Category Archives: About Me

The Doctor’s Dilemma

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Being a physician is a career that can become one’s life. There are many reasons for this including the 24/7 need for healthcare, the pressure from healthcare business for productivity, the need for advocacy to improve the system and increase health equity, and the desire to help others. There is also the added stress that medicine literally deals with people’s lives and wellbeing. Given these career features, being a physician historically was a way of life, not just a job.

Despite the historical trend that being a physician was a way of life and an identity that trumped all others, there has been a shift in recent years. This shift started some time ago and was, perhaps, expedited by the COVID-19 pandemic and the severe toll it took on all healthcare workers. The shift is that newer ages of physicians don’t just seek to be doctors – they seek to be partners, parents, athletes, cooks, travelers, readers, vacationers, relaxers, and gardeners to name a few identities they claim beyond the physician identity.

As a member of the newest generation of physicians I find myself caught between the old dogma that to be a physician is to prioritize it above all other aspects of life with the newer view that to be a physician is to be a person with a serious career. I think of these completing identities of “way of life” vs “profession” as the “doctor’s dilemma.”

Sometimes self-imposed and sometimes externally-imposed the training physician (and all physicians really) are driven to do more. More reading and learning, more shifts, more leadership roles, and more research. It’s hard to balance the forces urging me to do more with the desire to also do nonmedical things like spend time with my husband, hike, and write. My medical training has taught me to hustle, be efficient, and work for long durations of time with high focus. As my training continues, I’m also learning how to say “no” and pump the break. Of course, these learnings are contradictory. The pendulum falls sometimes more on the hustle side and sometimes more on the relax side.

As I finish my 1st year of residency, I’ve been thinking about the doctor’s dilemma because in the remaining years of residency I’ll make decisions about my post-residency career path. While I contemplate my career’s trajectory, I also find myself thinking about other things in life. For example, living in a city apartment has made me miss walking barefoot on grass. I don’t suspect I’ll own a house anytime soon, but missing grass has made me think about homeownership more than ever before.

What do I put on hold and what do I pursue? What opportunities if not taken now will disappear? Where do I want to be in 5 years?

While wellness preaches “live in the moment” heavy careers, like doctorhood, require forward thought. Doctorhood requires the balance and blend of one’s professional dreams and identity with one’s personal dreams and identity. During my 2nd year of residency, I’ll become a team leader and gain more independence. With this greater responsibility doctorhood feels more serious than it did as a new resident when I had more people guiding me. As my training continues, it is my turn to step up with the answers. Patients will depend on me. Each choice, like whether to study or run, has a ripple effect on my future and (perhaps) on my patients’ futures. There simply isn’t enough time to “do it all” at the same time. Choices must be made along the way. The choice options are what pose the dilemma.

A Letter to My Intern Self

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Dear About-To-Be-Intern Self,

Intern year (as the first year of residency is called) is going to be tough. At times, in fact, it’s going to be downright awful. There will be stretches where you don’t see the sun and can’t remember the last time you felt anything but exhausted. The trend you noticed in medical school, in which current physicians and administrators don’t value your time (and waste it) and then wonder why your mental health is poor, will persist. You will be told by some to do more because “you’re a doctor now” and you’ll be belittled by others because you’re new and you don’t know what they think you should know.

You will be impressed by how your health deteriorates intern year. You are welcome to take some of the blame for your decline if you’d like, but the truth is that everything about intern year is the opposite of the wellness advice we give our patients. From your sleep schedule to your stress level, or from the food the residency program gives you to your work hours, there is very little healthy about intern year. It would be misleading to ignore these negative things that will unfold, one way or another, as they have for every intern. They manifest a bit differently for each person, but their occurrence is a guarantee.

Like all things in life, the negative of intern year is paired with the positive of these 12 months. First off, you’re paid – a huge victory after 4 years as a medical student. Your salary will be meager compared to your future salary (and it will be poop if you calculate the hourly rate) but remember that the intern salary is higher than the average annual income of Americans. Second, you are a doctor now. A real doctor. This title, alone, allows you to meet the most extraordinary people and hear their amazing stories. People will tell you things they never told anyone else. Your kind patients and your brave patients will be beacons helping you through intern year.  Focus on remembering the kind and brave patients more than the hard and mean patients; it’s the opposite of what your mind will want to do. I assure you that remembering the kind and the brave will help you more than you realize.

There will be difficult senior residents and supervising physicians; there will also be amazing ones. Take a moment to appreciate the inspiring senior residents and supervising physicians and reflect on why you respect them. You’ll be in their shoes before you know it and you can learn from them. Let the degrading and unkind supervising physicians and residents bounce off you; let them be a lesson of what you do not wish to become. The same goes for the nurses and other staff in the hospital. Nurses will be your biggest nightmare and your biggest savior throughout intern year. A knowledgeable and respectful nurse is gold. Thank the hard working and thoughtful nurses. Learn how to navigate the mean and not patient-focused nurses. You’re a doctor now and, once intern year is over, you’re going to be a team leader. Intern year is about getting ready to be a leader.

No one is good at being an intern when they start. Every intern gets better at medicine, navigating the healthcare system, and working with the interdisciplinary teams of healthcare. You won’t notice how much you’re learning at first. The days will pass slowly and the weeks quickly – before you know it, you’ll wake up and realize that you are a new version of you. You’ll blink and a new July 1st will be just around the corner. Then, intern year will be behind you…forever. I’m not delusional enough to say, “enjoy it while it lasts.” I am delusional enough to say fight for your health (because you’ll need to) during this year and soak up as much knowledge as you can. In the end, intern year exists to help you get closer to becoming the best doctor you can be. Intern year will force you to grow. It will challenge and push you to a new level. Always remember that intern year is finite and only one small phase of the Doctorhood Quest. It will pass.

You got this. I know you got it. At the end, you’ll know you got it too.

Yours truly,

Jett

Space

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I often think about space, specifically taking up/claiming space. My most conscious ponderings about space are while I’m running in the park near my house. I’ve observed that people are more likely to step aside for a male runner than me, a female runner. It’s so blatant that when my husband and I are running or walking together we strategically put him on the outside because people move over for him and not me. It’s an annoyance. I’ve started to run strong and serious. I’ve learned that a confident stride and a squared shoulder do help remind people that women also deserve to run without stride interruptions.

Guarding my lane while running is a newer claim of space for me. The first time I claimed space was changing how I sat. Changing my sitting stance was a project that took the better part of my twenties. For some reason women in my culture are taught to sit small and closed. I’ve found that sitting small is counterproductive. It has (perhaps) made it easier for males to harass me on public transportation and (definitely) made it easier for my colleagues in healthcare to ignore me. These days I try to sit large and open, just like my culture teaches their boys to sit. I don’t take the inside seat on the train/bus (that’s more for safety as I’ve learned the hard way) and I take up my whole seat even when it’s wider than I am broad. If there’s a seat at the table in a conference room, I take it. Which brings me to medicine, my most recent occupation (both meanings of occupation, wink, wink).

I have a very distinct memory from medical school related to being a female in medicine. I was mid-sentence presenting my section of a group presentation when a male member of my team cut me off, talked over me, and started his section of the presentation without letting me finish. It was so rude that several females in the class texted me in solidarity. The experience made me think about why seats at the table are not enough on their own. Seats must be claimed and, sometimes, defended.

Being a first-year resident brought with it a whole host of interesting space claiming challenges, many simply related to being a new doctor and some related to being a female physician. Filling the role of physician involved learning how to defend and explain my medical decisions, striving to take the high road and set boundaries when other members of my interdisciplinary team did not, and observing how physicians I admired conducted their doctoring and led their teams so I could model their techniques.

The challenge of being a new doctor exists for all new doctors. But filling the role of a female physician comes with its own occupational hazards. Here are some concrete examples from the past year of times I was reminded that I was female while at work:

  • I frequently must remind my patients that I am not their nurse — a challenge that my male counterparts don’t have.
  • My name is gender neutral, so nurses often think I’m male when communicating electronically with me before they meet me in person. (We have a secure chat in our electronic health record system that we use in the hospital). It is interesting to see how nurses’ tones change after they discover I’m female when they originally thought I was male. At times the tone change is dramatic and frustrating because I get more pushback as a female than as a male physician.
  • I have been lectured by a male supervising doctor about what clothes a doctor should wear. The lecture was somewhat confusing given that all the female residents wear exactly what all the male residents wear… scrubs of similar fits, styles, and colors. I doubt any male resident teams have been subject to such a lecture, but my all-female resident team was.
  • Several times I have found myself uncomfortable on rounds (that time of day when you talk about all your patients with the supervising doctor) because the male supervising doctor was very good at looking at my chest but never made eye contact.

The above situations illustrate that there are additional features of the medical terrain that female physicians must navigate that their male counterparts don’t experience.

As my second year of residency approaches (starts July 1), I’ll soon find myself no longer a first-year resident. In my second year of residency, I’ll start to be a team leader and I won’t be the new kid on the block anymore. I’m excited about this next step in my training. I feel ready to take on the challenge knowing I’ve learned a ton already and have a ton more to learn as a physician. I continue to have much opportunity for growth on my journey to lead with humility and excellence. As I wait for my second year to begin, I’m curious what the phase of “senior resident” (my title during my second and third (last) years in residency) will be like and the space challenges it will present. All adventures have space challenges however they present themselves in different ways.

How Strange to Be Unable to Name a Daffodil

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“We saw daffodils!” I said. My voice sang with an enthusiasm that only such a definitive sign of spring could coax from me on such a rainy, gray afternoon in February. My co-resident looked at me blankly. The importance of a daffodil passing through their genius brain just as the medical terminology doctors like to use pass through patients’ ears – jargon without meaning, hardly in and definitely right out. “You know, it’s one of the first flowers of spring. I saw it in the park.  They’re yellow…” I gave up and the conversation moved on to other topics.

Doctors are more diverse than we once were, but our makeup doesn’t come close to mirroring the population we serve. My visible profile is common in the medical world – white (always very common) and female (slightly more females are entering medicine than males these days). Yet my unseen profile, my story before medicine and path to medical school, is unusual for a doctor.

Sometimes I’m reminded of my different background when it’s easier for me to relate to patients than my colleagues who come from medical families and have never known what it is like to not know what “coronary artery disease” and “hypercoagulability” mean. Other times I’m reminded of my different background when it’s easier for me to understand the social determinants of health such as why someone might not have transportation to appointments and why medications might not be worth the monthly bill to a specific individual. Where I grew up if you didn’t have a car you went nowhere; further, I solely used public transportation for most of my 20s. I’ve also run a tight budget most of my life which has given me a lot of practice deciding where my money will and won’t go.

It’s not just my economic background that makes me different from many of my co-residents (though I’ve come to realize more with each passing year that economic background is a mountain that dominates world view). The nuances of my difference from many of my colleagues present themselves at unexpected times such as on slow days when making small talk with co-residents and supervising physicians.

I grew up in a world where medicine was minimally understood, mysterious, and (perhaps) feared. The distance of medicine was partially possible because my family was healthy and required minimal medical care; it was also who we were. Our lack of medical knowledge did not mean, however, a lack of knowledge. For my colleagues who have known the medicine way of life since childhood as they watched their parents (many doctors and some nurses) come and go from work, the hospital system is familiar and almost second nature. I didn’t grow up knowing the hospital. Yet, I know other things that are part of who I was, am, and will be.

For example, I know the birds, trees, and plants of my childhood and I’m learning the ones of my new home in Virginia. I know how to grow plants indoors or in a garden because I grew up in a culture where we all knew how to tend plants. In a similar way, I don’t believe cows are cute because I’ve been almost late to school chasing them after they got out of the fence. I know how to stack 6 cords of wood in a day, use power tools and wood tools, and change my car tires because these are skills that were necessary in the world where I grew up. I notice architectural details, complementary colors, and other design elements because these were some of the themes of my childhood.

Being an older resident with a different background and careers prior to medicine is isolating at times. A small portion of my co-residents can relate or are interested in where I’ve been before medical school. I’ve become accustomed to this. My life extends beyond the hospital. I have family and friends who understand the nonmedical aspects of my life just as my co-residents understand the Doctorhood Quest in a way non-physicians can’t.

I have so much to learn about medicine from my co-residents and supervising physicians regardless of whether they understand any aspect of my life outside of residency. But, on days such as when I find a resident who can’t name a daffodil, I’m torn between amusement and sadness. In my world it’s ridiculous to be unable to name one of the most common spring flowers in the US. The realization that there may be many doctors who can’t name a daffodil reminds me just how different we all are. It also reassures me that there is much I can teach my co-residents too. And, perhaps more importantly, it reminds me how much physicians can learn from our patients and non-doctor colleagues if we find time to listen.

Sights Set on 2024

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Stopping by Woods on a Snowy Evening

By Robert Frost

Whose woods these are I think I know.  

His house is in the village though;  

He will not see me stopping here  

To watch his woods fill up with snow.  

My little horse must think it queer  

To stop without a farmhouse near  

Between the woods and frozen lake  

The darkest evening of the year.  

He gives his harness bells a shake  

To ask if there is some mistake.  

The only other sound’s the sweep  

Of easy wind and downy flake.  

The woods are lovely, dark and deep,  

But I have promises to keep,  

And miles to go before I sleep,  

And miles to go before I sleep.

2023 was a year of change. My themes of focus were quietness, absorption, and forward movement. I wrapped up medical school, moved halfway down the East Coast, and started residency. Despite all the professional development, I enjoyed a 7-week adventure in Puerto Rico, visited Paraguay, hiked the 33 highest peaks in the Catskill Mountains of New York, and undertook other small hiking/traveling/outdoor excursions as the opportunity arose.

Residency leaves me tired and overworked, but my progress toward becoming the doctor I wish to be is rapid. On one hand, Frost’s line “miles to go before I sleep” is a literal interpretation of what I expect 2024 to bring professionally. I have many professional goals which will march along as the days pass. On the other hand, the “stopping by woods on a snowy evening” part of Frost’s poem (pausing in an unusual place), resonates with me as I think about my personal goals and themes for 2024. As I set my sights on 2024, three themes are on my mind: quietness, pause, and connectivity. It’ll be a year where I focus on personal health.

Quietness

This was also my first theme in 2023. I’m carrying it forward both because I think it is of utmost importance and because I still have growth to achieve in this area. Being a doctor and learning to become a better doctor involves constant stimulation and 1000s of decisions daily. Adult life is full of challenges including finances (bills and earnings), home management, and unexpected disruptions like illness. With so much happening, I find that it’s easy to get lost in the hullabaloo and lose track of my inner calmness. As the unexpected challenges of 2024 unfold, I will continue to cultivate my inner quietness because I believe it is at the core of resilience and central to success.

Pause

Related to quietness, my second theme is pause. As the hustle of life unfolds, I easily forget to stop to appreciate small and large successes and delights. In 2024, I will take time to pause so I can absorb the joys of life. Focusing on joy will train my mind to see the positive and diminish the negative.  

Connectivity

The aspect of connectivity I plan to focus on in 2024 is the mind-body connection. My medical training has been extremely demanding in multiple ways. I have watched my health decline as the doctorhood quest unfolds because of my schedule, external pressures of doctorhood and the healthcare system, and the stress of my work. While my medical training will remain vigorous throughout 2024 and beyond, in 2024, I plan to focus my free time and energy on re-cultivating my physical wellbeing. This focus on physical health combined with my focus on quietness and pause will strengthen my mind-body connection. I think cultivating my own mind-body connection will ground me as I seek to connect with my patients, colleagues, family, and friends.

10 Years Blogging

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September 2023 marks 10 years of my blog Connecting the Dots. I started the blog in 2013 to document my experience in the Peace Corps in Paraguay. When I finished my Peace Corps service in April 2016, I had already formed the habit of writing and decided to keep going to share my experience of becoming a physician. Some months and years I’ve written more than others as my life unfolded this past decade. My blog has documented my time in post-bacc and as an EMT as I strived to build a resume strong enough to get into medical school. The blog was a constant as I trudged my way through 4 years of medical school. And now, after 10 years blogging, I’m 2 months into residency.

I’ve periodically wondered if I should stop blogging. Life reflection/journal blogs like mine aren’t designed to become highly successful or business ventures like other types of more broadly relevant blogs. But I keep blogging both out of a love for the writing process and because my journey has been a unique one. I suppose a key lesson that the Peace Corps and then medicine have taught me is that every human has a one-of-a-kind story that if given the opportunity to be documented as a movie or book could be the next blockbuster/best seller. Most folks, however, will lead their amazing lives and die without much of a trace. My posts about people I’ve met and lessons I’ve learned are my way of remembering all the lives I’ve intersected with as I trundle along my life journey.

The warm welcome I received in Paraguay as a Peace Corps volunteer gave me an opportunity to learn about a culture different from my own and to make life-long friends with individuals who I could not have imagined if I never did the Peace Corps. Similarly, the experience of being a doctor gives me a window into countless lives that are nothing like my own. Medicine, above all, has taught me that there is nothing as fantastic, comical, tragic, beautiful, and surprising as real people’s stories. I’m often reminded that as outlandish as any fiction story might be, reality is more extra and harder to believe.

Just like when I started my blog 10 years ago, I don’t know where I’ll be in 10 years. Reading some of my first posts, it is amazing to me how far I’ve come. I’m sure the next decade will be equally full of surprises. I can’t wait to reflect on the inevitable unforeseen events to come and then write about the highlights.

To those who have read my blog for a while, thank you for your unwavering support. To new readers, thanks for stopping by to sample and for considering future readership.  

Here are some of my favorite posts over the years (I’ve left many out for brevity):

Getting Ready for Departure – DC Chapter, 12/8/2013, on leaving DC, the city I went to undergrad and built my first career, for the Peace Corps

Getting Ready for Departure – DC Chapter

Ideal Boyfriend, Ideal Girlfriend, 11/10/2014, quotes from the 7th – 12th graders I taught in Paraguay describing their ideal life partners

Ideal Boyfriend, Ideal Girlfriend

White, 12/12/2014, on being the only white person in my Paraguayan community

White

Crosses in the Sand, 8/6/2015, on a uniquely Paraguayan form of ant control

Crosses in the Sand

Overheard In Paraguay: Friendship, 10/19/2015, on friendship that last forever

Overheard In Paraguay: Friendship

Guardian Angel, 1/23/2016, on feeling cared for

Guardian Angel

See You Soon Dearest Paraguay, 4/11/2016, on finishing my Peace Corps service in Paraguay

See You Soon Dearest Paraguay

Determination: 2 Girls, 1 Hill, 1 Tree, and 1 Ladder, 11/12/2017, on childhood and the nature of determination

Determination: 2 Girls, 1 Hill, 1 Tree, and 1 Ladder

Christof, 6/25/2018, on kindness and thinking of others

Christof

Below the Surface, 12/28/2018, on returning to Paraguay and learning an unexpected lesson

Below the Surface

Q-tips and Time, 5/16/2019, on how our perception of time changes as we age

Q-tips and Time

True Love, 7/27/2019, on true love as witnessed in the ED

True Love

Memory, 5/24/2020, on thinking about how memory works

Memory

Goodbye For Now Vermont, 3/21/2021, on moving out of Vermont (again) and reflecting on my time there

Goodbye For Now Vermont

A Cup of Coffee, 10/24/2021, on acts of kindness witnessed in the hospital

A Cup of Coffee

Together,  1/7/2022, on working as part of a diverse medical team

Together

Echoes from the Third of Medical School, 4/12/2022, on finishing my third year of medical school

Echoes from the Third of Medical School

Windows to the Soul, 9/6/2022, on caring for critically ill patients

Windows to the Soul

Nothing to Do but Be Happy, 2/14/2023, on waiting for medical school to end while spending a few months in Puerto Rico

Nothing to Do but Be Happy

Goodbye Danbury, 4/15/2023, on my time in Connecticut

Goodbye Danbury, CT

What do you want to be when you grow up?, 5/25/2023, on becoming a physician

What do you want to be when you grow up?

In the Quiet Presence of Plants

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“Some people look for a beautiful place, others make a place beautiful.”

~Hazrat Inayat Khan

I’m a keeper of plants. Some might call me a gardener but, having grown up in the rural US, I reserve the term “garden” for plants that root in the ground. And so, I’m a keeper of plants because all my plants are rooted in pots.

I have over 75 plants in my smallish apartment. Some of them have followed me through 6 moves. Some joined just this month. The only common feature among them is that they prefer Virginia to any place we’ve lived before. I attribute this to the sparkly sun here which was a key feature that drew me to the state in the first place.

My plants are as diverse as Richmond. There’s the Norfolk pine I’m growing as my Christmas tree. There are begonias adding their clashing leaf patterns to the balcony-dwelling jade plant, banana plant, snake plant, umbrella tree, and palm. On my desk is a battalion of orchids, most of whom bloom in spring. There are calatheas, peperomias, and bromeliads mixed in with the succulents and cacti. The coffee plants, passion fruit vines, and lemon trees are some of the newest additions. A dear friend got me a money tree for luck, around the time I got a lucky bamboo – it was a period of much change, so luck was needed. These lucky plants keep on growing. My crown of thorns hasn’t stopped blooming since I got it 5+ years ago. The fig, rubber, and dragon trees all were recently decapitated to encourage side branches (so far these experiments have been fruitful).

The plants sit along the windows and in layers such that those that need the least light live in the middle of my apartment and those that need the most are on the balcony for the summer or reside on the wide windowsill between my bedroom window and the blackout curtains necessary for daytime sleeping when I’m on nightshift. I know each plant’s light and watering preferences. I have a strategy for keeping each one alive when I leave for vacation.

Sometimes I wonder if it’s silly to have so many plants because I work such long hours outside of my home. However, when I come home to find a new flower bud or a fresh leaf unfurling, I’m reminded that it’s not silly but genius to have so many plants. The plants add a different beauty to the apartment than art (I have that too) and their quiet company is something I enjoy. With my plants even the most frustrating day can be softened when, upon sitting on my couch, I notice just how much the peace lily likes its new spot or how much the Chinese evergreen has flourished since we arrived in Richmond only months ago. And when I see the plants that I’ve potted up at least 3 times threatening to outgrow their current pots, I remember how we all change and grow with time. Sometimes our process of growth is too slow to see from day-to-day and only can be realized when we compare month-to-month or year-to-year. Yet, just as surely as my plants are renewing their roots and leaves, I’m also growing as the days of residency pass.

First Impression of Richmond, VA

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The James River winds through Richmond, VA and serves as the city’s playground. On a sunny day you’ll find folks lounging on river rocks; testing the rapids in rafts and kayaks; and biking, walking, and running on the riverbank trails. From the numerous walking bridges across the river, you can watch osprey dive, great blue herons fish, and geese and ducks eat bottoms up.

When you turn away from the river you find yourself wandering along streets lined with old brick buildings including row houses and factories-converted-to-apartments. Murals are scattered throughout the city. Parks and green spaces are more numerous than tall buildings.

Downtown Richmond is quiet. There isn’t much traffic – even at the peak of rush hour the traffic is manageable. There’s a boarded-up window or “for lease” sign every couple of storefronts on the primary street at the heart of the city. Neighborhoods with different vibes sit like cars on a Ferris wheel around Richmond’s often sleepy downtown.

Richmond could be called the city of highway sampling. Numerous highway bridges crisscross through the city. Under these bridges are blocks filled with restaurants and parks. When you use Google maps to navigate almost anywhere in or around Richmond, you’ll find yourself driving on several highways for less than 1 minute each.

Richmond is easy living. It’s urban enough that there are big name shows yet it is quiet enough that you can often hear birds singing. Without many tall buildings, Richmond feels more like a large town than a big city. I suppose “big city” is relative. I like having a 6th floor apartment that feels like a penthouse because a 6-story building is tall in my neighborhood.

From my mini balcony I have a lovely view of the sunset. From my apartment windows, I can watch the numerous lightning storms that come from the south-west to dazzle the city. I guess living in a hot and humid place leaves ample opportunity for any cold front to make the air zippy-zappy. I’ve never seen so many lightning storms in such a short period as I have living here.

After about 3 months in Richmond, I’ve found my favorite ice cream place and some go-to walking routes. There’s still a lot left to explore and learn about the city, but it already feels like home. It doesn’t usually take me long to settle in a place, but Richmond was an especially easy transition.

This Is How I Started Residency

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Starting residency was like a flash flood. Beginning from the first day, I was overtaken with more work than I knew what to do with. As a new doctor in a new healthcare system, I found myself equally challenged by creating care plans for my patients (like deciding which medications to prescribe them) and implementing the plans my supervising doctors and I devised (like ordering medications in the computer system). I completed tasks more slowly than I imagined possible. My patients were well cared for because I was part of a team, but my work hours lengthened in a way that the saying “burn the candle on both ends” was created to describe.

All of us headed to residency (regardless of specialty) are warned that it will be challenging. Each person experiences different challenges and different low points. Residency is hard for everyone because the hours are long and there’s a lot to learn. So, when my work hours exploded like water through a broken dam, I wasn’t surprised. I was surprised by how my program responded.

As my hours lengthened to a point where I was exhausted and just barely surviving, my chief residents stepped in to help me develop ways to become more efficient. Senior residents observed me throughout a shift and offered advice on how I could streamline my workflow. People on my team and other teams helped take some tasks off my plate so I could focus on learning the computer system better and on writing patient care notes quicker. I was given a little extra time off to catch up on sleep because I was on track to work far more hours than permitted by the national governing body that oversees US residency programs.

At first the extra help and attention made me feel like a failure. I tried to keep my spirits up because I’ve struggled to overcome big obstacles before; I always learned more from those experiences than I did from experiences where I didn’t struggle. Similarly, past experiences have shown me that it’s okay to accept help. Still, I wondered if I was going to learn enough or as quickly as I should if people helped me more than some of my peers. I wondered if I’d get better at being a doctor.

On my extra time off I reviewed my senior residents’ feedback. I reorganized my view of the electronic health record system to make it easier to access all the information I knew was important. I took time to recharge. When I returned to work, I was still a new doctor. I hadn’t changed much from the days prior. Yet, I found myself checking things off my to-do list without the help I’d required before my recharge day. With a little more sleep behind me, I was able to see how much I’d learned in my previous days of working – something I hadn’t noticed when I was exhausted.

As I reflect on my first two weeks of residency, I don’t look at them fondly. I do think that I’m a tiny bit better at being a doctor now than I was two weeks ago. I appreciate my past self for prioritizing a work culture of support and collaboration when applying to residency. I know that there are many hard days to come before residency is over. However, my experience during these first weeks made me confident that I will be able to overcome future hard patches when they come – not completely alone, instead, with a program supporting me as I find my path forward. Feeling like my residency program genuinely wants to help me become the best physician I can be gives me confidence in the residency training process and makes me excited for who I’ll become by the end of it.

This is how I started residency. The future will tell how I end residency.

The Happy Stillness Between

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I find myself sipping mate and gazing over my desk and plants out at a new skyline. Several days ago, I moved to Richmond, VA from Danbury, CT. The move was a grueling 28-hours of loading the truck, driving overnight, and unloading the truck. My partner and I took only a 30-minute nap to get us through the driving, knowing that there are an infinite number of less tiring ways to move, we wanted it done as quickly as possible. Our main hiccup was finding a way to navigate the ~400 miles along the East Coast on highways that allowed trucks because our U-Haul was quite robust. We learned that there is no setting on Google maps for truck routes. Luckily, we know how to read maps despite the prevalence of technology in our lives and found a route using our brains, yes unusual.

We’re mostly unpacked now, just a few more projects to do before we will be completely settled. We’re chipping away at these tasks, such as hanging paintings and donating no-longer needed items. Knowing our apartment is in a good place, my focus has shifted to the next adventure. Later this week we travel to Paraguay to visit my friends there. It’ll be my partner’s first time to the country where I did the Peace Corps and where my mind always wanders when time slows. Slow as it is now.

Medical school, at least as it is organized at my school, is a sprint that comes to a halt not at graduation but at Match Day, several months before graduation. It’s not a bad system. It leaves time for vacation and residency onboarding tasks while also giving us students a moment to enjoy non-medical pursuits before we plunge into the rigors of residency. But, when one is accustomed to a sprint too fast to breathe, as those of us in medical school are, the slowness of these days between Match Day and residency is as strange as a journey to a new, very different country. I’ve read more books for fun these past few months than I have in years. I’ve hiked and slept and pondered life. I started baking again, something I hadn’t done since I returned to the US from Paraguay in 2016. I’ve planned trips and moved.

I wanted to come to Richmond early, many of my peers won’t move to their residency locations until weeks prior to our start date this summer. I’m a person who centers at home, regardless of how new the home is to me. I like moving, but I also like time to settle before I’m expected to excel in life pursuits. I like time to find the grocery store and walk the neighborhoods that’ll be my stomping ground. Yesterday I did both of those things – I found a grocery store which had nice spinach (the primary way I grade grocery stores) and I strolled through a giant cemetery not far from my house with trees that had new, full leaves and singing birds.

It’s beautiful in Richmond and the politeness of the South is a welcome kindness after living in New England for years. New Englanders don’t, for example, say “hi” when you pass them on the street in a city or let you cross the street without threatening to run you over, even though there’s a red light for oncoming traffic. I’m too new to Richmond to have major complaints, but so far, the things that bothered me in Connecticut aren’t present to the same extent. I do admit, I’m not used to having streets named after important people from the Confederacy. I don’t yet fully understand how those imposing names from the past will impact my life though I know they already do and will in new ways here.

Richmond is green and quiet for a city. My apartment is high up without taller buildings around it. It has ample windows. What this means is that I’m surrounded by sun and have a stunning view of the sky. My few days living in Richmond have taught me that it’s a place of expressive skies – which is something I always loved about Paraguay too. The clouds cross the sky with bright colors and exciting shapes. The morning, afternoon, and evening look different in the clouds and sky of Richmond. My apartment, specifically, has a magnificent view of the sunset.

I lived in Washington, DC for 6 years before I did the Peace Corps. And while Richmond is distinct from DC, coming back to the DC-VA-MD area feels like returning home. I’m happy to be back. I’m happy to have arrived when the weather is absolutely perfect, just before the humidity and heat of the summer set in. I have about a month to explore Richmond before I start work. Richmond feels completely different from Vermont or Connecticut. I’m happy to uncover the opportunities hidden in this new place. Opportunity to learn to be an excellent doctor but, also, opportunities to explore life beyond medicine. I’m excited to reconnect with the urban passions I have and to find new ones that suit me in a green, urban home. And small mountains aren’t too far away in Shenandoah. I’m grateful for the slowness of these days so that I can sit with my happiness. Life has taught me that, much like sorrow, complete happiness is fleeting. So, I’m pleased to have time to revel in this happiness storm until the next emotion rolls in.