One thing I’ve mastered during residency is the timing of vacation and making the most of those few days of freedom. Four months without vacation is far too long, one month intervals is too soon, but a vacation every 2.5 months comes out to be just right. I’m at the point of yearning for some much-deserved time off, which I plan to spend soaking up sun to boost my Vitamin D and eating/shopping/partying in one of my favorite cities. My key to surviving residency incorporates a balance of combining work, relaxation, and fun, because the former can easily dominate over time, resulting in high anxiety, struggles to get up in the morning, a shorter temper, less sleep, and less people wanting to be around me.
mental health
I have a simple theory that I like to follow when it comes to psychotropic meds: “Simple is Better.” Pretty straight-forward.
When I inherit a new patient with a list of meds the length of the Declaration of Independence AND they’re still depressed despite all the designer brand name drugs at their disposal, I don’t think it takes a medical degree to figure out that something’s not right.
Question 1: Question the diagnosis. Question 2: They’re still depressed—what the heck am I supposed to do about it?
Whereas most might seek comfort in adding yet another miracle drug to the list, I was inspired by one of my Attendings and made a goal to venture in the opposite direction of the less anxiety-provoking intervention and instead take a medication out (slowly, of course, before withdrawal throws them into a far worse state) and maximize the therapeutic benefit of a truly helpful medication at the same time.
And, the outcome? Well, it’s worked out in many of my patients thus far. Maybe my warmth and reassurance helps as well. Only thing I need now is the research to show it (my next residency venture).
Image via ramoscentral jpg
{driving on I-395 in Miami}
Two things that annoy me on a daily basis: drivers who tailgate and drivers who drive too slow. Being from California, I’ve learned to drive aggressively and posess a constant level of road rage. I never thought a driver who followed traffic laws existed until I moved to Oregon where the average person makes full 3-second stops, drives below the speed limit, and is shockingly courteous towards other drivers. Now that I’ve lived here for over a year, I admit to some appreciation for the overly-cautious driver though I constantly find myself in a tense, angry state every once in awhile. On my way to work today, I noticed my tight grip on the steering wheel and my frequent glares at a speeding car through my rearview mirrow. I felt my neck muscles tense and head start to feel heavy before I realized that I just needed to relax and BREATHE. Take a deep breath…and another deep breath…then switch to the next lane and simply let the driver go. Breathing sounds like a simple solution to high anxiety situations though plenty of people, including myself, have to remind ourselves to do so. I wanted to attach a video demonstrating the diaphragmatic breathing technique, but the videos online have a cheesy 1980’s vibe. I’ll find one eventually, or make my own.
Tip of the day: Next time you go into anxious or angry mode –remember to breathe!
{as a not-so-stylish intern during a 30-hr night on-call}
Rough day today. Sometimes when I get a second to relax at work, I wonder where time has gone. Four years of college, one year of academic research, four years of medical school, four years of residency training — 13 years of life devoted to a career. Thirteen years of life spent accumulating knowledge and learning how to best care for others. Thirteen years of life spent possibly neglecting loved ones, events, activities, experiences, and myself. Balancing priorities in life is necessary, but definitely challenging. Anybody who has mastered the art of balancing priorities receives my respect. I’m slowly getting there…finally, after 11.25 years filled with sleepless nights, feelings of self-defeat, confidence-boosters, and affirmation that sacrifice is worth achieving the ultimate goal. One year and eight months left until freedom.
On the day I graduated and officially became a doctor, I wished that my grandfather could’ve been there to see it. I’ve noticed my tendency to get teary-eyed during therapy sessions, specifically when the issues are related to grief. I’ve told patients to write letters to their loved ones to aid in processing their emotions and work towards resolving issues associated with their loss. Now, if only I could get myself to write that letter…
{Welcome BBQ 2009}
Time flies. One year ago, I packed my bags and moved from my comfortable home in sunny California to a rainy, agricultural town in Oregon for my 2nd year of residency. Though I truly hated the first few months being away from my family and friends (and fabulous shopping malls), I can now willingly admit it was for the best. I work with amazing Psychiatrists, gained friendships that will last a lifetime, and most importantly, I’m learning more about myself. I guess these next two years of residency won’t be nearly as painful as I originally thought.
{Team Building River Raft trip 2009}
{Residency Retreat in Bend, OR}
{Snowshoeing event in Bend, OR}
{End of Year Party at Ankeny Vineyard}
{View from the deck of the Willamette Valley Vineyards}
Being the first full weekend of sunshine in Oregon for months, the last thing I wanted to do was stay home. I admit to constantly whining about Oregon weather, but when the sun comes out, the Oregon landscape offers breathtaking views in comparison to the smoggy skies of southern California. I spent the day with a fellow resident exploring the beautiful wineries in the Willamette Valley and gained a greater appreciation of Northwest viticulture. Impressively, there are about 400 wineries in the Willamette Valley alone, so I’ve barely made a dent on the list. But, at least I know there are places I can escape to just minutes away from the busy I-5 Highway to sit, relax, and enjoy the sunshine.
{yummy Spanish latte at Urth Caffe, Beverly Hills}
1. Wear black.
2. Be around a group of friends who look at least 5 years older than you.
3. Wear professional clothing.
4. Pile on the makeup (especially foundation and smokey eye shadow).
5. Listen to NPR to stay up-to-date with current events talk (and not so much on the latest celebrity gossip & what’s hot on the fashion runways).
For my birthday, I contemplated cutting my hair short, dyeing it black, and wearing a professional black outfit in attempt to look closer to my age. I can say with confidence that I look at least 20 yrs old. For the longest time, I got offended each time someone looked shocked that I was a doctor, every time someone told me I look like I just graduated from high school, each time I was asked if I was a nurse despite wearing my lengthy white coat. In general, I get commented on how young I look almost every other day. On my way to celebrate in Los Angeles this weekend, I was carded at the wine bar in the Portland Airport, then carded the following day at Pizzeria Mozza in West Hollywood. Yet, after my birthday, I had an epiphany. This time around, I wasn’t so bothered…if anything, I fully embraced the fact that I look younger for my age and profession. In fact, if I’m still carded at the age of 40, I’ll consider it a major compliment (and a genetic accomplishment).
Tip of the Day: Embrace who you are. If you change aspects of yourself, do it for your own happiness, and not for the sake of convincing others of the type of person you’re expected to be.
I first tried Mindfulness to help with my attention issues, which I documented here . Yet, Mindfulness can be applied to nearly any aspect of daily life. Here’s a simple exercise you can try:
Do you recall the last time you truly savored a piece of food? And no, I don’t mean devouring a mouth-watering morsel, but instead, actually truly recognizing each component…each ingredient…each texture…each burst of flavor. Now, start by making an M&M (or Skittle if you’re not a huge chocolate fan like me) last in your mouth for about 2 minutes (or as long as you can) and be aware of every single sensation you experience in relation to that one piece of candy. Be aware of its texture. Notice your increase in salivation. Feel how it changes from smooth to slightly bumpy. Place it against the roof of your mouth with your tongue. Sense its temperature change from cool to warm. Recognize details of its flavor – sweet, rich, fruity, slightly bitter, etc. Feel the breaking of its shell as it splits into little pieces. Recall your sweet childhood memories of happily walking through the candy store, carefully selecting each yummy treat, sharing them with friends, or keeping it all to yourself.
Now apply this simple exercise to everyday life. Instead of stressing about the next minute, hour, or upcoming events, savor what you experience in the present time. Be aware of each moment. Focus on one thing. Let go of distractions.
Exercise derived from my residency’s associated Clinical Psychology Professor. Image via flickr.
Happy Mother’s Day!
{Mother’s Day 2009 in Napa, CA}
Ever since I moved away for medical school, my mom has grown accustomed to my busy schedule and fully understands when I can’t make it to family gatherings. In fact, her greater concern is ensuring that I eat an appropriate meal while they enjoy a hearty celebratory meal without me. I’m always aware of my mother’s love no matter where my location may be. Her gift is scheduled to arrive on time, but no gift does justice to what she’s worth (especially on a resident’s salary). I owe my mom a million thank you’s (plus a vacation to Hawaii) when I’m done.