To Elim, On Your Estimated Due Date

Dear Elim,

I thought I would write to you on this, your estimated due date, to say a few things that have been on my heart. Had we not lived in this fallen world, you would be in my arms by now or I would be just itching to have you the heck out of me so we could cuddle and do all that newborn-mommy stuff. But alas, that was not how it was to be.

I want you to know first of all that I love you. And I always will. Even though I barely knew you, I know God made you and I will cherish our short time together before you went to heaven to be with Jesus. A lot of other people loved you and mourned your short life too.

I miss you. I miss what could have been. But, I am so happy you are in heaven now. That you are safe and protected and loved. One day, I’ll actually get to meet you and that will be awesome.

You are a gift. You are an answer to prayers and longings. And you were used by God to teach me big lessons about redemption, real love and how to celebrate well and suffer well.

Because of you, I appreciate new lives more. I appreciate the miracle that it is to see a pregnancy progress and babies be born and children who grow. I want to celebrate new lives instead of hiding them with secrets and fear. I will be honest and say, I also know how fragile life can be and it scares me a little and that is okay. I empathize better with other Moms and Dads who have to miss their kids until they see them again for all kinds of reasons.

Because of you, your Dad and I got to learn to lean on God and each other a whole lot more. We got to grow up more (which I’m sure sounds crazy because we are theoretically grown ups, but even grown ups have more growing to do).  We got to see God do amazing things with what seemed like a terrible situation.  That is what He does, but I suppose you had that figured out already.

I been counting down to this day for many months. Not because of some sick fascination or because I wanted to feel sad or bad. Just out of instinct. I like numbers and it is simple math to know where I would have been with you at any given point. Plus, today’s date has been etched in my mind. And to be honest, I wanted to remember when you would have hypothetically come into this world. Just like I will remember when I knew you went out. Because I care. These are important moments, even though others may not see them as such.

You will have brothers or sisters, maybe both someday. I will be grateful for each of them and know them as individuals. I pray every day that they get the chance to grow up and that it will hopefully be a long time before you meet them (no offense). I also pray that they will all one day meet you in heaven. Know that in my heart you will always have a special place and when they are ready and old enough to understand, I will tell them about you.

You count in my kid count in my heart. So, happy “birthday.”

Love you always and forever,

Mom

White As Snow

The M family has been on the road (minus our guard cat, Jeter). 

Vacation is a beautiful thing.  Especially when it is spent with friends and family (and good books and beautiful scenery).  It is late, we are still away and I am lazy, so no pictures for today.

I just wanted to quickly share a song that has been on my heart.  It is called “White As Snow” apparently, although, I thought it was called “Create In Me” so it took some epic searching to track down the actual song and not some random hymn.  We have been singing it a fair bit in church the last few months and some words in the song are taken from Psalm 51.  

 

 

 

 

Have mercy on me, oh God

According to your unfailing love

According to your great compassion

Blot out my transgressions

Have mercy on me, oh God

According to your unfailing love

According to your great compassion

Blot out my transgressions

 

Would you create in me a clean heart, oh God?

Restore in me the joy of your salvation

Would you create in me a clean heart, oh God?

Restore in me the joy of your salvation

 

The sacrifices of our God

Are broken in a contrite heart

Against you and you alone

Have I sinned?

The sacrifices of our God

Are broken in a contrite heart

Against you and you alone

Have I sinned?

 

Would you create in me a clean heart, oh God?

Restore in me the joy of your salvation

Would you create in me a clean heart, oh God?

Restore in me the joy of my salvation

 

Wash me white as snow

And I will be made whole

Wash me white as snow

And I will be made whole

Wash me white as snow

And I will be made whole

Wash me white as snow

 

Would you create in me a clean heart, oh God?

Restore in me the joy of your salvation

Would you create in me a clean heart, oh God?

Restore in me the joy of your salvation

I have been struggling with anger and guilt and a whole host of other emotions because of a friend and some other crummy circumstances life has thrown my way.  They have come to a head of late and I stated to notice some of my behaviours and tendencies.  To be honest, I don’t like them.  I also realized that although some circumstances are crummy, some people don’t always treat me the way I know I should be treated and some difficulties are bigger than I can fix, it doesn’t mean I can’t pray through them and love and act in such a way that demonstrates grace.  I haven’t been so grace filled.

And yes, I am human.  And yes, I am allowed to feel hurt.  But, it is wrong for me to be bitter.  And I shouldn’t be spiteful (even if it seems satisfying in my head at the time).  Really, I choose how I feel.  And yes, feelings are just feelings, but continuing to fester can be harmful.  And it is sinful.

So, basically I have been reminded that those thoughts, those tendencies, although completely human, they are wrong and hurtful to God.  And in the end, they are hurtful to me and those around me.  But, most importantly, they are wrongdoings against God who has done a ton for me and loves me despite the crap I do.

I don’t deserve to be forgiven for some of this garbage.  But, the cool part is that God has taken care of all that stuff.  A big sacrifice.  And I keep getting second chances.  And that is awesome.  And should make me more excited than it does sometimes.

I really want to be restored to that kind of joy.   The happiness that comes from knowing what I have been saved from and how loved I really am.  I want to move away from some of my harshness and bitterness.  I want to love those who hurt me and those who seem beyond my reach.  I want to be patient.  I know there is no magic switch.  Relationships are hard.  Life is complicated. I’m human.  

But, He is God.  So, He can move me in the right direction better than I or anyone else can.  So, this song is my prayer.

The Blessing and Learning Curve of Gaining and Losing Elim (“ball of cells”)

Image from tochristifrommommy.blogspot.com.

Less than two weeks ago, I found out I was finally pregnant… I called the baby “ball of cells.”  That was my term of endearment.

My medical training made me cautious.  I know that pregnancy does not equal baby.  I know that life is fragile.  I took 3 tests to confirm before I even told Patrick because I wanted to be sure.

It didn’t change our excitement and happiness.  Talking about the future.  Planning for when to tell people. How to make work function.  What we would have to change or do.  Rejoicing.

I knew the longest besides God, of course.  I remember that first Sunday in church when it was still just our little secret thanking God for the new creation growing inside of me and wanting to tell the world and yet wanting to keep it to myself because if others knew, somehow something would go wrong.  The only other person who found out before stuff started going wrong was Patrick and I told him on Sunday night (with what I believe was a very adorable and entertaining card).

Then, we had to say goodbye to “ball of cells.”

I knew something was wrong mid-week.  I re-took a test.  The line got lighter and although this isn’t a perfect system, it wasn’t a good sign.  I told Patrick.

Usually I am the high-baseline, optimistic person.  This time it was him.  He refused to believe anything bad happened to “ball of cells.”  I didn’t want to go to the doctor.  I didn’t want to hear what I already knew inside.  Finally, I went to the doctor who instilled a bit of hope in me instead of flat out dashing our dreams.   I wanted hope.  Cautious hope, but hope nonetheless.

I went for bloodwork.  It was either going to confirm what I thought I knew or make everything better.  I hoped it would make things better.  I needed it to make things better.

Nothing is more bizarre than being congratulated on your pregnancy, being asked about your due date, where you plan to deliver and all that good stuff while sitting there with that gut feeling that your baby is dead.

I didn’t have the heart to tell them.  I didn’t want anyone to feel what I was feeling.

Also bizarre is walking around all weekend not knowing and yet knowing.  It feels surreal.  I have lovely best friends (three of them) who checked in incessantly.  I have a husband who bought me beautiful flowers, cooked me food and was all around over protective.  I don’t know what I would do without them.  I was just glad I wasn’t on call.

Sunday, we watched the Canadian men win the gold in hockey (WHOO!).  Happily, we went to church still not knowing whether we would be parents of a living baby in 8 months.  I was still having some morning sickness and weird headaches, but the acne was clearing up, the cramping was worse and I kind of felt empty.

I prayed for God’s will in my baby’s life and in our lives.  I prayed for strength.  I prayed that we would glorify him in whatever was to come.

We left church on our way to have lunch and board games with friends at our place and there was a voicemail on my phone.  It was my new doctor.  In summary:  My bloodwork was perfect except that my HCG was less than 5.

There would be no baby.

So much for that hope.

It is funny.  I have always thought pregnancy loss was a big deal.  I remember learning about it in med school and thinking how awful it was.  I remember when the first couple I knew miscarried shortly after telling everyone about their pregnancy.  I remember thinking that I didn’t know how they coped with it.

At the same time, I have always been kind of flippant about it, particularly when it comes to me and when it comes to early pregnancy.  I mean, an embryo is an organized ball of cells and odds are there is some sort of genetic flaw that is incompatible with life.  It just makes good scientific sense to clean up mistakes.

I thought calling “ball of cells” just that would make it more clear to me that it may not make it.  I thought explaining to my friends that I was waiting to make sure things were growing or dying appropriately made it all sound more clinical.

But really, there is nothing to be flippant about.

Sure, life goes on.  I know that.  It doesn’t change the hurt of the life that won’t.  Especially because I was one of the only people who really knew it.  And I didn’t even know it that well.  We only got to hang out for about 3 weeks total.  And 2 of them, I didn’t even know it was there.  And it died at some point in the last one.

I feel in some ways like I should care less.  This is technically still a chemical pregnancy (miscarriage before 6 weeks).  It felt different from what I thought might have been my last ?chemical where there was a squinter maybe positive (but in reality probably an evaporation line) and then definite negatives.  It was sad and disappointing, but really not the same as actually existing pregnant for several days when you know something is happening.  It is the difference between thinking maybe and knowing for sure.

It was literally just a ball of cells that wasn’t able to survive.  “It was God’s will” after all.  It was, I guess.  Still sucks though.  Maybe somehow they did have some sort of potential.

I am, in part, glad it happened so early.  Maybe I am less attached than I would have been if I was further along.  People have told me I should be less attached, at least.  That kind of makes me scared for this happening again later in pregnancy.  I have the utmost sympathy for women who loose babies who are more developed and for those who lose children.  At the same time, I am jealous because I was robbed of the experience of even seeing the little sucker on an ultrasound screen.

Sure, I will have more kids.  Sure, I am young.  I know most women go on to have no issues with future pregnancies and get pregnant shortly after something like this.  The statistics are on my side.  I also know I was in the wrong end of the 50% of women who have bleeding in early pregnancy.  Something has to go right.

It is a funny experience telling people you miscarried when they didn’t even know you were pregnant.  Not that we’re telling many people.  It makes them super uncomfortable.  It makes me uncomfortable too (and I often love embracing the awkward).  But, because nobody talks about, I kind of want to.  I know statistically, I am far from the only one to experience this.    I know because, like the big nerd I am, I have read everything I can on the subject.

Because “ball of cells” was so little, I have had a lot of anxiety around whether or not I would see him or her in heaven. Seems silly, right?  I mean, if you believe life begins at conception, of course “ball of cells” was alive and then died.  But, my scientific mind picturing a little cell collection had a hard time picturing my ball of cells chilling with Jesus and my Grandfather.  But, Jesus said, “Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these.” (Matthew 19:14)  Pretty cool, huh.  “Ball of cells” was a pretty little child, so I suppose he or she counts.

As a result of this, I then got thinking that we should give “ball of cells” a proper name because I am sure they don’t want to be known as “ball of cells” for all eternity.  That being said, the snarky and cold side of me didn’t want to name it because, well, that would make it more real and felt as if I was making much out of little.  Also, I could have other dead balls of cells that I don’t know of (most people probably do), so what about them (I don’t know how to answer this question)?  And, I didn’t want people to judge me (I, in the past would have).  Patrick liked the sounds of naming him or her too, so we went with it.

We named him or her Elim because I have been reading Exodus recently and about how God provided water for the Israelites in the wilderness.  Plus, it is a gender neutral name.

I’d love to say I am all better now, but to be blunt, I’m not.

I’m better in the sense that my body is no longer rejecting the remains of my child.  I’m better in the sense that I know for sure now that Elim died and is in heaven now (while his or her biochemical bits are somewhere in the sewers).

Grief is a funny thing.  And this grief is of a variety that I haven’t experienced before.  Even though I am okay with death, this doesn’t feel okay.  And that is okay too.

I’m sad.  I’m still a bit angry.  But, I feel a whole lot of peace and a whole lot of joy, which is a big testament to answered prayers and the awesomeness of God.

I know, you probably read joy and now think I am taking some sort of pills.  I’m not.

This isn’t smiling, frolicking joy.

So also you have sorrow now, but I will see you again, and your hearts will rejoice, and no one will take your joy from you. –John 16:22

It is more the I’m happy I’m okay, Patrick is okay and Elim is okay.  I’m happy Jesus came and that I’ll get to see my baby again, even though I don’t get the logistics because he or she was just a ball of cells.  I’m happy because I feel protected and loved despite the crap that has gone down.

The really cool thing is that I get something more now.  I have just a little bit of a better understanding of how much God must love us.

Sure, I’m still ticked He didn’t fix Elim and I’m not still barfy and headachey and pregnant (okay, confession… I was pretty excited when I was feeling physically well today).

The Lord gave, and the Lord hath taken away; blessed be the name of the Lord.  -Job 1:21

But, if I can love a little ball of unborn cells that I barely know that much…  So much that I am mourning their death… That is pretty huge.

If God loves me more than that, then I can’t even begin to imagine how sad he feels when we draw away from Him, when He loses one of us.

So yes.  This sucks.  I am not alone in this.  Neither are you.  But, I am growing and learning in my relationship with God and as a physician and human from this experience in ways I definitely didn’t expect.  Funny how gifts come in bizarre packages sometimes.

Image from spiritualinspiration.tumblr.com.

On Two Years of Blog.

WordPress just informed me that today is my two year anniversary of starting my blog.

My second blogiversary, if you may.

Crazyness.

When I started this thing it was more of a social experiment and a bucket list check off thing for me.  Then, a way of keeping in touch.  Now, it is all of those things, plus a way to get to know some super awesome people… And de-stress/procrastinate.

And my, how life has changed in those two years.  

No, I am not going to look back or make a list of things that happened.

I think I did that last year.  

I am busy, content, and all around kind of where I hoped I would be at this point with a few bumps in the road.  That is what really matters.

And all I will write about tonight.

I am happy, but wiped out from a weekend that was jam packed with visits from L&C, a uro-oncology conference, a work Christmas party, church and Catching Fire with the Child and her husband.  I need to catch up on work, sleep and time alone with the husband.  

Finding joy in the sadness of loss

Long time no speak.

It has been over a week since I last blogged.  That is my longest blogging hiatus since I started blogging.  I must argue that I have a rather legitimate excuse.

Last week, my grandfather died.

Worst. Vacation.  Ever.

I contemplated whether or not I would write about it.  The experience leading up to it and all that good stuff.  I couldn’t last week.  I barely had time to bathe myself, let alone write a blog post.  Plus, my family is kind of private and not always big on talking about that kind of stuff.  I didn’t want people’s pity or sympathy.  But, today I finally have time to sit.  And think.  And I feel like it is something I want to share.  If nothing else, just for me.

This will probably be several days in a series of posts over the next week or so.  I had all kinds of thoughts and ideas of things to share…  The experience of being away when someone is terribly sick, the experience of caring for a loved one in hospital as someone who works in a hospital, grief, stupid things people say at funeral homes, life lessons brought to us by my grandfather… I can go on.  If I had time to write last week, it would have been deep.  Hopefully, I will get to some of those.  But, as it turns out, this week is pretty crummy including me having to submit my research manuscript for the post-grad research day and a physics exam later this week (*whines*), so it may be super interspersed with other randomness.  Sorry to drag it out.

But yes, my grandfather died.  And it sucks.

Not that I didn’t see it coming.  I have for as long as I remember.

He had bypass and valve replacement surgery when I was just a few months old.  He thought he would die.  Then, he was told that this stuff would only last for so long.  My entire life, I was reminded that he thought he wouldn’t make it to milestone x.  But, he did.  Consistenly.  Nonetheless, over 26 years later, he was still around.  Growing more and more frail.  But ever present.

If you want to know the truth, I expected he would drop dead doing something he wasn’t supposed to be doing.  I was wrong.  It was more of a slow congestive heart failure death.

I happened to be on vacation.  I got to be there.

It was the worst vacation ever, but for the best reason I could think of.  Had it not been for my vacation, I would have really missed out.  I am bitter because I am tired and have a ton of work for school to do and have a messy house and have to go back to work without a real break.  But, I am glad because I got so much time, even though it does not feel that way right now.

I think in some ways I wish he just dropped like I always expected.  Like he always expected.  Because nobody wants to see someone in a hospital bed feeling like crap.   But, then we wouldn’t have had the time we did.

It is bittersweet.  It still sucks.

I was not only an only child, but an only grandchild for almost 16 years.  That is most of my life.  I got to spend a lot of time with him.  Pretty awesome.  But, I think that makes it tough.  Especially when I see my little cousins who got so much less time.

The piece that is the worst for me, as a selfish grandkid is that he was my last grandparent who knew who I was.  Actually, I have Patrick’s grandfather.  So, I still have one, kind of.  And I have my “other grandparents” (like my “other” parents).   Everyone else has Alzheimer’s.  It is like that last bit of my childhood is gone.  My grandmothers barely know who they are, let alone who I am.  Not that it matters, but it does in my head.  At least I grew up with grandparents.  But, now it is kind of like they are all gone.  Some to death, one to bad parental choices  and two to the disease that ate their memory.

It isn’t like I think I don’t have grandmothers.  I do.  And they are still my grandmothers no matter how lost they become, at least to me.  But, it does make it different.  When we bring home great-grandchildren, they will love the babies and such, but it won’t be the same as someone knowing who they are and where they came from.  I lost that bit this week.

I felt guilty for not jumping on the reproduction bandwagon sooner.  It is silly, I know.  But this is the stuff that goes through your head.  Or at least mine.

I feel guilty about not being home more.  About not being home now while my parents try to take care of my grandmother and deal with all the other stuff that comes from losing a loved one.

I know this guilt is not of God.  I know that things will work out.  That we all do the best we can.  And that I can rejoice for all the good things.

Feeling sad about this stuff makes me feel bad about those who did not get to have grandparents.  Really, I am the luckiest girl in the world.  And I know it.  But, the more you have, the more you can lose.

I don’t think I expected to feel this sad.

I am cool with death.

I know he is with Jesus now.  And he is way better off health wise and stress wise up there.

But, I am sad for what I lost.  What my grandmother can’t remember she lost.  And what my parents lost.

The good thing is that death has been conquered.  I take great solace in that.  I will see him again one day.  We will play music and dance and laugh and it will be a great time.   So, I am joyful in my sadness (if that makes sense).

Mothers’ Day

It is Mothers’ Day.  Happy Mothers’ Day to all of the Moms and Mom-like people out there.

Thus, all over Facebook and WordPress, I see cheesy odes to mothers, changed profile pictures and all of that good stuff.

I was pretty excited when the pastor at church wished everyone a happy Mothers’ Day and then moved on say he was going to continue on with our current series because the focus should be on Jesus and that can strengthen Moms (and everyone else).

Just so you know, I love my mother.   I am grateful for her.  I don’t need a holiday to say it.  But there you go.  My Mom is awesome.

I think it is great we honor mothers.  They are the unsung heroes of many families.  Superheroes of sorts (refer to song below).

I do think that we are taken advantage of by the commercialism we live in.  Clearly, I am also a conspiracy theorist.  But realistically, why do we expect so much on a made up day?  We need to be grateful more often than not.  That being said, it is great to have a designated time to say thanks… As a reminder.

Plus there is another side to this story.

Mothers’ day is not always a happy day like people make it out to be.  It is actually a day when a lot of people are hurting.  People who want to have children and for whatever reason have been unable to.  Those who are being put through lengthy adoption processes.  People who have had miscarriages or children who died.  People who have been estranged from their mothers or children.  Those who have a mom who died.  Sometimes it can be a day that brings back all sorts of hurt or loss.

I don’t think we need to stop our hoopla for fear of upsetting someone (because then nobody would be able to do anything ever), but I do think we need to be mindful of the unique circumstances of others.  That sometimes this is not an overly happy day or that it is a mixed feelings day.  And that some aspects of life just go on as normal.

I am grateful to have a Mother who loves me and who I get to see on a regular basis.  I am glad that my grandmothers (as “interesting” as they are) are still around.  I am fortunate enough to have a number of mom figures in my life.  I have no children, but I want them, but I have been lucky enough to not experience the loss of a child.  I am thankful that Mothers’ Day is a positive happy day for me and for much of my family.

Check out these articles about Mothers’ day for people who may not find it quite so happy: “Treasuring God After My Miscarriage” (domestickingdom.com), “When Mothers’ Day Is Hard” (thegospelcoalition.org), “Mothers Day and Mixed Emotions” (crosswalk.com).

Orange Rubber Boots

It has been a long day. To top it off, we are driving home now after work.

Bright side to all of this is that I have fabulous orange rubber boots. They are so fabulous in fact, that I took a picture of them. And I wore them to academic half day when I was post-call because they made me feel better.

My orange rubber boots are magical. Clearly. And not just because I can trek through puddles without getting my feet wet.

If only it was socially acceptable to wear them on bad days at work.

One just can’t help but smile whilst wearing orange rubber boots.

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One of THOSE days

Have you ever had one of THOSE days?

One of the days where doing your job… The job that you love and feel called to do feel feels like a chore.  Where duties that you like are enough to make you want to gouge your eyes out and you drag your feel at every step?

That was my today.

Well, at least that is how my today turned out.

It started out like any other day doing routine morning rounds on the inpatients when I got a call about one of my sicker and more complicated patients.  They weren’t well and were asking for the attending to come see them.  Instead, they got me.

Needless to say, although we like eachother (I think) they weren’t thrilled to see me.  And I really couldn’t do very much at all to help, except hold hands (until I got yelled at because I was limited in what I could give or do until I spoke with someone else).

And thus began a roller coaster of a day.  I somehow managed to speak to every consultant involved during the course of the day, some of which have starkly different opinions and approaches, all of whom want me to in speaking with my staff have a million changes happen.  And some of them are discongruent.  And I seem to be one of the only common points of discussion except the patient.

As the day went on, I found myself caught up in a he-said she-said drama and somehow managed to get paged at least once an hour about some sort of issue with orders, a need to reassess a new symptom, talk to a new family member/team member and yet still needing to do the rest of my work.  And I still needed to complete my other regular duties (not that they are particularly heavy at the moment, but nonetheless they do exist and I missed rounding with staff on our other patients and teaching and part of clinic due to this important, but relatively non-life threatening conglomerate of events…)

Normally, I would take all of this in stride.  But, by noon, I was frustrated with being pulled in different directions, tired of having to go back to that floor every time I tried to leave and annoyed… Not with the patient or their family or the team, none of this is within their control (one might argue the team could do better, but it is really complicated), but with the whole package and with myself for being annoyed.  I began to feel resentment at whomever was the source of my pages.  A little voice inside my head wanted to yell “No, I don’t want to go up and reassess the patient!”

But, I didn’t do that.   I took a deep breath and prayed for the patient and for myself.  Then, I smiled and ploughed on.  There was a lot of fake it until you make it happening on my end today.

I feel awful when I don’t want to see patients or when I get annoyed with people calling me.  It is my job and it is their job.  I try not to show it ever and it doesn’t happen often, but sometimes, it really can be a struggle. Sometimes calls or duties that are not necessary happen.  Sometimes you work with people who you don’t always enjoy spending time with.  Neither of these sometimes were in this situation, this was more of a sheer volume and confusion thing.   And often, it snowballs and the feelings get more intense if I don’t do something to calm down and regain perspective.

Was I the picture of perfect?

Nope.  I sighed and occasionally rolled my eyes while writing notes.  At one point I contemplated throwing my pager out the window.

By the time the afternoon was starting to come to a close, I thought I was in the clear.  But, then I had to go do a procedure.  Which, of course, like the trend of my day was not without complication and then a page from my staff wanting to see the patient immediately after (which turned out to be longer than they would have liked).

This all made me think of this song by (one of Patrick’s favourites) Mark Schultz… Including the getting the name wrong piece… One of the staff I work with is convinced my name is Krista, no matter what I tell him.

I would like to say I was never so happy to go home, but as it turns out, I was on call.  I missed the last shuttle to the other hospital, so I had to power walk with all of my stuff.  Where it has been busy since my arrival up to right now.

But again, there is something to be said about keeping my cool.

I know the nurses appreciate it.  And as irritated the patient and family are with the circumstance, they probably prefer me to be calm and pleasant (I hope anyway…).  And I always appreciate people who are nice, especially if I expect them to start getting annoyed.

The day is far from over.  And, to be completely honest, I want nothing more right now but to go home and curl up in the fetal position next to my husband. However, I look at it like this… I am usually happy.  I love what I do.  It was a bad day and things like that happen.  I remind myself I did my best.

I am far from perfect.  I know I wear my emotions on my face.  I have been told that before.  So, I am sure someone along the way picked up on my frustration or angst or fatigue.  And sometimes I overcompensate.  But, I like to think I was still helpful and open and wiling to try at a times (and they were multiple today) where I could have thrown in the towel or avoided the situation.

Tonight, I still feel on edge.  I still feel bitter about a ton of things that happened.  I also feel good about some of the things that happened.  About what I learned.  About the progress we made, even if it felt small.

But, the cool part of it all is that this is just one day in a million. There will be other bad days, but there will be many more okay days and some awesome days too.

The other cool part is how great God is at getting me through the suckyness without gouging out someone’s eyes.

Without Him, I would never have the patience or the perseverance to deal with stuff.  As strange as it may sound to some of you “Trisha is all crazy and Jesus-freaky sometimes” folks, the brief pause to say a prayer is time to gather myself.  And my premorbid personality is such that I get annoyed with inefficiency, disorganization and complaining, three things that today was full of.  So, without big changes that have taken place in my life, this would have been much worse.

I also firmly believe that God acts in some of the tough situations to help work things out.  Can I prove it?  Not especially, but I still believe it (maybe I am crazy, or maybe I have seen some pretty weird things work out the right way).

And God keeps my perspective right.  Again, this is something people can do without God, but I like having Him in the equation, I think it makes it easier.  But, I try to see people how God might.  With love, with respect and I try to treat them as such, even when I don’t want to.  It is hard.

I guess you could say I tried to Golden Rule-it-up today by treating others how I wanted to be treated.  And some of them treated me nicely back… Even though their days were clearly going poorly too.  Funny how that works?!

Sometimes, I think people need a V-8 (remember those V-8 commercials where people would smash others on the forehead?  No… Well, I do.).  It isn’t always my place to give it.  And some days, I do too.   And sometimes there doesn’t seem to be anyone to crack me on the head.  So, you get through it and carry on.

When you love what you do, when it is a calling, not just a career, having one of THOSE days is not enough to make you want to quit, but it is enough to require you to take a step back and breathe (and possibly consider taking up some bad for you habit as a vice), but then carry on happily (maybe not quite that same day, but a few days later).

Cheerful

I have been told I have a high baseline.

I am a cheerful person.

I remain happy and positive when other people get bitter.

I do have my bad days.  I get sad like everyone else.

I am empathetic to a fault.  I put myself in people’s shoes to the point that I reflect and dwell on tough stuff sometimes too long.

Today, for the second time in my life, I was told today in a simulated communication session I am too cheerful.  That it puts people off in difficult situations because I seem like I am too busy frolicking through my day to really seem that I care.

I never want that to be what happens.  I care greatly for people.  And although my personality follows me, I have always thought that it shows through and that I seem caring and empathetic when I need to be.  Patrick jokes I have a “serious doctor voice.”

I would think if it were actually a problem that this would be feedback I would get more often.  That it would be a problem.  That I would notice it puts people off.

I adjust based on situations.  But, I am still me.  When I walk into a room, until I gauge a situation, I am who I am.  I adjust my tone of voice, I grasp when things are grim or sad.  But, if I don’t know for sure, I will offer a smile and an upbeat greeting.  It just seems polite to me.  You can be professional and empathetic, but also be a happy, positive person.

Do I really need to check my personality when I walk into a room?

Patrick thinks no.  And that if it were a real issue, it would come up more.  That I probably charm more people than I offend with my sunny disposition.  That I have always seemed appropriate when he is around in tough circumstances.

I get that personalities don’t always click.  And I am in a learning setting, so people will give feedback and not always agree with how I approach things.  Especially when that is what they are specifically looking for.  And I get sometimes I come on too chipper.  But, most of the time, does that colour an entire encounter?  Especially when I adjust based on the circumstance?  Or at least I thought I did.

How do  I process that when every other time, including the other three situations in this day, I have had nothing but praise (and of course, some more minor basic approach feedback)?  When the verbal feedback starts with pointing out that my personality is probably “cheerful”?  And basically only included that I was too cheerful coming in and initiating our conversation and how that colored our entire discussion that was too serious to start with such a friendly introduction.

I felt that the scenario didn’t go as well as I would have liked because I felt I didn’t have as much time as I would have liked and wound up trying to almost rush part of it… Because I tried to take more time to flesh out other stuff.  Because I thought that piece was as important as some of the later discussion stuff that in real life would be a dialogue over time or at least beyond the 12 minute timeline.  But I took that extra time early on for the other stuff because I care… That much.  Even if it is imaginary.

I didn’t cover everything because I ran out of time.  So, I didn’t get every tick box.   I didn’t miss stuff because I was avoiding it.  I missed it because I was trying to communicate effectively about the issues at hand.  And if it were graded, I still would have passed.

But, it bothers me.  Because I could have done better in that regard.  Had I had more time.  Or managed my time differently.    Yes, we have time limits.  Yes, there are ways to be efficient.  That is a fine thing to work on.  But, some things are just so important I think we should take our time.

But it bothers me more that cheerful disposition threw the person off…  Made them feel like we didn’t have a partnership.  Maybe made it more difficult to share.

I would never want that.

What if that happens other times and I don’t know?

When I was in Med 1, I had an SP tell me that I was too cheerful during a physical exam session.  That I should consider toning it down a notch sometimes.  But that it is good that I talk to people.  Just that I don’t always have to seem so happy to be poking them in the thyroid.

That is also how I sound when I get really nervous, interestingly enough.

I asked for feedback on my cheerfulness with others and there was no complaint the rest of the year.  So, I figured it was okay.  So long as I don’t let myself get too nervous.

In this case, I shifted when the mood shifted.  At least I thought so.  Initially, I was my chipper self, but I adjusted when we got serious.  I thought I adjusted to the mood in the room.  My voice was still too sunny early on, though.   Maybe I missed the boat?

But, do I really need to change my style?  Do I have to change me?

Or do I just chalk it up to a difference of opinion?  A one-off event?  A bad moment on my part or the person’s?  And maybe some nerves?

Or maybe it is somewhere in between…

The whole thing makes my head hurt.  I don’t know how to grapple with it.  Except to take it at face value and try to more consistently subdue myself before going into unknowns.   I don’t want to lose myself in the process, though.  Generally, it works for me.

I want to do what is best.

It is only the second time I had someone comment on my cheerful disposition negatively.  But, it hurt my feelings.  As foolish as that may be given the circumstance.

Not JUST an R1 and other difference making moments.

Today, I was answering my attending’s pager and a GP calling from outside the hospital said the nicest thing to me.

It is my first day doing GI consults, which can be rather interesting.  I find consultation services fascinating because you get to see people with all sorts of problems for all sorts of other problems.  The bigger the puzzle, the better in my books and I saw a couple doozies today.

In fact, in one of them, someone with some liver test abnormalities, I solved the puzzle without prompting thanks to my time spent on the liver service!

Anyway, back to my story… So, I answered the third outside call of the day.  The people calling expect to get the specialist, not the junior resident.  And normally this person is excellent at answering.  But, because they were mid-scope or mid conversation, I was sent to answer, so at least the person would get a response and some interim advice before the attending could call them back.

I heard the whole story from the GP and agreed that the person needed to be seen and that things weren’t right (but I had no clue what else needed to be done or in what timeline exactly), so I told the GP that, “I am just the R1, so I can’t really make any suggestions,  but I will get my staff to call you back when they get a moment.”

The GP responded, “You are never JUST an R1… You are a part of the team.  Had you not answered, I would have been stuck waiting by my phone.  At least now I can say I talked to someone and they need to check into things.  This is how you learn.”

Such a nice thing to say.  A simple and obvious statement, but one of those things that you need to be reminded of.

I know that deep down inside.  But, sometimes, especially on a consult service… And new to that service, you feel as if you are just a middle man.

But, that is what I am there for.  To help people.  And to learn.  And part of that learning and helping is answering calls and consults that I really can’t do much about besides take a good history and physical and do some reading around it.  And once I review it with staff, I learn.  And next time, maybe I will know what to do for real.  Or at least have a better educated guess.

I am so thankful for people who understand that situation.  Who take time to teach or understand that I am learning.  It makes a world of difference in my day.

Other world of difference to my day moments were less profound.

I woke up and Patrick informed me that I slept through yet another Habs win.  On the bright side, I stayed awake to the end of the second period (I sure felt it this morning, though).

I finally pulled that darn grey hair out of my bangs.

I realized that the cold Patrick gave me last week has now had me talking like a man for a week.  I think there are people I have met on several occasions now who may think I just have a husky voice.  And for some reason, that strikes me a little funny.

It was unseasonably warm today, so I walked home without wearing a hat and mittens for the first time in ages. Also, I left work at 5 and it was still somewhat light out when I got home.

Clearly, my life is exciting.  Thank goodness that doctor was nice.