life, in a nutshell

i am off today!

dreams again
i woke up with the barenaked ladies’ life, in a nutshell in my head. i have no idea why. i was infatuated with the bnl when i was in high school, long LONG ago. i even had a bizarre crush on ubernerdy lead singer steven page, because i liked his pretty voice and his songs. recently, he was arrested on cocaine charges, which is rather horrifying, actually, considering the band recently put out a kids album! i am guessing sales have probably slowed on that one, although i bet it isn’t bad because i could see them doing some great lyrics for kid-type songs.picture from mymusic.com

fatigue report
it is amazing what 11 hours of sleep will do for my mood. well, that and not having to go to work today. please don’t misinterpret this — i still really DO like what i’m doing this month. i just wish i could have more balance in my life. i realize that medicine is one of those careers where you are not really supposed to have balance, but that is just not the way i want to spend my one and only life. i want to be a good (actually, excellent) doctor for my patients and also a happy well-rounded person who enjoys life. someday in the not TOO far future (2-3 years? don’t get excited yet) i want to be an excellent parent as well — and that will completely alter the pie once again.

perspective
yesterday in morning conference, one of the residents presented a case on a patient that he had cared for while working in tanzania. the kid was horrendously malnourished and had dramatic splenomegaly and spent a month in the hospital being cared for. the interesting part of his talk was not really the medicine involved, but hearing how the health care system works in a place like tanzania. the biggest difference is that everything is paid for out of pocket there. if a family does not have resources to pay for labs and xrays and the inpatient stay, there is no way to get these things. labs are about $1.75 each, xrays and ultrasounds $4, a day of inpatient stay $1.75, and a CT scan a prohibitively expensive $100. even the $1.75 is not a trivial sum for many patients, so a hospital admission is going to be a big hardship no matter what is done. there are a few exceptions to the ‘pay in cash’ system, like chemotherapy for cancer and HIV medications, but even then costs of getting and staying at a medical center are just not affordable for many families.

the whole thing hurt my heart. here we are in the USA spending thousands of dollars on every hospital stay (basically, care here is LIMITLESS if you can get yourself to a tertiary care center and have medicaid) and rarely ever thinking of the cost effectiveness of anything we do, and yet there are so many out there in other countries who just get nothing. we are all people living on the same planet — and yet because of the imaginary lines we drew on the earth at one time to create countries, there is inequality so immense that it is hard for me to wrap my head around it. the conference really made me want to commit to doing medical outreach work in underserved nations someday, hopefully as a regular part of my career. i realize that healthcare in the USA is still far from perfect (TRUST ME), but this was a major reality check for me.

pressure
in my completely negative post yesterday (sorry) i mentioned SIG E CAPS and it got me thinking about the big G part of the mnemonic, which is guilt. as someone who always has a lot of goals and high expectations, i think i set myself up for G on a pretty regular basis, and it kind of sucks to feel like i am never quite measuring up to my own standards. this month, i wanted to do tons of teaching at work while running my team with a big smile on my face at all times, do lots of outside reading about my patients, run/work out 5 times per week, continue with nightly cooking creations, and enjoy all of it. i have tried to do all of these things, and i have not really fully accomplished any of them. i think it is time to cut myself some slack and appreciate what i HAVE managed to do: learn a lot about managing a team and general pediatrics, get in a few runs/week most weeks, and write about it every day.

not perfection, but really not all that bad.

i am going to head out for a run now in my neighborhood and i’m just going to explore and go for as long as i feel like. next week i will resume real ‘training’ but for this week i am just going to give myself a (well-deserved, i think) break. which means this miles-long post needs to end.

happy friday, peeps.