The Burnout Ended

Finally my week off arrived! And let me tell you, it was a long time coming.

Prior to my week off I had a set of night shifts which were pretty awful and draining. Made me worry a bit for the coming years and whether I would even have the energy for night shifts. It’s just not natural. Eugh.

But something else that happened in the weeks leading up to my week off is that I was asked to step up to be a registrar 2months earlier than everyone else.

Our employers in Auckland, being as useless with admin as they usually are, realised much too late that they do not have enough medical registrars for the coming year and especially for the transition period in November. So their last-ditch attempt was to ask those of us who are going to be registrars in February, to start in December. I was one of them.

Initially the whole thing freaked me out because I was still in my burnout spell and I didn’t think I could tolerate more responsibility and a more difficult roster (being a registrar is nothing glamorous, let me tell you.) So I was super scared. Every one I talked to thought I was ready. Except me.

I didn’t quite know what I should do but I kept telling myself it’s the burnout talking. Because I knew I wanted to be a reg and I knew if I did it early, my senior regs who I know and who like me will still be around to support me before they move on to their next rotation. So that’s a bonus.

But on the other hand, it was more responsibility when others at my level were still House officers and I sure as hell won’t get the week of leave I had asked for around Christmas time and what if I screw up? How do I just step up early?

Well as someone who just recently read The Subtle Art of not giving a f*ck, I guess the answer to that question is, you just do it. If you haven’t read that book, I recommend it. Helped me through my burnout stages.

I guess the point is I knew I was gonna do this so I guess, just do it. (In the most non-Nike way possible).

There was no real point to being scared. I mean of course I have to be a bit scared and make sure I do a good job and not screw up, but there’s no point in being so scared that I go backwards from progress that I need to have.

So anyway, during my week off, I reflected, and agreed to go ahead and take the job starting in December. Only time will tell how thing shall turn out.

I went to Tauranga on my week off, a city in the East Coast of the North Island. Famous for the beaches and nature trails. Climbed up a mountain and took some pics as I do.

It’s been a good week off. Much needed, tried to be productive, reflective, get back into photography, reading, writing and being some version of happy.

And the weather was just gorgeous! Here are some pictures of the Tauranga coastline from Mt. Maunganui

Pride

The world is a very different place now. I’ve not pondered my existence quite as much as I have in the last few weeks.

It’s hard being a single 20 something. Everyone looks at you wondering why you’re not with someone. Some people even ask callously.

And if they don’t, they start assuming. If you’re not with someone by now…. is something else going on? Are you batting for another team? Are you even in the game?

Sometimes I see people who are so comfortable with who they are and I envy them. What must it be like to be totally aware of who you are and know exactly what you want?

I know they didn’t get there easily. Something would have given them that ability. But it still must be so liberating. To know what you want, and have the freedom to be who you are and want who you want and actually get that. 

I’ve been told I’m not the “girliest girl”. Among the guys I’m just one of the guys. Among the girls I’m just one of the girls. I’m comfortable, see everyone as a friend and hardly ever speak about what I want. 

But I do wonder how people see me. It happens on days when I am self-conscious about my appearance. People don’t give me a second glance. No matter how I change what I look like or how I walk and talk. I feel plain. Do people ever wonder about me? Probably not. Too often I’ve had the feeling that the person I’m talking to looks straight through me at someone else. 

When you see two people together, Any two people – girls and girls, boys and boys and everything in between, it’s just nice. They are just so lucky. It gives me a hope for the world. And I want that for everyone. Even if I don’t have it for myself. Not that I even know what I really want for myself.  

But I’m grateful the world is full of colours. Just like a rainbow. Just gotta have pride in who you are.

Looking Down

Today was my first experience as a house officer with hierarchy.

I have been newly trained in carrying out DC cardioversions. The procedure where a defibrillator machine is used to shock your heart from an irregular rhythm to a regular one. 

This is usually done under anaesthesia. 

This wasn’t my first DCCV procedure. Me and a PGY2 house officer walked into the theatre and waited for the patient to be put to sleep. The pgy2 has never carried out a DCCV before. The anaesthetist, a tall stranger walked up to us and immediately turned to the other house officer, looking expectantly for an introduction. 

I spoke up and introduced myself as the cardiology house officer who will be carrying out this procedure. The other house officer introduced herself. Instantly, the anaesthetist’s eyes narrowed. But it disappeared quickly and I wasn’t sure if I had seen it.

He said okay then went back to putting the patient to sleep. A few moments later, patient still not asleep, the anaesthetist turns to me and says “who do you call for help?” 

I told him I would call my registrar. He asked for their name. I gave it to him.

A few moments later he instructed a nurse to ask me to write my registrar’s name and phone number on the whiteboard in the theatre “just in case”

The temperature in the room dropped fast.

I did as I was asked.

The patient was finally asleep and I delivered a single shock to the patient’s heart. I then began analysing the rhythm. 

The anaesthetist quickly interrupted me and asked if I was happy. Well Mr. Anaesthetist, I was not in fact happy as the rhythm was still slightly irregular. I was just discussing this with the other house officer when he began taking monitors and oxygen masks away from the patient, and essentially packing up. 

I still thought the rhythm was irregular. I voiced that I wanted to deliver a second shock to the patient. The anaesthetist gave me a look and told me I should really call my registrar if I’m having “trouble”. Ie he was not going to start again and anaesthetise the patient.

I called my registrar and she said she would come up but agreed that the patient should have a second shock.

I told the anaesthetist this and he said “you shouldn’t shock her on this rhythm”. Funny how you’ve made that conclusion now instead of straight away. 

I was wondering what I should do when he said “if you’re having trouble you should really call your registrar to come and review this patient”

He then proceeded to leave. 
The patient did not end up getting a second shock. Luckily for her, her heart reverted back to a regular rhythm later on.

But I was annoyed.

Mostly with myself because I had just let another doctor make me feel small and incompetent when what I should have said was “this isn’t my first DCCV” and asserted what I know.

But I didn’t expect to run into this problem. As house officers you’re the bottom of the ladder, sure. But for someone to outright assume that I don’t know what I’m doing and make that very clear to me is just not on.

You hear a lot about hierarchy. And I’ve experienced it as a student. But this was my first experience as a house officer when I’m actually NOT incompetent at this particular procedure. 

If you look down at someone when you’re at the top of your game, forgetting that you were once at that level and still learning….. well then you haven’t learnt anything really. 

Learning point for me is to be more assertive when I know I’m not incompetent at something. And to not treat anyone else like that. 

Some people are just shocking. Would rather be in the dark ages. 

Can he just not, step on my gown. He needs to calm down.

Who Cares

Today I had a conversation with a friend of mine. Well actually, she called me and said she needed to vent. So I listened to her troubles for an hour or so.

It was a typical story. She was all cut up over a guy who, in my opinion, was a bit of a narcissist. Basically he spent a lot of time talking to her and then began phasing her out.

So she wasn’t happy. She told me it hurt immensely that she cared about this person so much and they didn’t care at all.

Towards the end of the conversation, she said she saw this quote online somewhere that said “if someone doesn’t care about you, stop caring about them”. She said she wanted to “stop caring”.

Now I have a few issues with this. 

Lots of people just go around saying “meh just don’t care about them”

First of all, if you really cared about someone, there’s no way you can just hit the “stop” button on caring. It ain’t that easy. No way.

And secondly, why should you??

Nobody ever started caring about someone because they thought to themselves, hey they care about me. I better reciprocate.

No. You care about someone because you like who they are. 

So why on Earth should you “stop caring” just because you suddenly realised this person doesn’t care about you? 

You didn’t ask them beforehand “hey are you up for caring about me? Because I’m thinking about starting to care about you”

Um yeah no. It doesn’t work that way.

Yes caring hurts. Yes it means that as long as you care, you’re likely to be hurt and feel awful. But I’m afraid you literally signed up for that. 

But I’m not sure I understand why caring is a bad thing. 

If anything, you should look at yourself and feel so proud that you are able to care about someone that much. And if you can’t stop caring, then even better!

Because you have a feeling that is constant. In a world where everything changes so rapidly and feelings run out or expire so quickly, you have a constant. 

You’re genuine. 

Don’t hate yourself for feeling something that pure. Don’t think it needs to go away. Embrace it. 

You don’t need to stop caring. 

Something about someone else made that feeling develop in you. Whether or not that something was real, your feeling is definitely real.

And if that feeling doesn’t change, regardless of whether the other person reciprocates or not, then even better.

This isn’t to say you should put up with any sort of abuse or neglect from someone else. Because definitely not. If someone makes you feel terrible for long enough, at one point you will stop caring. It’ll be a thing where you distance yourself and start trying to make yourself feel good in other ways.

But what I mean is, don’t feel bad or pathetic that you continue to care about someone. Caring about others is all about you, really. It’s how it makes you feel.

And I think that’s a good thing. 

Summertime Feels 

Summertime is really the best time to go out and reflect in places. 

Chances of coming by a view that is absolutely stunning, while on a walk, are much higher in summer than in winter. 

Unless you live somewhere where it snows and you like going on mid winter walks in a winter wonderland of course!

But anyway. Today I was due some reflection and mindfulness, as I’m 2 weeks off from finishing my first rotation as a house officer. 

I haven’t talked much about what my job actually entails. I deal with all the medicine for psychiatry patients. Often, most of them are perfectly healthy. But occasionally I get someone who is very comorbid so I have to order tests, make sure they happen, talk to a bunch of different departments, trying to piece together their management. And because of where the psych unit is placed at my hospital, people are very reluctant to come over there and do things for patients. And getting potentially aggressive and high AWOL risk patients to different parts of the hospital is also challenging. So getting things done is hard.

On my long days I also cover geriatric wards. Where every patient is liable to crash, the nurses are super nervous and the house officers during the day dump whatever they are unable to do while they’re there, on the psych house officers. 

But I’ve made it this far. And I’m going on to general medicine next. Which is going to be a massive change in pace which I would welcome, but also will be a huge challenge as I feel I haven’t done much medicine in these three months to prepare me for what general medicine will bring.

Lots of emotional highs and lows this rotation. Being told by someone that I lack motivation, that I lack common sense, that nobody would take me seriously, that I’m not trying hard enough to be involved, coupled together with my own insecurities, fears, the feeling of being frustrated that I can’t do more with my life, and the sickening realisation everyday that I know that I will never get what I want….

It brings me down.

But I’ve been chugging along. 

All of the stuff above is just noise I hear in my head everyday. 

But when I’m on a walk and see the omnipresent sea, the gentle lull of waves going back and forth on the shore, sounds of people and birds and boats going about doing their thing, the sun setting and creating the most beautiful set of colours as a backdrop to the city line and the ocean, my eyes and the rest of my senses are pleased. A wonderful stillness and peace comes upon me and drowns the noise out. Just for a little while. Making me feel that I’m part of something much bigger in the universe.

Of course those moments pass and reality and the noise comes back, but I’ll try holding onto that feeling of peace just like in the photo. 

Measure Up

I thought I was moving up. 

But I’m really only following lines in the sand. 

It gave me joy. Every rung I climbed, the feeling that I was enough..

But when I looked down, the pit was there. 

Within my reach. Waiting to swallow me whole. Just as easily. 

As though I meant nothing. 

I wonder if I would ever measure up. 

I thought my ruler was bigger than yours. 

But we’re measuring different things. 

Always out of step. 

My ladder turns to dust. And I am falling. 

Maybe if my ruler matched yours, I would move up. 

But at the top, I know I wouldn’t be me. 

My ruler is simply lines in the sand. 

But I will keep climbing. 

For that feeling. 

Getting Compliments

So I just finished 3 weeks of my immunology rotation. I knew zero information about immunology before starting this rotation and now I know a little bit more than that.

Anyway! I had a consultant on this rotation who I had briefly during my general medicine rotation. He’s also an immunologist. Who knew!

He is without a doubt, the nicest, most down to earth consultant I had ever seen in any specialty. He’s always ready to help literally anyone with any issue, regardless of their position in the hierarchy.

He is extremely respected as a consultant by his department. He’s just generally nice and funny and smart.

I have massive respect for him too. Not only does he teach and answer my questions clearly and lets me see patients in his clinic, but he also acknowledges my presence wherever and whenever he sees me. Even when I am on a ward round with a different team. If he walks past, he waves and smiles sincerely. 

Which, I can say from 6 years of experience, is a Huge deal. 

Anyway the point of this topic is that for some reason, he seems to think I’m great. 

Now. I’ve mentioned before that I’m awful at receiving compliments and basically not good at being given any attention at all. Dr. AJ (This consultant), told me I’m really good and it’s been a pleasure working with me in both general medicine and immunology.

Err as great as it was to hear that, it immediately made me 10 times as nervous around him. 

Okay I don’t know what it is, but if someone likes me and gives me compliments like that, I feel like they have these expectations of me that I’ve got to live up to. 

Which makes me super nervous because I have no idea what I’ve done to have these expectations of me.

I still think I’m pretty average. 

Yes I realise this is probably a self-esteem issue but whenever I realise that someone seems to think I’m good at something, (specifically something I don’t believe I’m necessarily great at), I start freaking out a little bit.

Which is the last thing I should do because it’ll make me overthink everything and make mistakes. And it also seems to manifest as this weird giggly version of me. It’s very bizarre when I get compliments I get uncomfortable to the point where I think the best thing to do is laugh it off. 

It’s really not the best thing.

Giggling like a 5 year old is hardly what you want from someone you just told was extremely professional or intelligent or whatever. 

Oh God is this one of things I have to hope will go away with time? 

I seem to have a long list of those particular traits. I’m starting to worry they won’t just go away with time. Blechh. 

Anyway that’s my self reflection.

Point is though I’m super grateful to have met Dr. AJ and so grateful I was able to impress him, even though I’m not too sure what I did. 

What Matters Most

Life’s tough.
Sorry to open with such a cliché line, but I’m a little bit frustrated currently. People ask me sometimes, what matters most to you? Or more specifically, Who matters most to you.

I find that whenever someone asks this question, you have to answer in a way that is politically correct. You gotta say your family, your friends, or your children or whatever. But in my case, if I were being completely honest, the answer would be

ME. Myself. I. Moi. Mi.

The most important person in the world to me, is me.

Now hang on. Yes you may view that as extremely self-centred. But frankly, I don’t think it is. And I’ll tell you why.

I have this philosophy. A lot of the major things in life are concerned with your relationships with other people. A huge part of every day for everyone is spent interacting with others. Things you value in life are people among other things. Then why is it that when it comes to themselves, people always fall short of appreciation?

You’re a person. You’re just as unique, beautiful, and important as any other life on the planet. Then why is it that people struggle with self-esteem?

My philosophy is this. You have to love yourself (Not in a Justin Beiber sense). If you cannot love yourself, how on Earth can you be expected/trusted to love anyone else?

Think about it. The person you know the most about, is you. Which means you know about your faults and your strengths more than anyone else. You can change them if you wanted. But in others, you could never know them as well as you know yourself. You don’t know for sure all their faults and strengths. And yet there are people you like a lot. In spite of faults. If you can accept the faults that you can clearly see in others and still like them, why can’t you do the same for yourself?

Conversely, if you cannot accept the faults in you and like yourself, how can you be trusted to overlook the faults in someone else? How can you like them or trust them? 

Everyone knows everyone has their faults. The people that matter are those that care about you, in spite of those things.

They say that if you can’t find a single fault in yourself, there’s something wrong with you. I’d say the same is true for the opposite. If you say there’s not one thing good about you, you’re either lying or you don’t care to look hard enough. 

You’ve got to realise that the only way you can form complete relationships with someone else, is by first appreciating yourself and deeming yourself worthy of that relationship. 

It doesn’t have to be major things. At the end of the day if you can say to yourself, hey atleast I have a nice smile, that’s enough. 

And heck yeah it’s hard. It’s hard to reach the point where you look at yourself and think, I’m not too bad. But you’ve got to try. 

You need an effective filtering system. One that focuses on the positives only. People that care about you regardless of what you do, are a good start. 

And you can’t say no one cares about you. You’re just not looking hard enough. 

Because even super villains have sidekicks that adore them….But this isn’t about Batman.

Everyone has someone they haven’t noticed who thinks they’re fantastic. Well if they do, then clearly there’s something about you that’s good. 

And it’s extra difficult if you feel that lately everyone seems to resent you. But even in that case, you’re still capable of helping others. 

In psychiatry, there are classes of defense mechanisms people have in times of adversity. The class that is considered most mature and healthy is to feel good about yourself by helping others. 

That probably also sounds rather shallow and self-centred (Ironic isn’t it?). But it’s definitely a good thing. By putting yourself in a position where you are useful to others, where they appreciate you for your actions, you should be able to realise that one good thing about you is that you have the capacity to help others. And if you feel great doing so, then hey! Win win. 

I’ve struggled with this quite a bit. I’ve had a long period of time where my reflection bothered me and I felt that that person bothered other people too. For me, this blog, the fact that atleast one person somewhere felt the need to respond positively to it, by liking or following, meant that I atleast had some good things to say. And that little mental note helped me feel much better about myself.

You’ve got to find it in yourself. If you want to be happy, you’ve got to be the most important thing to you. And that isn’t a self-centred thing. That’s caring about the only person you can truly influence in this world. 

If you’re all you have, you gotta make sure it’s good. 

I can’t say what made me write all this. But I guess I’m tired of people, who I know to be great, not seeing what I see.