ontario when my kids were small and except for the subzero weather we always did this. Find a nice kid in your neighborhood to help with walking the furry kids, it will be invaluable.

3. All the aches and miseries of pregnancy will be forgotten as soon as you set eyes on your newborn, trust me and millions of other mothers. Otherwise why would we go through it more than once?

4. If you were reasonably fit prior to baby there is no reason you won't get a reasonable facsimile of you pre-baby body, besides - who cares?

5. Having a baby is a great way to meet people, there are all kinds of mommy and me things nowdays, exercise classes, swimming classes, mother with baby movies, mom with children coffee shops. Take advantage of them all. One of the greatest things I did when my kids were small is attend La Leche league meetings. What a wonderful, warm supportive group of moms. You can go while you a pregnant.

Try to relax about finances, you'll get caught up eventually after residency. Just be glad you don't have huge debt like American docs.

10:16 PM

Anonymous Anonymous said...

C, I am doing the third year EM as well, and I have come to the conclusion having read your blog .. It's a case of 'beyond mountains there are more mountains', you are stressed about your baby, I am stressed about my lousy evals, not being as smart as I thought, being tired all the time and not having time for my personal relationships and fun, and last but not least not fitting into the "click" that EM tends to be. That's what I am fretting over and, if it's not one thing it's another. It is a stressful year, so I will join the chorus of "Hang in There" It can only get better ;)

12:21 AM

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7:18 AM


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