If you grew up in a low- to middle-class household or maybe just an Asian/immigrant household, you probably had some exposure to the scarcity mindset. I am thankful for my family’s super-frugal philosophy because it allowed me to be financially comfortable today. I am education-debt-free. I am working a lucrative career. Life is good.

But… the scarcity mindset has its downside. It means that there are some weird things I struggle to spend money on. It’s irrational. One example: I have a hard time taking Ubers/Lyfts when there is a train station/bus and my ability to use my own two legs. Once, I was out late and I didn’t feel safe while I was waiting at the platform of a train station so I walked 30+ minutes home instead of just taking a < 10 minute ride in a rideshare. In my mind, this was being frugal. Totally reasonable. [It was irrational. I can admit this now.]

Clearly I should buy new shoes but some inner voice of mine is reminding me that these are still functional. They mostly cover my feet. They mostly protect me from the bodily fluids that I’m exposed to in the operating room and ICU. They are still comfortable to walk around in. They will just end up in a landfill so I might as well keep wearing them!

Where the scarcity mindset gets tricky is when it creeps into other areas of life. I’ve seen it seep into my perspective on dating/relationships; there were moments in the last couple of years where the scarcity mindset kept me in a relationship or seeing someone that I didn’t really like, but felt like I should keep trying at it. Kind of like my shoes. They are functional so why would I trade them in for something better? There probably isn’t anything better!

[Actually, I believe there is often a better “fit” when it comes to relationships. It’s important to have alignment on the big life values. The best thing about being at this stage in my life: I am incredibly fulfilled by my work, family, and friends. The bar should be high. A life partner should be a value add to your life.]

I’m now in the process of evolving from a scarcity mindset to one of abundance. It feels lighter to live life this way. From a financial standpoint, this has looked like spending money on purchases I value [e.g., vacations/experiences, higher quality clothing that I look/feel good in, items that bring ease into my life]. I also recognize that lifestyle creep is a real thing, so I try to be mindful about that without resorting back to complete scarcity. I’m proud of how far I’ve come in the last few years… I no longer believe that these purchases will rob me of my financial stability. [For those of you wondering about my work shoes situation, I bought some Brooks shoes but I just haven’t brought them to work yet to break them in.]

From a life standpoint, I have started to see abundance everywhere. There are abundant opportunities at work for making a difference in patient care. There are individuals I am lucky to have the opportunity to connect with on a deeper level. There is the incredible feeling of unconditional love that my chihuahua, Minnie, shares with me each day.

In dating, just a year ago, I think I was giving off seriously desperate energy. I believed that quality partners were scarce. But as of late, I’ve connected with some incredible humans. And more and more seem to show up randomly, when I least expect it. Even if these connections don’t work out as life partners, I am enjoying the opportunity to meet new people and get to know them. I still feel sad and lonely sometimes… but don’t we all?

Those of you who know me in real life know that I have always looked for silver linings in everything. I feel that this is my true nature and that the dark years [i.e., premedical, residency, some of fellowship, a bit as an attending] were not a good representation of my true character. My true character has always been to believe positive intent in everyone. There is an abundance of goodness all around, if you just look for it. [Plus, gratitude interventions have a proven track record of helping mood.]

[Do I sound woo woo or what!? At least there’s some research to support it!]

Let’s get this out of the way: I am happy, satisfied, grateful, etc, etc for this beautiful life I get to live. I have the best job, the best friends, the best dog, and the best family. 10/10 would recommend this life.

But I’m missing the romantic partner. Heh. The other things in my life, I can somewhat control. Finding another human who chooses to put up with my quirks, finds me attractive enough to want to make babies [and of course, vice versa], and is a kind soul that I want to throw my mountains of my love at… this annoying thing… is not in my control.

So, like any human being that is starved for connection, I get sad sometimes. Like really deep dark well of sadness kind of sad. We all seem to be fluent in therapy speak these days, so yeah, there’s some sort of childhood wound that’s mostly scabbed over in the last decade or so but still rears its ugly head sometimes. I guess I have been known to pick at scabs.

Being out of medical training has helped lessen the sadness. The loneliness is lessened by the unconditional love of my dog, and strengthening of my friendships. I was always been terrible about reaching out when I was in a dark place. I appreciate my friends in residency who could pick up on the signs of my sadness and reach out to check in. But now, I’m in a place where I will actually reach out to people and let them know that I need their support. So that’s good. *pats self on back*

There is a real weight that is lifted when you’re done with residency/fellowship [do not recommend critical care fellowship in the midst of a global pandemic…] AND you’ve found a nice stride in your clinical work. Not everyone will experience this luxury that I have, which is why I have to preface this whole entry with being appreciative.

But let’s just dive right in. It sucks to feel alone in your mid-30s when you’re surrounded by your favorite people who have partners and babies [the human kind, not the fur kind]. Who have the proverbial white picket fence [or are hiring someone to build one]. Who have challenges in their marriage but are doing the work with a therapist to work things out because they realize that their partner is worth it. Who are in relationships and building something incredible together. I am happy for my friends but the constant reminder of what I’m lacking when it’s staring me in the face can make a person crazy.

Certain life things are just easier when you have a partner. I’ve been going through the process to freeze my eggs. And you know what you need when you freeze your eggs? A responsible adult to pick you up after your anesthetic [during the egg retrieval process, patients typically get sedation with propofol]. When you’re a single lady with bada** professional friends, it’s hard to ask them to rearrange their lives to pick you up on a random morning. I want to just tell the clinic that the anesthesiologist is my responsible adult. They’re my colleague. I’ll just sit in my office at work until I’m recovered. Promise! As long as I don’t get any midazolam!

[Doctors make the worst patients.]

I want the security of knowing that someone else cares that I am alive at the end of each day. That there’s another human being that will open their arms to me and wrap me in a warm embrace when I’m having a tough day. I want to know that I can ask things of a partner and they want to be there for me. I want to know that someone cares enough about me to try to make life better/easier [Snow storm? Someone who loves me enough to drive me to work!].

Prior to this current season of my life, I was a serial monogamist. I had a serious relationship in high school. Then college into medical school. Then residency. And now… this is the longest period of my life that I’ve been single. When I look back at my serious relationships, I can’t help but wonder, did I f-up and fumble something that would have been good for me long term?

[The answer is no. None of those relationships should have worked out, BUT, only in retrospect can I appreciate what characteristics I took for granted. Like, really took for granted.]

The thought that I’m most scared of when I’m in this dark place: what if I never find another relationship?

When I reflect on this single season in my life, what scares me is that I haven’t grown close to any potential partner in years. It is not for lack of trying. Ask my friends – I’ve been on dates. A lot of dates. I meet people. I make time to date. I try to give people a couple of chances to make an impression on me. But nothing has stuck. Nothing recently has felt like a good connection with aligned values that could actually go somewhere.

What is going on?! I am not that picky. I believe there are suitable men out there for me. I make the effort to meet people. But nothing is sticking.

I think that there are a lot of people on the apps that are purely seeking validation. And a lot of people out there that are just not willing to put in any effort [not prioritizing dating and finding a partner, probably].

No one has offered a set up – I’m open to them! Promise!

Anyway, there is a real catharsis with writing down these thoughts. I am loving the DMs I’ve gotten from people who are in the same boat as me [Hi! Keep sending me messages!]. Even though I’m scared that there may be a universe where I will never find someone to call my partner, I do believe in my heart that it’s possible for me. That it will happen. Someday. [#manifesting]

I recently posted a reel on my instagram about how I experience seasonal affective disorder (SAD) annually in the winter and how I try to manage it. One thing that I mentioned on the reel is that I will take fluoxetine (Prozac) for a short course to help me through the season.

Let’s back it up to almost 5 years ago when I was going through a major breakup. Like… we lived together. We survived most of residency together. We sort of endured the COVID pandemic together [I think that the pandemic ultimately was what accelerated the realization that we were not a good fit for each other]. And I was facing the most challenging exam of my career: anesthesia oral boards.

There was a day that I was scheduled for an afternoon operating room shift and I spent the entire morning crying. I could not stop the tears from flowing. I could not stop my mind from feeling horribly sad and despondent. You’d think that eventually your body would run out of the salty water that pours out of your eyes. But apparently my body saw no end to it and I somehow had to go to work and study for this high-stakes exam?!

That was the day I realized I needed to do something. I had to overcome the voice inside that represented my upbringing and its resistance to psychiatric ailments and the medications used to treat them. There was no way that I was going to be able to focus on studying and figure out how to live post-breakup without a little help.

So I made a virtual urgent care appointment with an internist and explained to her that I had an acute life stressor and I needed an antidepressant to help me through this period. I also made it very clear that I needed an antidepressant that would not make me gain weight or lose my libido because… well, I was single now. And I wanted to look hot for dates. And I want the ability to get aroused by potential future partners.

The internist recommended Prozac and I said, “sign me up”!

I’ve always been extremely sensitive to any medication I’ve taken. The dose she started me on was the “lowest” dose but it was still incredibly stimulating. I’m so sensitive to medications that literally the day I picked up the medication and took my first dose, I could feel a difference. I felt like a person again that wasn’t weighed down by heartache and the reality that I was going into my 30s as a single woman [if you don’t know me… I’ve wanted that whole nuclear family thing for my whole life; I want kids and I thought I’d have them by this point in my life].

I got through oral boards. I started dating. And eventually I recognized that the medication was starting to have more side effects than benefits. Or maybe through time, and therapy, and journaling, I was finally able to get over the acute stressor of the breakup.

For me, the side effects included: lack of appetite [which… I actually enjoyed since it was a great way to lose weight and feel confident in my single hood], GI distress, diminished libido, and a total lack of ability to cry.

It’s like we came full circle! I started Prozac because I couldn’t stop crying and now suddenly I’m complaining because the tears won’t come?! Make up your mind!

One thing that I have always been proud of is my ability to be empathetic and caring. My ability to feel emotion. Strongly. I’ve always equated crying with catharsis. I think that I am a better intensivist because I feel the emotions surrounding tough medical situations so strongly.

In my life I’ve been prone to depression/sadness. I fought through waves of very dark times. But as I’ve grown older, I’ve started to realize that the feeling happiness and joy seem exist because of the contrast to the sadness and despair I’ve felt before. I think I needed to experience the struggle into order to appreciate the sweetness of when life delivers good things.

So when taking Prozac meant I was numb to feeling and emotion… I decided this was too much. I weaned off of it [I believe it was during the spring/summer] and could feel like me again. Life was steady. Life was good.

But each winter would roll around and I would start to descend into a darker place again. Or I’d find that my anxiety would act up. One thing that I was amazed about while I was on my first course of Prozac was how well it quieted my anxiety.

A few years ago, I decided, why not go on a short course of Prozac for my winter seasonal affective disorder? Turns out, this is a relatively effective approach for me and has gotten me through a number of very dark winters in New England.

I was inspired to write this today because I wondered if this season would be different. I wondered if I would be able to get through winter without the Prozac. I’ve made it pretty far into the season and haven’t felt like I am incapable of living life. It’s almost halfway through January and I cannot say that I’ve needed to curl up into a ball and cry my eyes out. Life feels steady. Work feels manageable. Dating feels mostly fun [sort of… more on that in the future].

But it hit me that the last few days I’ve noticed time passing in a weird way. It’s both moving too fast but also too slow. I’ve sat down and felt like I needed a fast forward option. I needed a 2x for this part of life. And I didn’t like that. Life is so short. It’s precious. Every moment is meant to be savored as best as it can. And I hated that I didn’t have the ability to do that.

So… this year will be a new experiment. Prozac PRN [as needed]. I pulled the trigger today because my monkey mind was raging. This time, it was crippling anxiety and the inability to just take action that led me to restarting.

More to come!

[P.S. This is not medical advice. None of this blog is ever meant to be medical advice.]

When I started blogging here on the internet in 2011, it felt like I was writing to no one. I was an early adopter of online journaling – I used Xanga and LiveJournal and loved playing with designing on those platforms and also sharing all of my angsty thoughts on the internet. Anyway, fast forward to 2011, I am about to start at a brand new medical school, I am working as an engineer, and I am also about to start a long-distance relationship. I thought, why not document this journey and also why not share about this crazy adventure I am embarking on?!

I loved [still love!] the community I built. It was small. It was cozy. There were really nice comments. I felt like this was all I needed to keep writing and sharing. At some point, my study plans made it higher up in the internet search ranks so people were appreciative of my musings there. Everyone was so uplifting and positive and nice.

Now… people are just not nice. The internet has changed.

This is the excuse I am telling myself, at least.

There’s probably a combination of things. I find that I very easily can hit a writer’s block if I’m weighed down by work and life. When emotions are running around… I just cannot seem to use words [words are hard]. What are words when your brain is going a million miles per hour spiraling on life things?!

Also the mean comments [mostly on TikTok for the minute I tried that and a couple on YouTube because people are weird about anesthesia providers]. WTF happened to civility?! I am a human. I have feelings. I am delicate flower/snowflake on the inside and saying mean things really can linger and weigh me down.

But lately… maybe the other stuff/noise has finally settled and I feel more clear. The stream of creativity is slowly opening up again and I am excited about the prospect of writing and sharing with you. I maybe even started drafting a memoir[!!!].

And maybe I grew some thicker skin and care a bit less [or internalize a bit less] the negative chatter. As long as the positive, uplifting, friendly conversation continues to dominate, I think I’ll continue to show up. And honestly, it doesn’t all need to be positive… constructive comments/feedback are taken to heart and also appreciated.

YouTube is an arena that I had fun with during the pandemic and I want to keep doing. I realized as I got back into recording this video and a future one that maybe I should figure out a more sustainable way to do this stuff because while the idea generation and the recording maybe take around an hour’s worth of time, the editing process does take longer. I enjoy it [most of the time], but it’s certainly a lower barrier to write these entries compared to the video content.

For a while, I hid my dating life. Maybe it’s something about how I couldn’t erase Mike from my life when that ended because he was so fundamental to this blog and my online identity. And I didn’t want to repeat being “attached” to another person who may or may not be my forever person. But now I feel like I missed out on early thoughts from my last few relationships. By memorializing my past love, I am also able to memorialize the feelings [the really good ones that are quickly forgotten]. Doesn’t everyone love a reminder of the giddy/dizzying feeling of early love? Of early excitement? Of fantasies of how a romance could unfold and a beautiful life painted in the synapses of the mind?

Anyway, I digress. I’m back, I think. And I’m really excited[!!!]

Back when I was an impressionable premedical student, my research mentor sat me down after I shared plans to leave his lab and said, “You won’t become a doctor.” He then explained that he would not be adding me to his lab alumni page on his website and that he would not write a letter of recommendation on my behalf to medical school.

I remember feeling totally crushed by this statement. But it didn’t stop me from achieving my goal/dream of becoming a physician.

Sometimes we encounter haters that don’t believe in your goals and dreams. When you encounter these individuals, I go over 4 ways to overcome them:

1. First ask yourself: Is there a grain of truth to what they said?
2. Find a lot of mentors and sponsors
3. Consider whether a pivot is necessary
4. Keep hustling, working hard, excelling

The anesthesia market is HOT right now so many anesthesia residents are going straight into practice without fellowship. Even though I initially dual applied for cardiac and ICU fellowships [more on this in the video], I recognized that I was making a $1 million dollar decision to pursue an extra year of training that didn’t align with my long-term career goals… so I dropped the cardiac fellowship part.

Everyone’s decision is unique to their current situation and career goals. Sometimes your situation changes. Sometimes your career goals change. That’s all ok. I decided that ICU fellowship was the right path for me and 5 years into practice, I am still happy with this decision.

In this video I go over:
– Why it might *not* make sense to do fellowship
– Scenarios where fellowship *should* be pursued
– Returning to fellowship after being an attending
– The potential “insurance” policy of doing a fellowship

Internship/residency were HARD. There were some REALLY low moments and some really tough scenarios that you face for the first time as a doctor-in-training. The hours are long and the work is tough. So… when I got an email that asked me to record a video about how I survived residency, it took me a little bit to reflect upon the experience and come up with 4 concrete things:

1. Mindset: I went into training with the mindset that internship/residency are TEMPORARY/finite and that the purpose was to advance to my goal of being the best possible physician I could be.

2. A strong support system: Both at work [to be able to vent, process new experiences/challenges, not feel alone] and outside of work [great to take your mind off of medicine].

3. Living close to the hospital/work: Not everyone is going to have this luxury. Some people will need to go to multiple sites for training. I go over in the video that during internship I had to drive 30-40 minutes each way and after a 36 hour shift… I don’t even remember driving home. That was scary. When I moved to Boston, I abandoned my car and made it essential that work was in walking distance. Also, my residency offered an Uber/Lyft reimbursement for post-call… I definitely used that.

4. Enjoying time outside of the hospital to the fullest: Even though the hours are long and the vacation is limited, there are weekends that exist and every once in a while you get out early [depending on the rotation]. I definitely took advantage of this time when I could and saw friends, celebrated milestones, went on weekend trips… I basically lived life to the fullest outside of the hospital. It gave me energy to go back in for the long, tiring days. And seeing what we see during residency makes you appreciate the little things.

There’s a stereotype that anesthesiologists are hiding behind the drapes trading stocks or doing sudoku puzzles, but that’s certainly not the reality of my job! I think it’s so important to share what the reality of the job is like and one reality of being an anesthesiologist is that it can be physically and mentally exhausting. Here are some of the reasons that contribute to this:

1. Covering multiple ORs w/sick patients 
2. Having to take call 
3. Unpredictability/feeling like there’s no control of your schedule 

I cover these three things in my newest Youtube video!

If you’ve come to this page, it’s probably because you’re a 4th year medical student searching how to figure out how to excel at your residency interviews. I have had the experience of interviewing for anesthesia, preliminary medicine, and transitional year programs when I was a medical student [back then, it was in person] and also the experience of being an interviewer [in a virtual setting]. I tend to like to give a lot of unsolicited advice, so here I am again sharing 7 residency interview tips that I think will help you get to a successful 2025 Match season.

Here are the 7 tips:

1. What questions do you have for me?

Do not be alarmed by this interviewer question! It will be standard at most interviews to offer an opportunity for you to ask questions. This is a very important opportunity to get a 1:1 chance to ask your burning questions about a place that you may spend 3+ years at. You should’ve done a lot of research into the program, which should lead you to questions that are relevant to your assessment of that program’s fit for you. Remember, you’re also interviewing the program, so use this opportunity wisely. I also discuss how when I got the interviewers names ahead of time, I would look them up to figure out if there’s a more specific or targeted question I could ask them.

2. We will [probably] ask about your hobbies

I think I was also taken aback when I was interviewing and was asked about my hobbies section. But at this point, it’s all over reddit and honestly it’s one of my favorite questions to ask. I want to know what you’re passionate about. I want to know what fills up your cup outside of medicine. Plus, I can often learn something cool from applicants. This is a pretty common question, so get ready to answer it with your favorite anecdotes that illustrate who you are.

Also in this section I go into a tangent about the Match algorithm – here’s the NRMP video on the process: https://www.youtube.com/watch?v=kvgfgGmemdA

3. Make sure you know *everything* in your ERAS application/supplement

You never know what seemingly esoteric experience you put in your application that your interviewer will get excited about. I personally did a lot for the American Medical Women’s Association [AMWA] so anytime I see AMWA activities on an application, I ask about it. Even if it’s at the bottom of your list. Sometimes it’s kind of obvious when the experience wasn’t very meaningful to an applicant… this doesn’t help us get to know you so please come prepared to discuss anything you put in your application.

4. Think about what “brand” you’ve curated with your application and emphasize that during your interview

Most applicants have some underlying themes about who they are. This is kind of hard to explain, but an example is from my own application where I really leaned heavily on the fact that I significant leadership experience and took a very non-traditional path as a premed/medical student. These were the themes that I referenced in some ways during my responses to questions and I felt were strongly conveyed in my application. Try to be consistent with what you submitted in your application!

5. Be prepared for the questions – a bunch of sample questions are in this section

I’d say that there are two buckets of questions – somewhat standard program questions that a lot of places will ask:

• Tell me about yourself
• Why X program
• Why X specialty
• Tell me something that isn’t on your application
• Where do you see yourself in X years

And also behavioral questions:

• Tell me about a time you failed. How did you deal with the situation?
• Tell me about a time your responsibilities got a little overwhelming. What did you do?
• Give me an example of a time when you had a difficult conversation with a colleague. How did you handle the situation?

Make sure you’ve searched for these lists of questions and prepped for many of the various categories they can fit into.

6. Practice, practice, practice!

Make sure you take advantage of opportunities to practice through your school, with friends, family… your dog? Just do it. You should consider recording yourself so that you can coach yourself on things that seem like they could go smoother. You should have also, by this point, looked into the common questions I alluded to above and have an idea of how you’d respond to most of them. Interviews are nerve-wracking so it’s important to try to make it almost like muscle memory and to practice figuring out ways to do your best and make a good impression. Interviews can help or hurt an applicant for their rank list position at a program so try your best to make it help you.

7. Do not neglect the virtual interview technology

A lot of residency interviews are still virtual, so make sure that your technology is as optimized as possible. I talk about not using a virtual background, stable internet [consider a wired connection], having great audio [like buying a wired microphone: https://amzn.to/40kgUzi – this is the one I use; this also usually means avoiding Bluetooth headphones], having a quiet environment to do the interview in, and considering an interesting background [I bought this room divider: https://amzn.to/3NFHone to add some texture to my background as an interviewer but I also saw some applicants with plants, instruments, books, etc].

Also, blog entry on virtual interview tips: https://blog.amandaxi.com/2020/10/26/practical-tips-for-your-zoom-interview/

Good luck!

We receive feedback in numerous areas of our life. When training to become a physician, there are a lot of different timepoints where structured feedback is given. Sometimes that feedback is negative or critical. It never feels good to be the recipient of this type of feedback, but it is inevitable… none of us are perfect.

I recently received written feedback from my residents and while there were certainly positive comments, all I could do was focus on the negatives. I’d almost say I perseverated on the negatives. So I thought I’d do something productive with it… figure out the best ways to deal with this type of feedback when it comes and share it with all of you. Here’s what I came up with:

Four tips for dealing with negative feedback

1. Find the right time and headspace to receive the feedback [especially if it is written]
2. Don’t forget/ignore the positive feedback
3. What are the lessons or actionable things you can take from this feedback?
4. Some feedback can be dismissed

In the video, I also go over 3 instances in my career when I received negative feedback that really impacted me. One instance as a pre-medical student [being told I wouldn’t become a physician], a second instance as medical student [during a clinical rotation that I almost failed because of my attitude], and finally, the third instance as an attending [I’m still working on this one!].