Sunday, July 18, 2021

a heavy heart

Warning: this is a sad post involving postpartum depression and physician suicide.

I had a friend from medical school come visit this weekend with her husband, which was absolutely wonderful and much needed for all of us. They played with my kids and cheerfully put up with a quick park stop (because lord knows a 3 year old can never pass a park without stopping). Unfortunately, she also shared with me that one of our medical school classmates and a friend of ours had recently ended her life after a struggle with severe postpartum depression. She had a daughter a few years older than my son, a newborn son, and a husband. I checked her Facebook to see if there were any updates there - and all I saw was a glowing maternity photo of her husband’s arms wrapped around her, and a warm photo of her snuggling her daughter and newborn infant. I couldn’t imagine how much pain she had been in to leave these faces behind. 

It made me think back to earlier this year when I found out one of my very best friends also had postpartum depression - she posted it on Facebook that she was seeking help, and I was ashamed that I hadn’t called or texted or done anything to see if she was ok in the last few weeks. We talked on the phone afterward about how the loneliness of COVID made pregnancy and the postpartum period so difficult, and how so many people had reached out to her after that Facebook post, opening up about their own personal struggles. And of course it made me think about my own recent maternity leave. 12 weeks of maternity leave in the winter of COVID was the loneliest thing I have ever experienced. It was both lovely and awful in its monotony -  it felt like one long day of sitting on the couch with a newborn and watching a preschooler play legos. I was lucky to have my husband working from home and a support network that was open to late night zoom calls with a bouncing baby on my chest. I had to frequently remind myself that this was a time like no other, a time to shelter my children from the rising COVID trends, and I would never get this much time alone with my children again - but there was definitely more than a little relief in returning to my job and a more consistent schedule. 

This is not the first physician suicide in the medical school classes surrounding mine - and I really haven’t been out that long. Learning of my friend’s death was a harsh reminder of the terrible frequency of physician suicides and how deadly postpartum depression really can be. 

Last night, I spent the evening snuggling with family and holding my little ones a little tighter. I wanted to make some space for my friend, but really didn’t know how - so I’m sharing her story here in this community, where my fellow mothers in medicine can help remember her and hold space for her with me. So if you’re reading this, light a candle, say a prayer, close your eyes and send warmth to her family - but most importantly, check in with the moms around you, because sometimes people are just not okay.

Love to all,


Sunday, July 4, 2021

the never ending box

Coming back to the blog after brief hiatus of getting stuck in the cycle of [drop kids off, daycare, work, pick kids up, make dinner, put to bed, random chores, repeat]. Whoof. In the middle of it all there’s been some shining moments. Baby girl is now 6 months old and sitting up and infinitely less breakable. Preschool boy is now super into legos - we’ve found my husband’s old lego sets at his mom’s house which have been so much fun to put together again as a family. 

However the last few months have been a little tough. I always knew primary care attending life would be more like a marathon with residency being more like high intensity interval training (sometimes you’re working nights and weekends on service, sometimes you end up shadowing a urologist for a few days and you take the breaks you get). But I’m struggling with the sheer never ending weight of my inbox. We did so much over the patient portal and electronically in 2020 during COVID restrictions and when we were short staffed - however now that the clinic is fully open, it’s still much easier for patients to try and get medical advice for free through the patient portal rather to make a clinic appointment that I have protected time for. Can’t really say I blame the patients because I’ve been there and done that too - it really is soooo much more convenient. However some requests are really inappropriate to be handled via email exchange and I don’t think patients get it. And yes - someone did send me an online message while they were literally having a heart attack. 

There are some shimmers through the clouds - administration is really working on getting nursing more involved in taking care of the things they can take care of within their scope, but still - the box is always there. I also think life will also be easier when I’m done pumping in 6ish months, and administration is also piloting longer office visits to make up for the increase in online work we’re all feeing. It’s also a little worse now while everyone else is on vacation and I’m covering their stuff and I don’t have any wiggle room left for vacation myself between maternity leave and sick kids. So there’s hope, especially for 2022 Kicks.

I did have to take a step back. I spend a couple nights a week catching up on things when I’d rather be taking personal time or hanging out with my family. I don’t really think my kids have suffered (I’ve used after bed time for catch up time) but I miss my husband and watching TV together. So I decided something has to change and I am dropping down to 0.9 FTE. I might try 0.8 if this still isn’t enough to protect my sanity (but the way my schedule is designed I bet I would do almost as much work at 0.8 and just get paid less). 

Today is a good day - the perks of outpatient medicine being a 3 day weekend every so often, but I’m still working on some balance. I had a professionalism consult recently in which my advisor reminded me I’m still new (only 2 years out of residency and practicing now longer in a COVID world than a nonCOVID world) and it takes several years to really master the clinic flow. 

Any other tips from my outpatient colleagues on how to conquer the work-outside-of-work?