Showing posts with label physician wellness. Show all posts
Showing posts with label physician wellness. Show all posts

Tuesday, February 14, 2017

How Many Balls Can I Juggle?

I've been trying to dig deep and reflect on my own work-life balance... I feel like I'm living in a world in which my mantra to my learners and advisees is "Do as I say, not as I do."

I love to teach. I'm in an academic position because I thrive on teaching while working clinically. I teach medical students, residents, fellows and am engaged in faculty development. I'm encouraged by my mentors to "be academically productive" however I'm not entirely clear what that means. Write, publish, be educationally innovative, do research, stay sane and be a good mom and a good doctor. 

I need a new organizational scheme. My most successful portion of my organization is my google calendar. I literally cannot do anything without it. I've got it color coded and labeled. My week in view is dizzying with color coordination and notes. My to do lists, however, are scattered between different notebooks, notes on my phone, loose pieces of paper that find their way into the ether. I need a new work flow solution. I need to find a way to keep track of things and move my academic work forward in meaningful ways.

I sat down in a coffee shop the other day to try to make sense of it all and stratify things into columns and was overcome by this subtle feeling of butterflies and anxiety in the pit of my stomach. I've never really been ridden with anxiety, however this discomfort is rearing its head more and more frequently... feeling like I'm missing something, am forgetting something, am going to drop a ball, be found out as a fraud who cannot "do it all."

While I'm not junior in life, being a "non-traditional" physician, prior career as a nurse, I am early in my career as an academic physician. As such, I feel this pressure to continue to do things which further my personal and professional development. At the same time, I want to be sure that I am giving my son the time and dedication he needs from his mom.

As an ER doc, my schedule is widely variable, shifts in the day, evening, night, weekends, holidays. Sharing my son with his father affords me the opportunity to work academically without interruption about half of the time. There's still work which needs to be done when I have him. So, I try to balance it by not working while he's awake. Sometimes I'll have a random Tuesday free and we do arts and crafts, read, go to the park, ride bikes, run around playgrounds, run errands. These are the precious moments I hope he will remember and treasure... I know I do. We make meals together, he shares his days spent with my nanny and daycare and at night, I tuck him into bed, sometimes dozing with him. He looks at me beforehand, puts his little hand on my face and says "Mommy, I love you bigger than the Earth." After drifting off with him for a bit, I get up and set my sights on my late evening tasks... emails, curriculum development, evaluations, mentoring grand rounds presentations via chat mediums or Google Hangouts or FaceTime. 

I sit here sipping my chai tea, reviewing important dates for the next academic year, the next evolution of my growth and development as an educator, curricula which need updating and modification to be in line with current educational methodology, exploring alternative ways in which to teach and engage learners in an overall curriculum which has less and less "time" for what I feel needs to be included. 

I feel fortunate to have been given some incredible opportunities to take on leadership positions and influence our future doctors. How many of these am I capable of managing? Am I giving each of these precious opportunities the time and dedication required? Am I being the best educator and physician that I can be? Am I being the best mom I can be? Am I seeking out mentorship appropriately to optimize my productivity? Am I interfacing with the right people? Am I serving my learners to the best of my ability?

My life is a concept map.



Saturday, November 12, 2016

What's This Week Been Like For You?

I’m sure we all have an opinion about the election outcome; most likely, a strong one. I was following with intense anticipation as a Canadian. I am utterly despondent with the result. The day after, I met a friend for coffee and together we tried to process the reality. It felt much like the morning after 9/11, where we knew we were facing a ‘new world’ and an uncertain future. 

Our national public radio station’s coverage was filled with interviews with Americans relaying their uncertainties about the future. One gentleman felt a sense of betrayal by his neighbours; that he did not feel he really knew his city as he thought he did. I know that some of you are heartbroken, as I am. Others may be elated, or at least satisfied with the outcome. Some of you may feel conflicted. Still others may be Republicans who feel dismayed that Trump was their candidate. Maybe none of these captures your sentiments. I know many people are struggling to talk to their children about the outcome. Many American citizens and residents of colour and other vulnerable populations are especially worried about the “Trump effect” on their children, and perhaps some of you are seeing its effects in your daily life in medicine. In Family Medicine, it's not uncommon for some patients to bring up political topics, but I try to stay pretty balanced and general.  Personally, I found inspiration here, which cites this great article about talking to your kids about the result. Reading personal accounts and opinion pieces by those who are processing the results thoughtfully is helping me deal with the result. 

I realize that politics in general, and this election in particular, can be polarizing to discuss, and I know this blog does a great job of being a safe space. A refuge from the constant barrage that was so consuming during this campaign, perhaps. I think we can maintain that safe space by respectfully sharing our own personal experiences, fears, and worries. Because no matter your political stripes, I think it’s fair to say that the months ahead are uncertain for the United States, and the world.  

I have great faith in the American people, and the American system, to uphold their democratic values. I believe that most people are decent and that political and social tides ebb and flow throughout history. Let's help one another navigate the best way forward for our families, communities, countries, and the world. 

Friday, July 29, 2016

Summer Book Recommendations

Ah, summer. There's nothing like the joy of sitting with an iced tea and a book on the deck... or waiting in the dentist's waiting room reading tiny print from a reading app on your phone.

1. Vaccinated by Paul Offit. It was completely fascinating to learn about the early days of immunization. Even if you've learned the science before, reading about the social context is so interesting.

2. Overdiagnosed by H. Gilbert Welch. This book changed the way I look at my practice, every day. Welch is an epidemiologist and explains the principles in a very accessible way.

3. Crazy Like Us: The Globalization of the American Psyche, by Ethan Watters. A must-read, especially if you work in mental health. I see a lot of refugee and newcomer patients, and do some element of cross-cultural mental health most every day. It's challenging because our entire mental health assessment is rooted in the culture in which it was created, and the very definitions of mental illness vary so widely in different contexts.

4. When Breath Becomes Air by Paul Kalanithi. I know you are hearing about it everywhere. It is beautifully written and helped me reflect on medicine in a different way. "But if I did not know what I wanted, I had learned something, something not found in Hippocrates, Maimonides, or Osler: the physician's duty is not to stave off death or to return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence."

I was on a female memoir kick last year, and thoroughly enjoyed the following:

5. Julia Child's My Life in France. Transport yourself to France and witness the early days of her love affair with French cuisine.

6. Nora Ephron's books of essays, I Feel Bad About My Neck and I Remember Nothing were, of course, hilarious.

7. Laughing All the Way to the Mosque by Zarqa Nawaz. Zarqa Nawaz is the creator of the TV show Little Mosque on the Prairie. She diverted from her parents' expectation for her of a career in medicine and found her way to journalism and the arts instead. As a fellow Canadian Muslim woman, I loved hearing her always-funny perspective on issues she faced along the way.

8. I Was a Really Good Mom Before I Had Kids by Trisha Ashworth and Amy Nobile. A down-to-earth book about the real issues we face every day as mothers, I found it totally affirming to read.

Fiction:

9. On Beauty by Zadie Smith. "And so it happened again, the daily miracle whereby interiority opens out and brings to bloom the million-petalled flower of being here, in the world, with other people. Neither as hard as she had thought it might be nor as easy as it appeared". Filled with breathtaking passages but also dry humour and wit, On Beauty was captivating.

10. Everybody Has Everything by Katrina Onstad. Following years of infertility, a young professional couple takes guardianship of a young child when their friends suffer a terrible accident. The struggles of being thrust into parenthood of a unique sort; with the same truth that we all live with - the uncertain future.

What books would you recommend?

Monday, July 25, 2016

The Zuckerberg: Space Does Matter

Hello everybody!  I am one new to the group and just wanted to introduce myself.  I'm originally from Massachusetts, currently a Bay Area Internal Medicine Hospitalist with a 2 year old daughter, siberian husky (mini) and techie hubbie.  Hope to contribute some entertaining stories.  The following is something I wrote last month after we moved into our new hospital. 

            The ‘space’ can make a difference.   I had already spent two years working as a physician/hospitalist at San Francisco General Hospital, and I had become accustomed to the old building and all its challenges.  Fast forward to the end of May 2016 to one my first shift working in the new building … Zuckerberg San Francisco General (ZSFG/The Zuck); change had never felt so good.
            I walked across the bridge connecting our old building to the new ZSFG which consisted of expansive windows and white beams that outlined the hall. It was a sunny day in San Francisco, and I was able to witness it for once.  At the entrance there was a quote etched into the wall  “Be the person who touches the lives and hearts of people. Be a positive light to others as you put a smile on their faces”.  I found myself taking a brief pause and a smile was taking form and there was no stopping it. 
            Onwards I trudged, only to be greeted by a security officer who looked at my badge, and then said ‘Good Morning Doctor’.  As I stepped off the large steel elevator onto the 6th floor, different routes presented themselves; I was warned about this and the likely confusion that would ensue. Nonetheless, the room numbers were highlighted with San Franscisco themed unit names like “Mission Dolores” and I walked to the zone I needed to get to.  The heavy blue doors which were often manually opened were now beige and badge activated, opened by a mere hand wave.   This might sound trivial given that its 2016, but let me emphasize that it is not.  The design of the building was doing work for me instead of me pushing my way through everything.  
            Now came the real test…how were the actual work floors and units.  What struck me immediately was the lack of noise; it was completely quiet! A brief instance of panic set in and I thought, ‘ Oh my god, I’m on the wrong floor…. Is this the morgue’ but no, I was exactly where I needed to be.  As I walked further around, there was a spacious work station with an lcd screen showing patient room information and nursing assignments with call numbers. 
            The time had come to finally enter my patients’ rooms.  I knocked and then with ease opened the door only to find my patient sitting in bed comfortably with the most spectacular backdrop of the city I had ever seen. The room had ceiling to floor windows that beautifully displayed San Francisco at its finest, and the sunlight poured in.  I sat down at his bedside, and began to go through my assessment and learn about his concerns.  Usually at this point I would be raising my voice to overcome my patient’s neighbor who was either watching television, or talking to others in the old building.  The rooms had no natural light, so lights always had to be turned on, which was of course bothersome for many as some patients were sleeping, and others were not.  The rooms were also filled with walkers, trays, and other medical equipment that were strewn about as there was minimal space, and it became an obstacle course for staff, patients, and family whenever anyone moved about in the room.    Now with this all gone, feng shui was in full effect.  I reviewed the plan with the patient, and calmly exited the room.  As I entered the next patient’s room, similar exchanges and observations happened.  With my mind unburdened by the environment, I just focused on the subject at hand.  My patients too were not being set off by surrounding stimuli; they now had peace and quiet.
            I finally ended that morning with some downtime in one of the new provider rooms to start the lovely exercise of completing my documentation, and again I was struck by the silence.  It was like a library where I actually had the space and time to think about what I was doing.
            Noise and chaos was often the defining feature of our intense environment, and as faculty and staff, we perfected our ability to deliver high quality care to our troubled and sick patients despite our surroundings.  Now with ZSFG, San Franciscans along with our many generous donors have contributed to a building that has shifted the mileu of our work environment.   My patients now have a space that truly honors them in tough times and gives them the space within which to heal.  As a provider, I now have the space to work more seamlessly and to think and reflect on my work.  Of course our space is not perfect, but you have to start somewhere right? So let the healing begin…