I know there have been a lot of physicians and would be physicians that have been reading some of my rants lately.

It’s not all bad news. I do enjoy the medicine. I do enjoy the patients. I’m proud to be a physician. I worked hard to get here and I’m not going anywhere. I just get so tired sometimes.

When  I read the article

Coping with Stress in the Practice of Medicine

from the Texas Medical Association it was with relief.  It’s really nothing earth shattering or revealing. It’s just good plain common sense and I gobbled it up.

I  told myself that I would spend this whole NaBloPoMo month talking mostly about medicine and now I feel at day #10, I’m ready to post a pretty picture or write about the kids.

I hope all of you in the medical field remember to do the  following. (This means all you  nurses and medical assistants too!)

1. Maintain a sense of optimism
2. Work on your friendships
3. Focus on two special individuals in your life
4. Plan for retirement
5. Take care of yourself
   • Find exercise you like and do it
   • Spirituality
   • Health maintenance
6. Keep a sense of humor
7. Do something you like
8. Be comfortable with assertiveness
9. Believe you can change
10. Get help if you need it

Here’s a recent photo of my oldest girl. She just turned 7 and she has a wise soul.

I got this from the Texas Medical Association.

It was really an eyeopener and actually made me feel better.

I have some  good more good pearls I’ll share tomorrow.

Before and exam, I’d stay awake for hours to cram in every last bit of knowledge. I’d study up to the last second before the test. When in residency,  I’d come in early and stay late. Nothing was too much. I was dedicated. I was a physician and I’d taken an oath. There was no other way. I laughed when asked if I would work part time after I had my first.

Then I had my first child and then the second and then the third. I had three kids in 4 years and it rocked my world.

I now lived and breathed them and couldn’t keep the medicine in my brain. Sleep deprivation had never felt so bad. I fell asleep once while nursing my oldest. She slid off my lap, down my legs and almost hit the floor until I finally woke up and caught her.

I pumped in the call room and later after graduation I pumped while driving into clinic.

Clinic medicine was worse than residency- My kids were dropped off at 5:30 am and picked up at 6:30 pm. They ate breakfast, lunch and dinner at the daycare.

I cried when I tried to call in sick at the office and was told that the 32 patients waiting to see me wouldn’t be too happy.

I felt trapped and angry.

How could I give more to my patients and deprive my children? Where had my priorities gone? And then we moved.

Guam saved me.

MPG pediatrics saved me.

For the first time I was able to work part-time. For the first time I was able to walk my kids down to the bus stop and pick them up at school. I now attend gymnastics and swim classes with the kids. I cook homemade meals and read to my kids.I keep up with the laundry and I now have so much time- I actually blog and play with photography!

What am I complaining about?

Nothing that’s what. At least not today.

Why today?

Today I listened to an ICU nurse talk of her recent deployment in Afghanistan. She’s been home a week and the trauma is fresh. There are dead and mutilated men, women and children on her mind.

I let her talk and felt lucky to be reminded that I am blessed.

This time here in Guam in good.

7 right?

Today I waited until almost the 11th hr to get my post in.This writing every day has almost gotten me beat. I could cheat and post a photo but I really wanted to do this because I wanted to give myself the chance to put something down, to actually write something.

I mostly I wanted it to be about medicine because it’s what I do the most outside of being a mother and wife.

The first dead body I ever saw- in the context of medicine- was an autopsy.

What a job.

This one was particularly sad because he was older, living alone in a trailer and when his dogs were taken from him, he turned on the gas oven and just let run. They found him days later and by the time we saw him he was bloated and well…you get the picture.  It was the first time I ever saw inside a body too. With the mask over my face to help me breath, I peered as the   medical examiner prodded around ruling out any other possible causes of death.

I think I went for a bike ride later and had pizza with friends. I don’t think I even thought much of it until years later.

The second dead body I ever saw was in Gross Anatomy- first year medical school. What a smell. It permeates through everything. After a while, amazingly you don’t even notice it anymore. People around you wrinkle their noses and you lift your arms sniffing your shirt and wondering if they can smell you. Trust me they can.

Years later you’ll be eating something or taking a walk and the smell will come out of nowhere and take you back.

And you will remember and be grateful for the air you breathe and the chance to laugh and smile.

Well the envelope is ready to be mailed. My  heart is pounding, the music is playing and I can’t find a paperclip.

Figures.

As many of you know I am in a writing class and months ago my teacher  told me my piece- The Ugly Side of Being a Doctor needed a home.

So I choose Oprah. She’s kinda warm and cozy.

I fixed it up, cleaned some sentences here and there and wrote a cover letter.

And now it’s ready.

My first submission.

John gave me the push last week. Do you even want to submit it? Because if not then don’t worry about it. But if you do, then make the time and do it. If it was really important you’d make the time. Seriously Sheila, is it important to you?

Uh. Yeah. Well… sort of.

Who knows maybe I have the editor wrong. Maybe it’ll be filed in the trashcan without even a look or worse they look at it and it’s still filed in the trashcan.

Ugh.

Oh well. Who cares? WTF. You only live once huh?

What’s the worst that could  happen? The worst is they don’t publish it and then we go back to where I was before- Nowhere.

So here goes.

I do need a paperclip though.

Did you know they hate it when you staple things?

His first bubble and I caught it! I didn’t mean to I was actually just playing with the manual setting and figuring out the metering. Then I looked down and yelped. Yeah!!!!!!!!

Imagine that.

The pose, the shirt, the bubble, the age.

It all means something and I’m glad I caught it.

NaBloPoMo Day #3

“I ‘m having trouble connecting!”

I yelled this out to my staff this A.M. . What I really meant was that my little hand held computer was having trouble connecting to the main computer.

But as I yelled it to the world it was a realization to myself as well. Busy with home and chores and now with NaBloPpoMo I am getting more and more disconnected with my life and everything is becoming a task. I tend to do this and then can’t quite figure out why I’m all amped up

Tasking Tasking Tasking.

Wake up- Check

Wake the kids up- Check

Drink coffee- Check

Make lunches- Check

Kiss husband goodbye- Check

Walk kids to bus stop- Check

Visit with neighbors- Check

Take shower – Check

Drop youngest at preschool- Check

See clinic, follow up labs, chart- Check, Check and Check

Go grocery shopping- Check

Pick youngest up at preschool- Check

Pick up kids at bus stop- Check

Make delicious and healthy meal- Check

Eat said meal- Check

Give baths to kids- Check

Check homework- Double Check

Read to kids and tuck into bed- A Relieved Check

I do eat and do laundry, occasionally work out and forget to clean the bathroom..

After the kids are down, I crawl into bed and read for a while. Lately I hear the TV on way in the distant living room but make no attempt to go and watch and talk with my husband.

Tasking Tasking Tasking.

I squeeze in little moments to think, to write, to collect myself.

Even some of this I wrote on a paper towel, while crouched over the sink in my office bathroom.

It’s the only place I am guaranteed privacy. At work is it unthinkable to bother someone in the bathroom. At home I’m free game.

Last night my dream was about a crocodile that wouldn’t stop chasing me. My dream sister let it eat her pinkies as a snack and this assuaged the beast and we got away.

How depressing.

See this is why I like to write because when I woke up this morning I would have thought it was any other day. Now I know I need to breath in between my tasks and  keep writing.

I feel better.  A warning for all those crocodiles-  “No more pinkies for snacks!”

Once a long time ago, I practiced in an affluent community. I was definitely the country cousin coming to visit. I stood out just a little.

After I  would drive an hour a half to start my clinic, the pretty mommies would sit in my office and shake their head and say while smiling,”Why Dr. Cason, you don’t want to live over there!”

I smiled a polite smile back and said I was doing okay. And I was.

My office was small and it was filled with the some of the usual professional families and sprinkled in there  every once in a while was an indigent case. But the run of the mill was immersed in a lifestyle that was and still is so out of my league. I was in a little bit of awe. Of course I was saddened by the occasional teenager alone and sitting in my office while the well groomed and lovely mommy drank their Starbuck outside enjoying the fresh air.

I flinched when I saw that, but truth is it also looked pretty nice and I wouldn’t have minded trading places.

After a day long clinic of checking ears before a plane flight to an exotic location- they were always exotic. I don’t remember the flights to Ohio just the Cabo ones- I longed for a massage. I ached for lovely face creams to erase the fatigue. I wanted to sit along with them and drink a sip of my own latte and talk about our next vacation.

But I wasn’t there on the bench or wandering the farmer’s market or lunching.  I was in an impossibly small room talking with very groomed and inappropriately dressed girls who admitted to stealing their parents alcohol. ..Woah! Wait a minute what did you say?

When I started I thought it was all ears before Cabo medicine but what I eventually found was that medicine was medicine and each subpopulation had their issues.

I didn’t last long- the drive killed me. But I miss it all the same. The patients and peek into a world so different from my own.

NaBloPoMo Day #1

Is this all there is?

Is this what I went to medical school for?

Now don’t get me wrong, I love the patients. How could I not?

My day is filled with trembling tearful smiles and

chubby hands that wave backward goodbyes.

So let’s get that straight.

I’m not talking about the patients.

I’m talking about the pace.

If the schedule is singly booked, well then it’s a good day.

It’s a day that means I will chart as I go.

I will return phone calls within the hour in which they were received.

I will linger and ask about how your family is doing and will laugh from room to room.

I will check on diagnoses and read up on the latest recommendations.

I will double and triple check my prescriptions.

And I will thank the Lord that I was blessed to be a part of your life.

But if the day is double booked or perhaps triple booked,  then I will hit the ground running.

I will move from room to room and chart every 4-5 patients if lucky.

If not so lucky I will just forget it all and come in early the next day.

And then wonder what little Maggie had and if  I gave her Amoxicillin or Augmentin.

I will forget to ask you how you are doing.

I will instead begin each encounter with, “Thanks for waiting.”

I will return a phone call at the end of clinic and will likely miss you.

You had to move on. And so did I.

I will practice on autopilot and hope that I didn’t miss anything.

And I will ask the Lord and search my soul and wonder…

Is this all there is?

Makes me smile just looking at him.