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Back To Work

I go back to work this week. It’s the first time I have been on a shift since mid August. My wife and I recently celebrated the birth of our first child, a baby girl. I was fortunate to be able to arrange my schedule in order to accomodate this time off.

It’s odd going back to work after a long time. Part of me welcomes going back. Part of me wants to hang out with this brand new, little human being.

They say that having children changes your priorities and perspectives.

Personally, I think its’ too early for me to say what, if anything, has changed.

Sure, I wish I could spend a ton of time with the little one. But I also have gotten antsy and wanted to get out of the house.

If it were an option or possiblity, I wonder how I would do being a stay-at-home dad/husband. I would probably have to be intentional about being active and doing things out in the community with the baby. Needless to say, I’ve got tons of respect for men and women who are full-time caregivers with their children at home.

We’ll see how it goes.

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Are you there?

A longtime reader (and by longtime reader, I mean my mother) of this blog recently commented to me that I haven’t been writing here very much as of late.

As a blogger, I suppose it is good to know that your absence is missed — even if that absence is noted by your mother.

My last post was published prior to this academic year ending. I was wrapping up my year as a Chief Resident. It truly was a good year. I felt that I learned a lot and developed not only as a clinician but an educator and (dare I say it) administrator too.

Am I still here? Do I still exist? Well the answer is yes, obviously. I have been left in the post residency… afterglow? Is it even appropriate to call it that?

Though I did round as the attending physician during my chief residency, those stints were scattered here and there. Now, however, that is life. I’m no longer involved in the inner workings of residency administration. And that’s ok. It’s time to move on. The new chiefs have taken over that baton beautifully.

But it does sort of force you to redefine your life. Because for so long life has been about training and learning and education and answering to a program director.

Sure, I still have a boss and a department chair. But there is a much more autonomous feel to it now.

I’ve taken up some leadership positions. I’m trying to get involved with our institution in ways I feel I can contribute positively. I’m working with residents and medical students. Overall, though, I feel that the path is now less defined and it’s up to myself to figue out where I’m going to point this ship.

That’s an exciting, scary, and daunting idea.

But this journey goes on.

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The End Is Coming

The end is near.

As I type this we are speeding through the month of June.

On June 30, my year as one of the Internal Medicine Chief Residents will come to a close.

Before this year began, I remember hearing a former chief resident fondly look back on his own time as chief resident years ago. He told me that was the best year of his career.

I don’t know if that nostalgic statement was supposed to be encouraging. It probably was.

Right now I hope that this year will not go down as the best year of my career.

I’ve had fun. I’ve had headaches. I’ve learned a lot — both clinically and in other professional areas as well.

But, like I said above, I sure hope that this year isn’t the best of my career and it’s all down from here!

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Thanks For Nothing, Thanks For Everything

Thanks.

It’s can be a powerful sentiment — as in gratitude for the ultimate gift or a heavy sacrifice.

But it can also be empty — as in a “thanks for nothing.”

I remember taking care of a patient midway through my residency. We had tried many different things, but eventually he succumbed to the disease and passed away in the hospital. I don’t remember what the patient looked like. I don’t remember his name. I don’t remember the disease.

What I do remember was that we tried. We tried to make him better, but in the end we did not meet this goal. As the futility of our efforts became clear to us and to the family, we decided to focus on comfort.

The patient passed away.

The memory that has haunted me to this day is walking into the room and having the patient’s brother walk up to me. As he drew closer he pulled me into an embrace and thanked me. He actually thanked me.

In dealing with death and dying it has not been uncommon for me to hear a thank you from the loved ones of a patient who has passed. But this was the first time I experienced this. And maybe that’s this memory has stuck with me since then.

Thanks. It jarred me to hear that sentiment from this grieving man. In that instance I could not do much more than return his embrace. I had no words but to say, “I’m sorry.”

To me, my words felt empty. They felt inconsequential. But it was all I could muster.

I felt like I was being thanked for nothing. I felt like I was being thanked for failing. Because that’s the lens through which I viewed the situation.

Now, I realize that I should be grateful for their appreciation. I marvel at how some people, in their moments of grief, can still take time to express their gratitude — even if it is “just” for compassion and care instead of the cure for which they had pleaded and prayed.

Medicine is a profession most of us go into because we want to fix problems and make people better. Too often it is easy to view death as a failure of what we set out to do. The danger in allowing us to view death this way is that we may feel that we have provided nothing to our patients and their families.

But sometimes patients and their families don’t need a savior. Sometimes they just need someone to be with them through the journey’s end. And to them, you have given way more than “nothing.” You have given everything.

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About 3 Months Left

There’s about 3 months to go in this academic year.

That means I will be a Chief Resident for only another 3 months. My contract is coming to an end. The incoming Chief Residents have already been chosen and announced.

It some ways I feel like I know what a lame duck president must feel like.

The year has gone by faster than I could have anticipated. It’s been a period of satisfaction, personal & professional growth, and frustration. There have been ups and downs. Joys and disappointments.

My fellow residents who graduated from residency last year — well those who went on to work “real” jobs — have pulled in so much more money than I have this year. I’m sure they are enjoying the dough. Sure it is not has high as those surgical specialties. But it sure is a lot more than what I’ve been paid this year.

Still, I don’t regret it. Knowing what I do now, I would do it again.

There is a fraternity of sorts with former chief residents. And I’m proud to have joined those ranks.

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Attending Status

What’s in a title?

My ID badge now says “Attending Physician.”

I guess that’s my title now.

Last month I worked two hospitalist shifts. A week later I followed it up with 7 MOD shifts.

As a hospitalist I was responsible for my entire set of patients. I did get to work with one resident who was spending the month doing a hospitalist elective.

During the MOD shifts, I was the attending on one of our Internal Medicine teaching teams. I had a senior resident and two interns.

It is definitely a new feeling to have “the last say.” All my previous experiences on inpatient medicine had been as a resident. There were always things that I deferred to the attending. Like discharges home, for example.

As the attending, I had the final say. And it was a very different experience.

Serving as the attending on the teaching service was interesting as well. I remember frequently paging my senior residents to check in and make sure they did certain things. And as I did that, a light in my head turned on. I realized why I used to get several pages from attendings as they wanted to make sure I followed through on certain things.

When you have other people taking care of patients under your license and supervision, you start to pay attention.

Part of my job as a Chief Resident is doing a cetain number of MOD shifts. Seven shifts down. Looking forward this upcoming year. I have a lot to learn about medicine still. I have a lot to learn about teaching residents and students. I also have a lot of fun in store.

Stick around, dear reader. This should be a fun year.

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Chief Residency

It has begun.

On June 30 I officially ended my Internal Medicine Residency. Well, maybe I should say that I completed it.

On July 1 I walked up to my brand new office. As I stood in front of my door, with key in hand, I read the new nameplate on the door. It was awkward.

Residency ended without much fanfare or closure. My program, for whatever reason, does not have a “graduation” ceremony. They did have a “graduation banquet” in May but I was on a pre-planned family vacation during that time. Maybe that’s why I felt like I lacked any real resolution to the residency phase of life.

So far there has been anxiety, confusion, frustration, and fatigue. I’m hopeful that the year will be one of professional and personal growth. I just hope that the growth does not require much pain.

On July 1 I attended the mandatory “new hire” orientation. After completing all required paperwork, I went to HR to pick up my new ID badge. As I already had a picture on file, I just waited in the lobby for them to bring out the new badge. After what seemed like 20 minutes, someone came out to deliver it. Instead of “Resident Physician” under my name, it now said “Attending Physician.”

Looking at my badge, almost 1 month later, it still seems weird to see that.

I don’t know what this year will bring. I’m sure it will be challenging. I’m sure it will push me.

So for those of you who have followed this journey through this blog, I invite you to continue with me.

And for those of you who have just found this blog, well, you’re invited too.