Miss Kitty is Gone

We spent 18 wonderful years together. She got me through my undergrad studies, medical school and residency. She has snuggled me when I felt like the world was an evil place, or maybe just the emerg department. 

She's been unwell for a year and needing extra care. I hope that I gave her what she needed. There is so much guilt associated with every death of a loved one. I shouldn't be surprised there is with the loss of Miss Kitty too. 

I was stoic during her euthanasia. Quietly crying and kissing her. My partner was devastated, so loudly mourning. 

Is it that I've seen so many patients die that I'm getting cold? Or that I'm too focused on the intellectual aspects of death of someone we love? But my body is grieving even if my brain isn't. My stomach feels empty and sore. I'm craving sushi and grilled cheese. I've had a migraine for days. I keep walking past her basket to give her a quick snuggle and make sure she's not in pain. My feet are lying to my brain, Kitty isn't there. 

I miss her. 

She Made It!

Just pronounced one of my favourite patients to date. She managed to stay until she had her Christmas Eve party in her home.

Happy and sad tears.

And something so beautiful about saying goodbye to my own patients in the way they want.

Too much

A few weeks ago, my class song started playing. Usually I don't just sing along, I bang my head and call all my med school friends. 

This time though, I did nothing. But I did realise that I was in trouble. It became clear that what was going on in my professional life was affecting my personal life. 

This is what burnout looks like to me. 

Who is having the heart attack here??

Ran a code STEMI a while ago. We are more than 1 hour from PCI so we do all the clot busters in our wee hospitals cross our fingers and go to the nearest cath lab. 

Obviously there is a long discussion about the pros and cons of using the busters. There are risks of bleeding. Our patient's medical history is reviewed to rule out any chance of bleeding. 

As we piled into the ambulance my patient's wife started crying. She said that she was remembering when her husband had hiis AAA burst and how scary that had been. 

o.0

It took me a minute to realise that she meant her former husband. 

Women physicians are smart enough to kill themselves but not as clever at finding help

"A widely cited decade-old meta-analysis suggests that the suicide rate among male physicians is 40% higher than among men in general, while the rate among female physicians is 130% higher than women in general (Schernhammer ES and Colditz GA. Am J Psychiatry. 2004;161[12]:2295-2302)."

http://jama.jamanetwork.com/Mobile/article.aspx?articleid=1920968

Happiness is...

Shaking the hand of the patient you ran a code on 2 weeks earlier when they've been repatriated to your wee hospital. 

Fighting with my sense of self...

I keep hearing "advice" from folks:

1. Fire the difficult patients. 

But who will take care of them? They're the ones that are always being left. How could I possibly be another one in a long line of people who abandon them?

2. Be more like Doc Marten. (If you haven't seen the TV series on Netflix yet, check it out.)

Doc Marten is a fantastic diagnostician but is an absolute ass. Patients don't want to be around him. He treats his staff, his patients, and his colleagues like they are subhuman. No. Just no. 

3. Ask for help. 

I have been asking for help for a year now. Occasionally these requests are masked as jokes. More often they are unofficial sit downs. I've asked colleagues, office managers, staff, nurses and therapists. Unfortunately, the culture of medicine dictate that docs don't need help. Ever. So I needed to make an ass of myself to be heard. 

4. It gets better in 5 years. 

Really. Brilliant. And until then, how do I keep myself from imploding? It's true that having a light at the end of the tunnel is helpful. However, as anyone who has ever been overwhelmed with anxiety knows, the future is something that happens to other people. 

5. Don't get involved in your patients' lives and anything but their immediate health. 

No. Just no. I refuse to pretend that my patients aren't people to make it easier when they die, make it easier to ignore their mental health problems and chronic pain. When I stop crying with and for my patients, it's time for me to quit.