Friday, October 29, 2010


So, Mere and I were talking about this last night and she said, "put it on your blog and get some opinions." Sounds like a GREAT idea.

When I was sick we were constantly (and still are) amazed at the kindness and generosity of the people in our life. But one particular incident was really mind blowing. About 1/2 way through my illness, when things were really getting tough and money was non-existent we got a card in the mail with a check for $500 and a REALLY nice message. You could really feel the love and genuine concern in what was written in the card, it was AMAZING and the money was life saving. The gift came from a couple that I went through med school and residency with. It was such a kind and generous gesture that I still get goosebumps when I think about it. They are in fellowship (read = not making a lot of money) and have 2 young children and $500 is a BIG deal to them (and me). Not to mention, I know that they are very money conscious...they are savers, not spenders.

When we were residents B (the wife) and I spent a lot of time together and that is really when our friendship started. But, we are in different fellowships and we all have young kids and busy lives so over the last few years I haven't seen a lot of B or her husband (mostly at Bday parties, etc). She had heard through the grapevine about me being sick. I will never forget opening that card, it brings me to tears as I write this. It was one of those "random" acts of kindness that makes you want to be a better person. Mere made them some of her super cool lunch bags, I wrote a thank you note, and she delivered them to their house. It was all we could do at the time.

Which brings me to my question. Now I'm better and we could send them a check for $500, but should we? It was a gift and I do not want to offend them. Our philosophy through all of this is to pay it forward (and we have been doing that) but for some reason this question keeps coming back to me. I was thinking of maybe sending them a nice gift card when they graduate from fellowship or something like that.

The reason this is coming up now is that I got a really nice text from B yesterday. She had heard about me leaving fellowship and had some super nice and supportive things to say. She also mentioned the lunch sacks and how much she loves them. I feel like we will be life long friends. The kind that might not talk or see each other a lot but are always there. I am so grateful for B and so lucky to have her in my life.

What do you think?

Friday, October 15, 2010

Crazy and Happy

Heme/Onc (blood and cancer) fellowships are competitive. As far as medicine subspecialities go, they are one of the harder programs to get into. I still remember how relieved I was the day I "matched" into Heme/Onc in Little Rock. I thought it was exactly what I wanted. And, that was the last time I can remember being excited about my career choice. I've never loved this fellowship. But, medical training is not meant to be fun so I have just trudged along feeling like it's probably the training and not the content that I don't like. From the start, I have talked about leaving but I was scared to walk away from such valuable training. Before I got sick I was just starting to get into a little groove and feeling like maybe it wasn't so bad...this Heme/Onc thing...I could do it and it would be fine.

But, then I got sick. I'm learning that such a life changing experience is, well, life changing. Fine is not how I want to describe my work life. I'm not the same person and I'm definately not the same doctor. I thought that after the fear of thinking I might not ever get the priviledge of being a doctor, I would relish coming back to fellowship. I mean, this time last year I was PRAYING to be able to complete my training. At one point while I was out there was a question that I might have to completely redo my fellowship because I had missed so many months in a row. I had decided that I would quit if that was the case. When my program director called to tell me that I wouldn't have to start over and could pick up where I left gut reaction was disappointment. I guess that should have been enough, but I just kept thinking I would start to like it more.

Since coming back to work...I have been miserable. At first I was just so exhausted that getting through the day was my only focus. But even as I get better and stronger, I'm still not enjoying my work. I have been unsure of my career choice from the start and the deeper I go, the more unsure I get. But, I kept on....I mean, people don't walk away from Heme/Onc would have to be crazy. I even started looking for jobs and I found that a career in Heme/Onc is pretty tough. You either hang out at the V.A and have a great quality of life but make not a lot of money (I could make more as a primary care doc) or you go into private practice, work like a dog, and make lots of money. The more I researched and interviewed and talked to practicing docs...the more I realized the reality of my options. I was nearing the end of the tunnel and I couldn't see a light. And, I was not loving my job (not really even liking it). So, what to do?

Then, my program director called me into his office. He said lots of things...some true, some not. Bottom line...he wanted to know if I was committed to this program. He said things like, "when your on, your on but you aren't on as much anymore." The conversation was long and when I walked out of his office I really started to consider my choices. It is one thing to have an internal struggle but obviously my struggle was not so internal anymore. For the 1st time I REALLY thought about leaving. And so the inner turmoil began. Of course, we were already scheduled to leave for Boston for my board review course (in Heme/Onc) so we went. I tried to forget about everything and just focus on the course. I did talk to a few people about hospitalist and primary care options, as well as, private Heme/Onc options. But, mostly I focused on having fun, learning, and trying to relax. I prayed about it and really tried to let it go..which I was only moderately successful at.

I could finish out the remaining 12-15 months of my fellowship or jump ship. My logic in staying was that I only have a little over a year left and I didn't have to practice Heme/Onc when I was done but I would have to option if I wanted it. But, it is not an easy year. I missed a LOT last year so this would be a year of back to back service (read = hard) months with plenty of call. Basically, it would be the hardest year of my fellowship yet. Not to mention the reading and studying I would need to do to get caught up and ready for full fledged practice. A challenge I could 100% take on....but did I want to? For what? I job I don't really like that much? More money?

At some point in time I just became really obvious that I need to leave. I may regret it later but I can't live my life worrying about regret. I have to do what makes me happy today (and in the near future). I was talking to a friend about it and she said, "what do you really want to do?" and I said (without any thought at all and almost instantly), "I want to take care of dying people." That also got me thinking about palliative care (end of life care/hospice) and why I ever chose Heme/Onc in the first place. Really, end of life care is why I gravitated towards Heme/Onc and it has always been where I excel. There is something so satisfying about helping a patient and their family at the end of life. I know it sounds grim, but it really is so amazing to be a part of the dying process and help make it a peaceful experience.

So...I resigned this week. I took a job working as a Hospitalist (taking care of pts in the hospital) and as a palliative care physician at a local hospital. The work is satisfying (I hope), the hours are good, and the pay is nice. What more could I ask for? Now I just have to make it out of here.......

When I resigned my program director cried. He tried really hard to talk me out of it and in the end made me an offer I couldn't refuse. He offered to relieve me of Heme/Onc duties and let me go do 2 months of palliative care with our palliative care attendings/team. The job I was offered was more than happy to let me wait until Jan before starting, so I accepted the offer to stay for 2 more months. I felt like it was really generous of him to make me such a deal. Of course, today I found out why he made me the offer. He is hoping I will change my mind and stay. He is hoping that in the next 2 months he (or someone else)can convince me to stay. I also found out that he approached a few people and specifically asked them to talk me out of leaving. Which explains the constant onslaught of questions, being told I'm crazy, and me repeating myself over and over and over.....

We will see what the next 2 months holds. I'm done worrying about it. I'm just going to do what fits for me, whatever that might me crazy (and happy).

Sunday, October 10, 2010

Taste of T Street

I complained and bitched and bitched and complained. It took A LOT of her time. I mean, A LOT! There were meetings, more meetings, and more meetings. Let's not forget the last week of her being gone and busy when she was home. I'm not built to do it all. I think I would be a pretty good stay at home mom and I know I'm good at being the working parent (which is what I prefer) but for those of you mothers who do it hat is off to you. Working full time and being a the main parent is not something I enjoy. Not even for a few days. It makes me cranky. But, I digress....

When Mere told me she was going to take on the co chair position for a huge fundraiser for our daughters' school, I was less than thrilled. She was already working full time, which has been a HUGE adjustment, and now she was going to do this to? It all started when the principal of our school called Mere this summer and asked her to come to the school for a meeting. Apparently, she had been at a big fundraising event for another private school and decided we should do the same. No cookie sales, wrapping paper, or chocolates this year. Nope, just one big bang of a fundraiser and that would be it. She also hoped to create a foundation so that our school would be able to give out scholarships, etc. It was VERY ambitious. They only had 5 months to plan it. I'm not going to lie, when she first told me about what they were planning, I was skeptical. BIG plans, 5 months, and a bunch of newbies (except for the event planner that they hired). The plans? Booths run by parents (volunteers only) for food, a HUGE children's area (games, petting zoo, etc), a stage with live entertainment, a killer silent auction, a live art auction (art work done by the kids and framed), and much more.

Well, it was INCREDIBLE! I should have known that the parents and teachers would come together to make it an amazing event. Our girls go to the coolest school ever....there is always so much love and parental involvement. Seeing it all come together was such a wonderful moment. I get tears in my eyes just thinking about it. It was such an overwhelming success (and I don't even know how much money we raised yet). It is such a honor to be part of the community at our school, we are so blessed.

Most of all, I am proud of my wife. She endured a lot and worked her butt off and it payed off BIG time. Everyone kept coming up to me and telling me how much they love Mere and what a great job she had done. There were a lot of parents that I didn't know who were really involved....I kept introducing myself as Mere's wife and they would be like...."oh yeah! HI! It's so great to meet you Jess, etc, etc." They all just love her. But, what's not to love?

I am glad it is over and happy to have my wife back. I'm sure she will be putting up pics on her site, once she tracks some down (she was WAY to busy to take pics). Oh yeah, you might have to remind of this post next year when she is the CHAIR of the event!