I’ve noticed a trend between late nights at work, being tired, and a vicious cycle of negativity. My temper kicks in, my fuse shortens, and I’m ready to brawl any chance the situation presents itself. But that’s not me. What the heck?
Let’s start with lack of sleep:
It’s so much easier being negative than taking the time to look at the positive side of things. I’m a realist so the positive BS gets a bit thick for me. I’m not outright rude to people, but I certainly don’t go out of my way to sugarcoat things. In today’s world, I do feel people need better coping skills. Does that make me a cold hearted snake? No, I don’t think so. I just think I’ve seen things and dealt with things that have made me stronger. Perhaps I’m out of touch.
Realizing lack of work-life balance
If 40 hours/week is the magical number for work-life balance and being able to maintain “full-time” status… I’m well over that. Perhaps the lack of being able to make my own hours is another imbalance. I’m a servant to my pager and to my hospital duties. Don’t feel sorry for me; I knew that going into healthcare. Is work-life balance an illusion?
But maybe this is what needs improving. As I get older, it’s harder and harder for me to find sympathy and feel empathy in situations. I don’t have any concrete examples coming to mind, but I find myself believing that people got themselves into a particular situation without a thought of consequences. There seems to be a huge movement for being in the present — quite honestly, I wouldn’t mind if people had the thoughtfulness to think of the present while also keeping an eye on the future.
I grew up in a small west Texas town called Abilene, TX. My mom was a standard tiger mom in that she encouraged me to pursue multiple activities while nudging me to do my best. After drama lessons, tennis lessons, basketball, volleyball, piano, violin, band, taekwondo, pageants, and just life, I left Abilene and pursued a biomedical science degree at Texas A&M University. My earliest memory of wanting to be a doctor started when I was in the third grade. I hadn’t been feeling well and was diagnosed with pneumonia — I had been reading a book called This is the Child. My family practice physician Dr. Lawson was about to prescribe me prednisone, and I immediately got worried because that was the same medication used to help with the child’s leukemia. Dr. Lawson picked up on my early curiosity and invited me to hang out with him in his medical office observing patients. After college, med school proved to be a great experience at University of Texas Medical Branch in Galveston and it felt like learning on steroids (as compared to college). My clinical rotations led me to the path of choosing anesthesiology as a career. Anesthesia is the perfect combination of anatomy, physiology, pharmacology, psychology, and sociology. I matched into a terrific internship in Austin, TX and continued my anesthesia training at the prestigious Massachussetts General Hospital. Following 4 grueling years of training, late nights, memorable cases, and lifelong friendships, I chose to pursue a cardiac anesthesia fellowship at University of California San Diego — a world renowned institution for the treatment of right heart failure following pulmonary thrombosis. 14 years after graduating high school, I have the job of my dreams. Here’s a sample of my day…
Today I’m #2 in our call lineup, which means it will be a pretty busy day. Typically, we have 15 call spots in our main operating room (OR) numbered #1 to #15. #1 position gets the first pick of cases. #2 gets the next pick and so on.
5:45a Early heart day wake up. Today, I will be providing anesthesia to a 70-something year old lady who needs a new heart valve. On heart days, I wake up at 5:45a to be at work by 6:30. And on regular main OR days, I wake up at 6:15a to be at work by 7:00. Ahhhh… To have more beauty sleep!
6:17a Breakfast in the car – it’s either green juice, Shakeology, or banana on the go!
6:31a I meet the patient and her family in the pre-operative area. We go over a detailed plan for her anesthesia as well as answer any questions. One of the best parts of my job is meeting all different types of people. It’s an amazing feeling to meet people at one of their most vulnerable moments in their lives and win over their trust and respect. It is my job to safely manage their physiologic processes. Oftentimes, patients tell me it is the anesthesiologist who is the most important part of a surgery — they understand how easy it is to bring them close to the brink of death and then revive them back to a wakeful state. It’s incredible the amount of trust patients place in your hands in such a short time after meeting them.
7:15am The patient is under anesthesia and all invasive monitoring lines (arterial, central venous pressure, cordis, pulmonary artery lines) have been placed. The transesophageal echocardiogram is performed and results are relayed to the cardiac surgeon.
7:45am Cardiac surgeon makes incision. The patient is monitored throughout the case. Multiple screens show all the physiologic monitoring results.
10:00a Bathroom break! Partners/colleagues break each other out so there is always an anesthesiologist monitoring the patient. It’s also a good time to grab a snack!
11:32a Drop first patient off in Cardiac Care Unit and grab some lunch. The doctor’s lounge keeps us fed with soup and salad. Today, I’m feeling the vegetable soup. Grab a quick bathroom break and then to interview the next patient.
11:45a Electrophysiology study for atrial fibrillation ablation. The view from this OR is such a delight!
The view from my little nook.
14:00 I get a call from our anesthesia czar, one of my partners who runs the schedule. He was wondering if I would make my 15:00 hip replacement. After a quick conversation, we decide that I would call him in 30 minutes for an update.
14:33 We are finishing up with the current case and I call the czar back to find out about my next case. I learned that there is an emergent heart that will be started by another colleague and that I will continue the lineup in EP (so my day went from a 16:30 finish on paper to roughly a 19:00 finish). Anytime I am in the top 5 call positions, I know not to make defined plans because you never know if there will be add-ons or changes to the schedule. This makes my social life a bit frustrating as my non-medical friends have a tough time understanding and adapting to this “you don’t get out of work at 5p?” concept.
15:20p Drop patient off in the Post Anesthesia Care Unit (PACU). Grab a quick snack and head back to EP for the next patient.
15:25p Speak to the next patient who has arrived for an a-fib ablation as well. Induce and get started with the case.
19:22 Drop last patient off in the PACU. As #2 on the call list, I look at my watch and realize that I am #2 at night. This means I will be the 2nd person they call tonight if extra rooms in the OR get booked (traumas, heart call, etc.). As much as I’d love to head home and grab a glass of wine and unwind, I meet up a friend for dinner to catch up and relax.
21:42 Head home. Shower. Brush my teeth and get into bed. There’s always a risk of being called into work. Tomorrow will be a shorter day. After the hectic day, I am still thankful for my wonderful job and colleagues. Looking back at my journey to get here, I smile because I couldn’t be happier.
This person is ahead of their time both in understanding and maturity. It’s incredibly beautiful and inspiring to see such poise, insight, and awareness in today’s world. Whether it’s a failure or success, I do believe there’s a lesson in every journey.