self-care
Destination Wellness – The Physical Domain
By Dr. Jaime D. Lewis The Clinical Practice Committee is again submitting a series of blog articles regarding a topic of common interest. Domains of wellness are variably defined and may be considered to include: occupational, social, emotional, spiritual, intellectual, and physical. In this blog, I focus on the physical domain. As a trainee, I found it difficult to schedule personal appointments and set a schedule for eating and working out. As a medical student, I often couldn’t even figure out when I’d be able to go to the restroom next. How could I plan meals and health care appointments? As a resident, I exercised very little except as during my two years of research. My diet at the hospital consisted of peanut butter and graham crackers. I nearly burned my house down one post-call day when I fell into a deep sleep on the couch waiting for ramen noodles...
Staying Well While Treating the Sick
By Dr. Brienne Ryan Trying to stay well is no easy feat in the time of COVID, for both those in the medical field and those not. Many of us who have weathered the oscillating storms of this virus over the last two years find ourselves entering the New Year with yet another wave of nauseating apprehension and dread. What will the next few months look like? Will elective cases be canceled again? Will I graduate with enough cases? How will I deal with another COVID variant? Even before COVID descended upon our lives, surgical programs across the country had started to adopt a wide range of policies embracing “wellness.” With its ambiguous definition, wellness remains an elusive concept in the surgical world, often eliciting a clash of opinions between the new generation of surgeons and the old. Gone are the days of the 100-hour work week, long stretches of...
The Façade We Keep: Masking Mental Health
By Alyssa Brown Trigger Warning: This piece includes details of a suicide attempt, which may be triggering to some readers. If you are thinking of hurting yourself, please contact the National Suicide Hotline (800-273-8255). This piece was written with the written permission of the friend in the story. Names and locations have been changed to protect her privacy. Do you feel like killing yourself? Yes. Do you have a plan of how you would kill yourself? Yes. During my psychiatry clerkship, I spent three of the six weeks in the psychiatric emergency department of University of Louisville Hospital. As a third-year medical student, my job was to screen patients with a brief interview before the team discussed the patient’s case. The general questions stayed the same with minor variations based on their answers. After an introduction with the patient and the regular, “what brings you here today?” question, I always...
When a Surgery Resident Gets COVID Pneumonia
By Dr. Sara Parmiter I awaken fatigued with body aches, not abnormal for a surgery intern. No one would think twice about taking acetaminophen and going to work. That is how I justify it to myself now. Hurrying to the clinic, I force myself to walk faster. I sit and catch my breath feeling the sweat roll down my back. I’m just tired. Walking back to the hospital, I stop and take a break; my legs are filled with sand. By the days end, I struggle to concentrate; it is physically taxing to keep my eyelids open and type. I have a cold, thinking to myself it cannot be COVID. That evening my temperature rose to 101; I reluctantly scheduled an appointment for testing the next morning. I am tough. My entire life I have been the strong girl, the one who can grin and bear it. I pride myself...
Highs and Lows of Surgery: Juice Boxes on my Surgery Rotation
By Hannah Case The first two years of medical school, I found myself fighting with an inexorable desire to be in the operating room. Surgery seemed alluring; addictive almost, yet I fought its appeal. I began convincing myself that what I surely desired was to go into pediatric hospital medicine. It wasn’t the hours, the sore feet, the years of training, the personalities, nor the competitive nature of the field that led me to adamantly deny my love for surgery: it was a subconscious fear that I could not survive the long hours of operating. After all, what is a surgeon to do if their blood sugar plummets, their continuous glucose monitor (CGM) alarms, and their hands begin to tremble as they’re delicately suturing? Surgery was my first clerkship of third year. I recall the week leading up to my first day, during which I met with my endocrinologist and...
Just Keep Swimming
By Elysa Margiotta, MD I could have given up. I could have decided that it was all too much to handle, and just faded away. To say that my path to becoming a physician was eventful is an understatement. I started medical school in Grenada as a fresh-eyed, hopeful 21 year-old, looking forward to the “first day of the rest of my life,” as we so often hear in movies. I had just left my family and friends behind in Canada, and I was starting my new life. Here is the series of tumultuous events that occurred during my medical school journey: - On my second day on the island, I was sexually assaulted by a senior classmate, which led me to develop and experience PTSD over the next few years. - During my second semester, the day before our first exam, I received an email from an attorney’s office...
Navigating The Red Tide: Menstruation and Myths in the OR
By Joy Alvarado Although there have been major advances in the field of surgery toward gender parity, some circumstances that are unique to women still remain poorly addressed. One such circumstance, colloquially known as The Red Tide, Aunt Flo, The Monthlies, The Cycle, or Shark Week (for those National Geographic fans; i.e. dealing with menstruation), still seems to challenge our expectations of what a surgeon should look like. At a minimum, it still induces fear of mythical proportions in young women who are considering the field. I know this to be true, because as a young woman entering surgery I heard many horror stories during medical school. They always starred a 4th year student or surgical resident who suddenly experienced The Red Tide oozing down her leg during an operation. Our protagonist would not be able to scrub out to change her clothes and would have to suffer with a...
Cura te ipsum — Surgeon heal thyself
By Lilah Morris-Wiseman, MD, FACS "Stepping into the operating room to perform heart surgery on a sick patient, being fully in control of the large team of people who are required to do the procedure, and feeling totally prepared to perform the task at hand is an unbelievable feeling that can barely be described." –Renee Hartrz, MD, FACS, Cardiothoracic Surgeon, FACS website “Why do surgeons become surgeons?” I received a call from my program director after the second time I didn’t show up to work. “We need to meet,” he told me. I was a fourth-year general surgery resident on our night trauma surgery team. I didn’t wake up for my shift and I wasn’t answering my phone or pager. I woke up to let the paramedics in, but only became truly aware when there was a needle in my vein infusing dextrose. I had not adjusted my insulin pump...
Not What I Planned, More than I Expected
It was approaching 3:30 pm in the afternoon as I sat finishing up progress notes for the day. As I looked at my watch, I felt the feeling of dread start to creep in. At any moment I would be getting a text message from my husband about how our son’s day at school had gone. Lately, the reports had been pretty grim with lots of refusing to do his schoolwork, hitting and swearing. I had little confidence that today would be any different. The stress of raising a child with special needs and being a surgeon was starting to wear on me, and I wasn’t sure how much longer I could carry on worrying as intensely about my son’s behavior as I did about the critically ill patients I cared for in the burn ICU. It would have been so easy to give up hope and believe that my...
Surgeons and OR ergonomics: When Doing What We Love Hurts Us
By Geeta Lal Almost 3 years ago, I woke up with a familiar throbbing pain in my left jaw and face. My first brush with it was four years prior, while caregiving for my mother with cancer. “Stress and teeth grinding…” said the well-meaning oral surgeon I saw, and proceeded to advise soft foods, muscle relaxants and NSAIDS for what was diagnosed as myofascial temporomandibular dysfunction (TMJD). That episode resolved and aside from some intermittent discomfort, I had done reasonably well. This time, however, things were different. The usual measures weren’t helping, and as the days and weeks wore on, the pain extended to my head, neck, shoulder, and upper back – and it refused to go away. My journey to feeling better has involved many imaging studies, specialist consults, and treatment modalities. But what I didn’t know was that a major contributor for TMJD was the exaggerated head-down posture...
