a heavy heart

Pierre Van ZylKicks, physician suicide, postpartum depression

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Warning: this is a sad post involving postpartum depression and physician suicide.I had a friend from medical school come visit this weekend with her husband, which was absolutely wonderful and much needed for all of us. They played with my kids and ch…

Materni-tine

Pierre Van ZylCOVID, Kicks, maternity leave

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It was the best of times and it was the worst of times to have a baby. For starters, I don’t want to be a pregnant healthcare worker in a pandemic again. No thank you.We tried to induce Baby Girl early in November when the COVID was really hitting…

Crunch Time

Pierre Van ZylCOVID, Kicks, Pregnancy, pregnancy timing

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Sitting in my rocking chair taking a few deep breaths.We hadn’t shared it on the blog yet but we are expecting Baby #2 any day now. I can tell you that the pandemic is about 8.5 months along because I took the pregnancy test the week we started shuttin…

Summer Vacation Comes to an End

Pierre Van Zylappreciation, happy family, happy mom, Kicks, motherhood

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It’s my last night of my long awaited summer vacation. Ever since I had Toddler almost 2 years ago I have been looking forward to this summer. I’m so glad that Past Kicks was looking out for Future Kicks and took a shorter maternity leave to get o…

Residency Roast

Pierre Van Zylbecoming a doctor, feeling grateful, Kicks, kids in residency

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Another academic year comes to a close this weekend. Tomorrow a fresh fleet of interns across the country will be starting their first days nervous and tremulous to be finally let loose on the wards. Although most of my classmates have walked out of th…

Residency Roast

Pierre Van Zylbecoming a doctor, feeling grateful, Kicks, kids in residency

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Another academic year comes to a close this weekend. Tomorrow a fresh fleet of interns across the country will be starting their first days nervous and tremulous to be finally let loose on the wards. Although most of my classmates have walked out of th…

Residency Roast

Pierre Van Zylbecoming a doctor, feeling grateful, Kicks, kids in residency

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Another academic year comes to a close this weekend. Tomorrow a fresh fleet of interns across the country will be starting their first days nervous and tremulous to be finally let loose on the wards. Although most of my classmates have walked out of the clinic for the last time, I and a number of my classmates have “mom time” to make up for maternity leave (which feels a little like a punishment for having a baby during residency, despite only taking a 5 week maternity leave….but I digress) so I’ll be around a few more weeks.

Our residency celebrates the end of each year with a large banquet to celebrate the new arrivals and to honor the graduating residents with awards, nice words, and roasts. The outgoing residents get roasted by the program director first, followed by another roast by the incoming chief residents. The outgoing chiefs roast the faculty, and everyone has a good laugh along with some good food and drinks.
As a graduate, I was able to bring a whole table full of family to the banquet this year. During cocktail hour I was able to show off Toddler as we mingled with my friends and coworkers and faculty and guests. I was honored to be able to receive an award as well as present a teaching award and was glad those close to me were able to make it. 
I awaited the roasts with some trepidation. I felt I had a lot of potential – I’m a messy eater, a loud talker, a clumsy walker. My PD went first. When it was my turn, he poked fun at my small town (as he is originally from a neighboring small town to my own), my instant apologies whenever something even mildly inappropriate escaped my filter, and my overall “church lady” nature (I used to play church piano and work at a Catholic hospital so it was fitting). He did mention how pragmatic I was, to the point I would send my child away when I was on weeks of night float to my small town (my mom and sister cheered at this point seeing as that was who Toddler spent the most time with on those nights). 
I instantly had a bit of a flashback and felt a familiar feeling in the pit of my stomach. I hated those weeks so much. I remember the first week of night float I had as a parent. I stressed Husband out so much trying to get us to cross paths for those 15 minutes before he had to leave for work and I was coming home and vice versa and losing sleep trying to spend minutes with my Baby. It was awful. It was nerve wracking and left me in tears. The next week I sent Baby to my parents. It was such a good logical solution. My Baby would get to spend time with his grandparents who lived out of town, and they coordinated things so my in-laws could see Baby too. My husband was less stressed trying to hurry home as fast as possible to I could see Baby for five minutes before heading to work. And I got to sleep. It worked so well we did it for pretty much every week I had of night float. 
Logic didn’t stop the deep pit I would feel in my stomach as I handed off Baby each of those weeks. It felt like an essential part of me was getting ripped from my gut every time. I would do those hand offs and head off to the hospital to spend overnights alone isolated in my call room or being crushed by the pager. It was absolutely awful. 
And even in the banquet hall, surrounded by those I love most and my co residents and members of my residency who I will miss dearly, surrounded by all the warm fuzzies from sharing memories and laughter together, I felt a remnant of that aching pain in the pit of my stomach. As I looked around the room and thought about all that I would miss about my program, I knew what I would be the happiest to leave behind.
I snuck into Toddler’s room that night when he was fast asleep. I watched him sleep with his face shoved against his crib mattress and his diapered butt up in the air. I thought about how grateful I am for my upcoming attending  job – outpatient with low volume OB call – and thought about all the weekends and nights we would be able to spend together from here on out. I am so happy for the bonds he has formed with his grandparents and extended families from those weeks away, but am even happier that those weeks have finally come to an end.
With love,
Kicks 

Saturday AM coffee

Pierre Van Zylappreciation, coffee, joining the real world, Kicks, kids in residency

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The golden weekend begins

I wake up at 7:30 before my alarm. Approx 10 seconds of quiet uninterrupted bliss ensues when I realize I’m the only one awake. I can’t wait to make Saturday morning coffee. Then Dog demands to go outside.

While dog is outside, I read the last few page stories of the mystery I’ve been working on. Toddler fusses. I think “only ten pages to go” and Toddler falls miraculously back asleep and I finish my book.

Toddler fusses again. No coffee yet. Upstairs I find Toddler covered in poo including pieces in hair and hands. Apparently letting him eat that much pizza last night was a mistake. Toddler is protesting in the tub but much much cleaner 5 minutes later. I peek out in the hall for backup, turns out Husband heard the commotion and closed the bedroom door for a little longer sleep in. Hmph.

Toddler is dried out of bath. I sit him downstairs with yogurt and all is forgiven instantly. He smears his yogurt-covered hands through his recently bathed hair as I rinse the poo off of sheets, his pajamas, my pajamas and throw in the wash. Coffeemaker is finally started. I sit down with my own yogurt, which Toddler immediately realizes is different from his own and demands some. We share a little more yogurt.

Toddler gets spot cleaned, and I finally pour my cup of coffee.

It’s a beautiful day. Toddler loves being outside. Dog, coats, boots are collected and I spill a little of my precious “mom juice” on the floor. (“Mom juice” is my explanation to Toddler for coffee, wine, diet Mountain Dew, etc.). Clean floor. I go out thinking I might sit outside a sip some coffee, watch the commotion and listen to the radio. Coffee is a little colder but still tolerable. Spill some coffee on my old white worn fleece

I drag my chair to the sunny corner of the backyard, before realizing I have nowhere to put my coffee down. Coffee sits on little mud pile.Toddler decides he wants to rock with me on the chair, then by himself.  The ball is thrown to dog. Sip. Throw. Sip. Throw. Toddler gets stuck in his plastic car. Extract Toddler. Sip. Run around yard with Toddler and Dog. Sip slightly warm coffee.

Sneak inside to top off cup with warm coffee and grab Kleenex for Toddler.

Back inside. Laundry gets  done, clothes are packed and bathroom gets cleaned. Toddler finds the Swiffer cloths very interesting.. Now off to our parents for a weekend away.

I think I need another cup of coffee.

I can’t wait until I start my attending primary care clinic job this fall (yay!) and this becomes more of a typical than atypical Saturday (minus the poo).

Kicks

Saturday AM coffee

Pierre Van Zylappreciation, coffee, joining the real world, Kicks, kids in residency

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The golden weekend beginsI wake up at 7:30 before my alarm. Approx 10 seconds of quiet uninterrupted bliss ensues when I realize I’m the only one awake. I can’t wait to make Saturday morning coffee. Then Dog demands to go outside.While dog is outside, …

Second chances

Pierre Van Zyldelivery, doctor patient relationship, family medicine, Kicks

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Let me tell you about my biggest regret in all of residency.I was a second year resident at the time. One of my clinic patients showed up in labor, but I was stuck working a 24 hour shift at a hospital shift on the other side of town. I was sad because…

Guilt and Determination

Pierre Van ZylKicks

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Quote of the week:

“Guilt is useless. Determination is important”.

One of my department faculty members is leading a day long seminar of Community Health.

She adds “If you really need guilt, keep it like a cat at home. Pet it every once in awhile, let it know you know it’s there – but when you leave the house, take determination with you.”

I love it. Even before Toddler came into the world, I told myself I would NOT be a guilty mom. I would logically know I was doing the best I could, logically know that I could not be in three places at once. I was going logic myself right out of guilt. Because we all know logic always wins.

I’ve been trying to be mindful when spending time with Toddler – no phones, no distracting screens, just him and me together. It makes me think of this post from Mrs Md PhD which is best characterized by the meme saying I WILL DO ALL THE THINGS WITH MY TODDLER!! (which is definitely due for a revisit if you haven’t seen it in awhile).

However since Toddler currently has the attention span of a small flea and likes to entertain himself a lot, a little too much mindfulness can send me off the deep end. So we’ll play legos together but a little podcast in the background goes a long way. Now that we’ve had a long awaited golden weekend together with minimal leaving-the-house plans, I was able to put that guilt aside for now.

One of my coresidents was feeling guilty lately about working her first week of nights while leaving her baby at home and I told her “you’re a better mom because you’re a doctor, and a better doctor because you’re a mom”. It took me awhile to realize that I really did mean it (at least about myself) and wasn’t just saying it to make her feel better. I appreciate the time I have at home without Toddler, but I also have a small glimspe now into why the nurses I work with who have 4 kids at home come to their busy shifts and sometimes consider it a “break”.

I also think guilt is ingrained into us in medical school. Guilt we didn’t present our patient perfectly. Guilt we missed that lab finding. I was with a second year medical student today, who kept saying “sorry” for things she couldn’t help – like the computer not loading or not having access to charts. It made me remember sitting with a co medical student on our internal medicine rotation watching her beg for an afternoon off for an appointment and constantly apologizing for having to leave. I’ve managed to cut out “I’m sorry” out of my vocabulary if it’s something I can’t help (unless expressing empathy for a patient). My feedback to her was to catch herself when she is going to say “I’m sorry”, see if it’s something she could have actually done anything about, and cut it if she can’t.

I’m sure there are still going to be times I feel guilty, especially if we have another day care drop off melt down tomorrow, but I’m going to do my best to pat Guilt on the head and leave with determination in hand.

Kicks

Guilt and Determination

Pierre Van ZylKicks

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Quote of the week:“Guilt is useless. Determination is importantâ€�.One of my department faculty members is leading a day long seminar of Community Health.She adds “If you really need guilt, keep it like a cat at home. Pet it every once in awhile, l…

Guilt and Determination

Pierre Van ZylKicks

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Quote of the week:“Guilt is useless. Determination is importantâ€�.One of my department faculty members is leading a day long seminar of Community Health.She adds “If you really need guilt, keep it like a cat at home. Pet it every once in awhile, l…

Exceptionality

Pierre Van Zylappreciation, Kicks, residency

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I learned a beautiful new word this week – exceptionalityI am on my community health rotation. One of the best parts of being a resident are the off-service rotations, which means less time at the grindstone of patient care after learning after patient…

Exceptionality

Pierre Van Zylappreciation, Kicks, residency

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I learned a beautiful new word this week – exceptionalityI am on my community health rotation. One of the best parts of being a resident are the off-service rotations, which means less time at the grindstone of patient care after learning after patient…

Interview Season

Pierre Van Zyljob interviews, joining the real world, Kicks

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I hate interviews. I don’t know why I hate them so intensely or get so anxious, but whenever I have a job interview I develop “functional dyspepsia” (or as my mother would call it – a nervous tummy). I’ve started looking for my first real attending job. Someday I’d like to be a residency faculty member, but my university system has zero openings. I got one job interview for a residency faculty at an outside system that met all my criteria – within a couple hours drive from our families, a community that both my husband and I would enjoy living in, and an established residency with good mentoring support. It was a long interview day – beginning at 7:30 in the morning and dinner going past 8 pm that night – and I admittedly wasn’t my best self. It was my sixth week of a stretch with only 6 days off total (2 of which were used for Baby’s first birthday with our family back home), so I was tired. I underestimated how difficult it would be to schedule interviews around a resident’s schedule, and I would have preferred a later date to have recuperated a bit, but this was the only date that lined up for both me and the program.

 I felt like I connected well with the current faculty and really felt like it was a good fit, except for one disappointing part over lunch. I was asked to give a lecture so they could evaluate my teaching style, and I was ready with flashy PowerPoint in hand with a topic I had done research on so I could actually answer a question or two. However, about 15 minutes into the lecture, I realized I was getting warm and lightheaded. The walls started closing in. I realized I was standing locking my legs in a warm suit jacket and hadn’t had much to drink for water. I started talking faster, thinking I could just get through it and no one would notice, but then one of the faculty members stood up and got me a glass of water and I noticed a bead of sweat dripping down my nose, so I finally quit faking it, apologized to the audience, and led the rest of the lecture and discussion from a seat in front of the podium. I was so embarrassed. I have had similar presyncopal vasovagal-y episodes before, but this was the first in front of a large group of people. Hopefully, I’ll get points for finishing regardless of my obvious physiologic distress…

The rest of the day went well but I still won’t hear from them for at least a month. The more I go to other interviews, the more unappealing pumping out RVUs day after day seems to be. I’ve had to stop myself numerous times from emailing the program director “Pick me! I think your program is exactly what I’ve been looking for! We want to live in your town FOREVER!”. But that probably looks bad so I haven’t.  😝 It’s my first choice for a job. I think I’m a decent candidate, but if someone swoops in with experience and/or someone from within their own system is interested, my chances probably aren’t looking too good.

I had another job interview at a community clinic within the past few days. It meets all my non-academic job wish list items except one. I’ve gotten more idealistic rather than less as medical school and residency have gone by, and I was really hoping to work in at least a somewhat underserved community – but this job is in the heart of a beautiful suburb which wasn’t what I was picturing for myself at all. The  more I think about my list of what I want in a job, the more I realize that this is probably a very good fit for me, but  there’s just a small hesitant piece of me that feels like a sell-out. Which is why I’m turning to you all for stories and advice – was there anything you had to sacrifice off your wish list to find a job you were still reasonably happy in?

Interview Season

Pierre Van Zyljob interviews, joining the real world, Kicks

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I hate interviews. I don’t know why I hate them so intensely or get so anxious, but whenever I have a job interview I develop “functional dyspepsiaâ€� (or as my mother would call it – a nervous tummy). I’ve started looking for my first real atten…

“Pumped� in JAMA

Pierre Van Zylbreastfeeding, Kicks, pumping

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I was at our block education the other day when one of my male co residents asked me, “Did you read the JAMA reflection piece from Sept 11?â€� (answer to this is always no, my JAMA sits on my kitchen table where it’s main purpose in life is to be a…

Bipolar

Pierre Van ZylKicks

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There is a patient that has been on my mind this year.I was fired as her doctor.I have had two patients fire me. The first was a sweet little old lady with mild cognitive impairment that wasn’t too cognitively impaired to realize I was moving in on h…

Ode to my couch

Pierre Van ZylKicks

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Sometimes I think the most definitive memories I will have from this time period will come from my couch.This is not my couch’s first life. It is secondhand from one of my aunts. We bought a house (our first house) after medical school and didn’t h…

Pink eye

Pierre Van ZylKicks, sick kids

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Sick days are hard.I’m on a tough couple of rotations coming up – I have 2 weeks of 24 hour shifts of my own, a week of nights, and another 2 weeks of 24 hour shifts I picked up for another resident’s maternity leave, not to mention some 12 hour shifts…

To OB or not to OB…that is the question

Pierre Van Zylcareer, joining the real world, Kicks, on call

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Career advice wantedI’m having a mid-residency crisis. I’m halfway into my three year family medicine residency, which means in a year and half there will be much more independence but also much less of a safety net below me.   I want to pract…