A New Year’s awakening: Life lessons from residency

January 16, 2015

Yalda Afshar, MD, PhD, Contemporary OB/GYN's residency blogger, reveals her New Year's realizations and resolutions as she heads into 2015.

I’ve never been a New Year’s resolution kind of girl. But there is something attractive about the idea that you can tell yourself you will “ctrl + alt + delete” to refresh and revise some aspect of your life over which you think you have control. It’s a chance for a small self-renewal in some shape, size, or form. Sometimes, feeling like you can control one aspect of your life is all you need as a resident to remember that you are not working in senseless automata.  Dr. Lockwood’s Top 10 list inspired me to reflect on a few residency-related New Year’s realizations (and resolutions) of my own.

Residency is intensely socially isolating, especially for those of us who have a large part of our personal and social lives unassociated with medicine. Friends I knew outside of medicine have slowly stopped inviting me out. I guess responding to invitations with, “sorry, but I’m working,” gets old quickly. Many holidays would come and go unnoticed, had a nurse not reminded me of the purpose of the night’s potluck. Do not get me wrong, there is something special about delivering the first New Year’s baby. And I realized how lucky I was to be a physician and not a patient when, minutes after midnight on New Year’s Eve, I admitted a patient with a small bowel obstruction following a recurrence of ovarian cancer.

Here are a few realizations and resolutions for 2015, in no particular order:

1.        Life is pretty good. Stop complaining. Last week, I rounded on a patient who was on hospital day number 53 and on whose abdomen I had placed my hands at least 30 times during her stay. How lucky am I not to be hospitalized with monochorionic-monoamniotic twins on continuous monitoring at 26 weeks, facing preterm premature rupture of membrane at 24 weeks, or a short cervix and bulging bag and breech at 24 weeks? Yes, I am at the hospital a lot. But I come and go on my own two legs without needing “ambulation privileges” or a physician’s order. I’ve awakened patients up morning after morning at 6 a.m. to ask about interval night events. I’ve watched these women have breakdowns, given them devastating news, and on some lucky days, I have given them hope. I am so thankful that I have been on service to share their experiences. My few minutes of morning rounds seems pretty minuscule in the big picture of their lives.  Residency is hard work, but I can control how I react to the work load. Life is good.

2.        Stop waiting. Let’s be honest, our 80-hour weeks are better than what our mentors had. We have it pretty good. So, the time is now for that project you’ve been thinking about or that race for which you wantd to train. Yes, you are busy, but you can always make time. Start now and go after it. Don’t wait for this rotation to be over or for residency to end or until your presentation is done. If you want to get going, start now, and if you care about it, you will finish it. Roll up your sleeves and get to work. Stop waiting.

 

 

3.        Let go. Many of us in medicine are have Type A personalities, which is a blessing and a curse. We are hard-working, competitive, and do not let go of our visions and goals. I am the first to admit that I take on more than I should. I am trying to learn to let go of self-imposed unnecessary stressors and obligations that do not enhance my professional life or make my personal life happier. Not everything is a competition. Letting go is not to be confused with being complacent. I hope to demonstrate competitiveness with intelligence, passion, and hard work, not involvement in every aspect of everything around me. This year, I’m trying to spare time to follow a few passions outside of medicine. I will stop doubting ideas or feelings that keep coming back to me. I aspire to think that my free time will also be filled with ideas that flood my mind. Be yourself without standing in your own way. Let go, stop feeling guilty, and keep moving forward dynamically.  Adjust your vision and goals with your own happiness in mind. Allow yourself to say no (with balance). Let go.

4.        There are many ways to do the same thing.  During our third year, residents spend a lot of our time working at a busy community hospital away from their home institution. At our home institution, we are trained by the book - evidence-based. Our training on this away rotation is filled with subspecialists and private physicians. Because of my academic residency experiences, I initially had a hard time adjusting to physicians who worked within the confines of ACOG recommendations but outside what I have been taught as the most evidence-based approach to medicine. I live and breathe evidence-based medicine; however, my experiences at this hospital have taught me that although I may not practice in this way, there is nothing wrong with doing it a bit differently. I am appreciating the art of medicine as I never have.

Working with a handful of family medicine residents and midwives has really strengthened my belief that low-risk pregnancies are in fact low-risk and should probably be left for the midwives and family docs. Management of high-risk pregnancies is the domain of obstetricians. Maybe this new belief stems from my recent realizations that I now aspire to become a perinatologist. I’m learning to stop micromanaging and empower my team members to make decisions while providing support and guidance as a senior resident.  There is nothing wrong with walking your own journey on a path you create, as long as it is safe for you and those around you. Thank you to the co-residents, nurses, and attendings who have taught me that. More so, thank you to the patients who have entrusted their health to residents.

 

 

5.        I have the best job in the world. I will say, one of the most wonderful parts about being an ob/byn is when your high-risk patient delivers without complications or completes a surgery and looks back to thank you. You remember what a privilege it is to be an intimate part of people’s lives. Honestly, I should thank my patients more often. So, here goes: I want to thank my patients with “ovary pain” and “women problems” for pushing me to be a better physician. These women challenge me to read literature and evidence and without fail, share with me aspects of their lives that are not about pelvic pain. Through their lives, they have helped me master the art of medicine. Thank you for allowing me to be a part of your intimate lives, your struggles, and your successes. Thank you to my patients who have invited me to sit in on their conversations with partners, families, and members of their circles of trust as they made difficult decisions. Thank you for letting me have the best job in the world: taking care of women!

Residency is emotionally, physically, and personally draining. There are some days and hours when the soul feels like it’s getting weaker. The great Dr. Albert Schweitzer talked about the inner fire that is often rekindled by another human.  I find there are some days I need rekindling. The fire starter is often just a stranger I share a word with down the hospital hallway at 3:00 am, a tired co-resident who brings me a cup of coffee, or just a patient’s smile. Really, any fellow human being can remind us to relight the inner fire and shine. This year, my realization is that I have deep gratitude for those who have rekindled my inner fire. I will use the New Year as a reminder to reflect and revise; a symbolic chance to move forward and light the fire.