Sowing Seeds

Hey Y'all,

I'm coming to you live from my Elective month; a much needed vacation from my 4 month stint on Obstetrics! You all know how much I love obstetrics, but 4 straight months of sick pregnant ladies whose care requires every brain cell you have can really wear you out. The elective month is new this year. It was put in place for 3rd year residents so that we may go on away rotations if we desire fellowship. For those of us who do not plan to pursue fellowship, we are able to choose something "education enhancing." I chose to do a clinic/research month. I help in our busiest clinics and have a day and a half to devote to my research. Research is not my forte. Thus, I knew I would have to force myself to get it done, as it is a requirement. This has been a great month so far. I get to be a "real mom" and take my child to school and pick her up each day. I don't have to take short call which is a blessing in itself. AND I have my week of vacation this month. I could feel myself wearing thin in those last few days of September, but I already feel renewed and ready to take on my very last month of OB for the year in November.

This month has also allowed me time to reflect on my first 3 months as an upper level resident. I set goals for myself as a new teacher, and while I didn't achieve them all, I did my best to do so. The greatest challenge is ensuring you sow the right seeds. I remember when I was in the 9th grade and my APAC English teacher, who is very dear to me, had a conversation with me that I will never forget. I was 14 years old and had just returned from being suspended for nine days (almost expelled), for being involved in a street fight after a football game. (Yes, me! Pick your jaw up off of the floor! LOL). I was getting into all kinds of devilment at that time, which was not reflective of the home I was raised in. I was giving my grandmother, who I love dearly, the hell that most teenagers probably give their parents. (I'm glad she lived to see me grow out of it and show her appreciation for what she did for me.) Anyway, Mrs. Leeann Bryan saw something in me. That day, I was helping her hang something in the hall and she looked and me and said, "Keisha, you are so much better than that. You're a smart girl and I know you know better. You have to stop hanging with people who influence you to do things that you shouldn't because you have a bright future ahead of you." That day, she sowed a seed. I have never forgotten it. She believed that I could be anything I desired to be so, I also believed it. Though that seed was sown at home long ago, sometimes, in those critical years, it also takes an outside influence to push you. I went on to babysit for the Bryan family through college. She continued to be one of my greatest supporters, even paying for me to pledge and allowed me to work it off; well, some of it. The rest, she gifted me as a Christmas gift. Mrs. Bryan is a great woman and I'm thankful for her presence in my life. She's also a firecracker. Anyone who was in her class knows exactly what I mean!

I think being an upper level resident (and a parent) requires sowing seeds. It requires the right balance of encouragement, autonomy, assistance, education and direct (sometimes blunt) constructive criticism. While I haven't quite found that balance, I continue to strive for it. I still feel like I have so much left to learn. How can I teach someone when I'm still in the learning process myself. That's the challenge. I'm also an introvert, so I don't talk very much. When I do, it can be like razor blades being spewed. As I said before, I begin each rotation telling those who haven't worked with me that I'm direct. I mean what I say and say what I mean. Anything I have to say about you will be said to your face. While I continue to get better control of my mouth, sometimes it still comes off as harsh, but I do it out of love. It's just who I am. If I changed that, I wouldn't be me. It is my hope that after I've graduated, those that I had the opportunity to work with and teach will be able to look at their experience with me in a positive light and be able to say that they learned something from me. I also strive to make the most out of this experience because if something is going to keep my from spending time with my daughter, I must make it worth it. Her sacrifice, and the sacrifice of my family in general, cannot be in vain.

Speaking of my little boo, school is going really well this year. She comes home everyday excited about what she has learned and accomplished. She continues to be an inquisitive, outgoing chatterbox (very much unlike me) with a heart for people. I'm glad that she's not an introvert like her mama. I think I miss out on a lot of opportunities because of that. I'm going to need her to control her mouth a little more in class, but I think most of our children have that problem. She is such a sweet girl though, and she LOVES her mama. That, I know for sure. Whenever I come home from a weekend call, she asks "How was your 24?" (as in 24 hour call) "Did you cut out any babies?," "Were they cute," and "Did you get to sleep?" She's always concerned about how much sleep I get. My child has become quite used to residency and is very understanding when it comes to my schedule. She is sacrificing much more than I think she even realizes, but she handles it all with a grace quite unexpected of a 7 year old. I think the fact that I've had to take her to work with me quite frequently helps her understand and appreciate what I do. She also loves the cafeteria food and the residents lounge, which is a plus if you're forced to be stuck at the hospital while your mom works. She has even converted one of my mailboxes to hers. She's very well known and well loved in the Women's hospital. I hope that she will have great memories of the experience.

Being a mom and a resident is not the easiest of combinations, but I'm thankful to God that He continues to be everpresent in our lives and our situation. There's no way I could do it without the support of the Lord, my family and my friends. When I think back on all of the times I thought I wasn't going to make it, I realize that He's always had my back and put a peak in front of every valley and sent angels in the form of family and friends to lift me up in my times of need. For that, I will forever be grateful. This is yet another reason why I must make the most of this experience and do all that He would have me to do. I must pay it forward for every blessing I have received and every seed that was sewn in my life. I will never be able to thank every one who has helped me along the way, but I can live my life and give back in a way that will make them and God proud. This is my ultimate goal.


Until Next Time...

Your Favorite MD,

Keisha B.


Mahogany Pearl: “Don't judge each day by the harvest you reap but by the seeds that you plant.” Robert Louis Stevenson

Just a few pictures of my baby girl :-)

White Coats and Clown Suits

Hey Y'all,

Can you believe it hasn't been 3 months since you've heard from me?! LOL. I'm trying to do better about my blogging this year. Last time I blogged I was writing about starting my 3rd year of residency, what that means for me and my fears about it. I've now completed my first month and am halfway through my second. I'm surviving! It's much more difficult that I ever anticipated. The transition from a lower level resident to an upper level resident is just as hard as the transition from medical student to intern. It's a whole new set of responsibilities and challenges. I suck pretty badly at it. It's so hard for me to supervise because I'm a doer. It's in my blood. So, it was extremely difficult for me to sit and watch the intern that I worked with as she found her way. It was even more difficult for me to let go of the control and the need to just get it done and allow her to learn. But it ended up being a really good month. It's really nice to watch someone grow and gain confidence. It was a privilege for me to be a part of that. (She's great, by the way)

This month, I am the OB-III. I'm in charge of the antepartum/postpartum service, I go to clinic 2.5 days a week and run labor and delivery while the 4th year is out on Wednesday mornings. There are 3 interns rounding with me in the mornings. I gave the interns a 3 page list of expectations because I wanted everything to be clear and have the month go smoothly. They probably think I'm insane! They have actually been doing a great job and have met and even exceeded all of my expectations. It is a very hectic service and, at times, quite nerve wracking.  I have to try to know all there is to know about the patient's, particularly the antepartums and manage them in conjunction with the MFM Fellows and MFM Staff (MFM = Maternal Fetal Medicine AKA High Risk OB doctors). Our patients aren't "normal." They're the sickest of the sick; lupus with end stage renal disease and hypertension with concomitant TTP, kind of sick. It's the stuff a lot of people only read about. It's basically an internal medicine service for pregnant people. Most of the time I feel as though I'm falling short, like my best isn't good enough because I never feel like I know enough.  I always tell the interns (and my child) that your best is all anyone can ask of you. So, as long as you've done your best, you've done enough. It's always harder to take your own sayings to heart though.

Another thing I've noticed about my new thirdyearness (yeah, I made up a word), is that I second guess myself in the OR a lot. Now that I'm standing on the other side of that table, I see things a little differently. Last year, I would have said that I was very confident in my surgical skills and thought them appropriate for my level. I was always excited to operate. Never cocky, but confident. Now, I try to avoid it like the plague. It always seems to find me though. There are at least 2 nightmare c-sections waiting for me on the suite every Wednesday morning and I have yet to do one that staff hasn't had to scrub into. That, in itself, is enough to lower your self esteem several notches. I mean, it's a c-section for God's sake! I've done A LOT of them. Heck, I felt like I could have done one with my eyes closed, but every one I've done this year has been a catastrophe, leaving me apologizing for my inadequacy and wanting to get as far away from the OR as possible! I'm pretty sure I've been talked about. That's how bad it is. I've been looking for Keisha, the girl with the quiet confidence. It seems that she left the minute I found myself on the other side of that table. You would think I was an intern again. I know that this, like any other change in life, will take some time for me to get used to. I'm already over this feeling though. I can tell you that. I keep telling myself it will get better. I'm waiting for it.

This year has also come with some new stressors. I blogged about my mom getting a new job. She moved a few weeks ago and she is very happy! I'm so happy for her because she deserves it! However, I've been quite stressed about many things from worrying about her being out there without family to child care issues to other, more personal things. Stress always lowers my tolerance for BS, decreasing my frontal lobe function. It doesn't take much to trigger the no BS side of me, who one of my former co-residents and friends has affectionately named. I'm keeping that one to myself though! I'm a no non-sense kind of person at baseline, but I think stress just lowers my breaking point. I have found myself having word vomit and calling people out on things a lot more than I have in a very long time. I usually keep to myself and try to fly below the radar. I socialize in the lounge, but I'm mostly very private and quiet. Lately, I've had to fight the urge to pull out my clown suit on people. What is a clown suit, you ask? It's a term I learned from my Granny and it's well known in my family. We all have one. You put it on when someone has done something to you or something has happened that really has you fired up and ready to "clown." My granny's trigger was her family. Nobody messed with us. If they did, they got to see the clown suit in full effect. I've only worn mine once in the last 2 years, but I have been on the verge of pulling it out of storage several times. More so in the last few months than every before. I think it has a lot to do with my stress level. Some people also know how to push you to the limit.

It's always the same things that set me off though: messing with my baby girl or my family in general,  saying negative things about me behind my back, talking down to me, questioning my patient care skills, etc. My biggest problem is that I have trouble holding it with anybody, not just people on my level. I just don't take being spoken to any kind of way lightly and it takes everything in my being to keep myself together. The "clown suit" doesn't care who gets it, if you get my drift. An incident actually occurred quite recently and I could feel myself getting more and more pissed off. I had to keep thinking to myself, "more white coat, less clown suit." Questioning how I care for patients or insinuating that I'm lazy doesn't go over very well for me. I could feel "It may be in your best interest to know the whole story before you comment" coming out of my mouth, but I swallowed it. I think that's progress. I'm also either really quiet and sweet or the absolute opposite. So, as my boyfriend likes to point out, there is no in between. It's all or nothing.

I know that my mouth has the potential to get me in quite a bit of trouble. Someone who I respect a great deal told me that my mouth will likely be the thing that keeps me from getting some of the things that I've wanted. I said, "why? Because I tell people how I feel?" and she replied, "Exactly." She told me that I have to find a balance and learn to say only what must be said. I just have to find the right balance. I still need to be me, just a more filtered version. I don't want to be "that girl with the attitude," because there's so much more to me than that. I'm a nice person who loves God, her family and friends hard; a girl who cares for people and wants to do what's best for my patients. I believe in being fair and treating people like I want to be treated. That's what I want people to think when they think of me. On the other hand, being direct and unfiltered is also who I am. I know that I'll be a little better once I'm a little less weighed down. I'm supposed to be Meditating with Deepak and Oprah, but I'm a little behind on my lessons! Just pray for me in the meantime!

In other news, Jai's first day of school was today! I didn't get to drop her off because of work, but when I picked her up, it hit me that my baby isn't a baby anymore! She got so tall over the summer and has really become a big girl. She's not a baby anymore and she doesn't hesitate to remind me of that. She still has the dimples over her knuckles though. That's all I have left of her "baby" years. She's growing up so beautifully and it's my privilege, honor and a joy to be a part of it. God truly blessed me when he gave me that little girl. I love her so much!

As always, I thank you all for walking this road with me. For your fervent prayers and constant encouragement. It still means the world to me! Until next time...


Your Favorite MD,  Keisha B.

Mahogany Pearl: "Remember not only to say the right thing in the right place, but far more difficult still, to leave unsaid the wrong thing at the tempting moment."  - Benjamin Franklin

Growing Pains

Hey Y'all,

I'm blogging live from 3rd year! Can you believe it? I still can't. It feels like I just started residency and here I am half way through. Ain't God good?!? There were many times when I thought I wasn't going to make it or felt like I just wasn't cut out for this but, again, here I am. I'm very grateful.

Last time I blogged, I was telling you all that I was going to spend a month in the SICU and how terrified I was. Clearly, I made it through it but I was scared the whole time. We had some really sick patient's and many times I felt incompetent. I made it through just trying to be confident in what I knew and asking for help when I didn't know. I also worked with a really great team of residents and a wonderful fellow who is probably one of the smartest people I've ever met. Believe it or not, I also managed to have a little fun. What I do know for sure is that I'm not cut out for critical care. I took a lot of those patient's and their situations home with me and I still think about them now. I had no idea how many young people we lose to traumatic brain injuries secondary to car accidents until I worked in the unit. Watching a parent weep over their dead or dying child is something you never forget. I'll just stick to OB/Gyn. I am still grateful for the opportunity to have had that experience, but one round is good enough for me.

I intended to blog on the night prior to the start of my 3rd year, but I was on nights and was kind of busy. I'm sure you already know what I am about to say... I was TERRIFIED and very worried. 3rd year brings a great deal of responsibility. Now, I'm not only responsible for myself and my patients, but I'm also responsible for the incoming residents AKA the interns. I'm responsible for teaching, guiding and catching mistakes. Any mistakes that are made fall on me, because I'm the upper level. So, I'm sure you can imagine the amount of stress that is involved. The first week, in my opinion, didn't go so well. It's probably because I'm a perfectionist and I don't like to make mistakes. To me, if there are mistakes made, I'm not doing a good job. So, that's how I felt after the completion of last week. This new role is also a test of your patience. I'm extremely impatient. Having to sit and let the interns learn their way and figure things out is difficult for me, just as it is with me and parenting. I'm a doer, so I'd rather just do it myself. However, it is impossible for them to learn if I do everything for them and instead of helping them, it cripples them. That's one thing I'm trying to work on. Her performance is a reflection of me and how well I've done teaching and being a good example. I also would like for her to look back on this time with me and be able to say that she enjoyed it and learned a lot. It's a great responsibility and I just want to do a good job. We have a good batch of interns this year and they are actually doing a very good job, but I'm sure they feel like they aren't, just as I do. We're all feeling the growing pains.

I had to make it a point to sit down with the primary first year that I'm working with and explain my personality to her. Those who know me well, know that for the most part I'm very serious (with occasional dry humor) and an introvert. I don't play a lot and I don't talk a lot.  I like for things to be done well and done expeditiously. I can also come off as abrasive because I say what I feel whether people like it or not and I mean what I say (which is probably why I have so few friends! LOL). I've tamed my frontal lobe quite a bit since entering residency and I don't say EVERYTHING that is on my mind anymore, but I don't do fake very well. If there is a problem, I'm going to tell you and I want you to do the same. I'm just very straightforward. This is difficult for some people, and probably why I'm sort of a loner and don't really fit in. So, I wanted her to understand that I'm not trying to be mean nor am I a B-word. I'm just very direct, and rather than talking about you behind your back and telling others what you're doing wrong or how you can improve, I'd rather just tell you. That's something I noticed when I started the program and swore I'd never do. There was a lot of talk about people when they weren't around; things that no one ever said to them. But how do you expect someone to improve if you tell others what they're doing instead of telling them. Yes, it's very difficult not to say ANYTHING behind anyone's back and unrealistic to think that it's possible. My point is that if there is an issue, you should just bring it to that person. And PLEASE don't smile in my face and talk about me behind my back. I HATE THAT. It's one of my pet peeves. I guess that's how things go when you're dealing with a female majority. It's kind of like being in a sorority.

In other news, my mama has gotten a new job... in ARIZONA *insert tears here*. I haven't dealt with it very well. I can't even really talk about it. She will be moving the last weekend in July and it has taken everything I have just to hold myself together. My mom has been my rock through residency (heck, throughout my life!) and this transition is going to be difficult, not only for me, but also for Jai. Her help has been invaluable. There aren't enough words in all of the languages combined that could express my gratitude for all that she's done. She has been waiting a very long time for this breakthrough, so I can't think about myself at this point. She deserves this opportunity and I thank God for giving it to her. Now, I have to figure out how I'm going to get through the next 2 years without her help. I'm looking for a nanny/sitter and trying to figure everything out. I don't even have to say how stressful it is, because I'm sure it can be assumed. I know God always makes a way, but it's difficult not to worry when you don't know how things are going to play out. I don't have a normal life. I'm in residency, working crazy hours with a 7 year old. I just want to get through it and keep my sanity. Going back to the paragraph above, the fact that I am an introvert also means that I keep everything to myself (which is why the fact that I even write this blog is so interesting). I don't let people into my life, so I just deal with things on my on. In doing that, my fuse gets a little short and my tolerance for BS gets even lower. So, please think of me and my little one in your prayers as our journey takes yet another turn. Also, please pray for my mom as she embarks on this new chapter in her life. I worry so much because 1) I'm a worrier at baseline and 2) She's going to be out there alone with family hundreds of miles away.

My life is definitely going through some growing pains and they hurt like hell (excuse my language). But, I know that growth is good and I will be able to look back on this time and allow it to remind me of where I've been and where I have the capability to go. When I look back on my life prior to med school when I was trying to get in and even during med school when I thought I wasn't going to make it out, I'm reminded of God's goodness. I'm reminded of the fact that He is the one who chose this path for me and He will be the one to carry me through the dark times, just as He has before. When I feel like I'm not doing a good job, or that I can't see the light at the end of the tunnel, He always finds a way to speak to my heart. For example, I was rounding with one of our Maternal Fetal Medicine staff last this past week and she said, out of the blue, "Your patient's LOVE you! Do you hear me?? LOVE you! They're always ranting and raving about you. Dr. Bell, this and Dr. Bell, that." She then referenced one patient in particular and talked about how she won't even take their expert advice without speaking to me first. This conversation came at a time when I wasn't feeling so wonderful. It was something I needed to hear and I'm thankful for the reassurance.

Growth is a part of life. It's impossible to get to new phases in life without it. This is a big spurt for me, though. I can't wait to see where it takes me... Thanks, again, for following my journey. Your support is greatly appreciated!

Love, Your Favorite MD,

Keisha B.


Mahogony Pearl: "When you come to the end of all the light you know, and it's time to step into the darkness of the unknown, faith is knowing that one of two things shall happen: Either you will be given something solid to stand on or you will be taught to fly." - Edward Teller

Mommy and Me

Mommy and Me

Guess who's 7!

My sweet baby girl and me on her 7th birthday!

Wait.... Is He Pregnant?

Hey Y'all ,

I've got to be the worst blogger known to man kind. I can't seem to keep up with this thing to save my life! I keep saying I'm going to do better, but life continues to get in the way. Thank you so much for continuing to follow me on my journey in spite of this! Of course, a great deal has happened since I last blogged in December. One of the most exciting things is that I wrote a blog that has been published on two medical blogging sites (http://thephysiciansblog.net/2014/04/03/the-p-word-how-to-talk-to-your-daughter-about-her-period/). I am very excited about those opportunities and pray that there are more to come. One of my life's dreams has been to become Oprah's official OB/Gyn guru/correspondent. Maybe that's the first step! LOL.

I'm currently completing my very last day on labor and delivery as a lower level resident. Today is my last day and I am truly sad about it. Labor and delivery is my most favorite rotation. How many people can say they have the opportunity to welcome new life into the world on a daily basis. It's such a wonderful blessing to hold those little bundles of joy even before their mama's do, call them by name and tell them Happy Birthday! One of my attendings once said that I am a laborist, and I think she is right. I like gynecology, but I LOVE obstetrics. I also have had the opportunity to work with the awesome night nurses who are some of the best nurses I've ever met. They know they're stuff and are willing to impart that knowledge on me. I always feel as though we're a team, working together to take care of the patient to the best of our ability. They're also hilarious and so much fun to be around. I can't believe that when I sign out my board tomorrow morning I won't be returning to labor and delivery again until I am a senior. That's a whole year and a half. I do get the opportunity to cover the suite a half day on Wednesdays for 2 months while I'm on a certain rotation next year, but that's not nearly enough. I'm really going to miss catching those babies and caring for their moms.

After I sign out my patients tomorrow morning, I am going to walk over to the SICU and start a rotation there (yay for the 80 hour work-week/28hr day maximum). As a second year, we are required to do one month in the ICU. To say that I am petrified is an understatement. Please pray for me, because right now I feel like I'm just gonna look like an incompetent fool because this is so out of my element. I've done nothing but OB/Gyn for almost 2 years and now I have to go take care of broad medical issues and I haven't taken care of a man since last June when I was in the ER. If he doesn't have a uterus, I can't help him (hence the blog title)!  I have also NEVER been responsible for a critically ill person who is requiring ICU level care. If we have a patient who is sick enough for ICU care, they are transferred to the ICU. I don't do critically ill.... but I guess I do now. Nothing about taking care of a person on a ventilator and potentially on the brink of death excites me or makes me feel all warm and fuzzy inside. I know that everything I'm faced with has a purpose and the more I think about this rotation, I feel as if I know what that purpose is. When I started this journey in medical school I knew that medicine was my ministry. My opportunity to serve the Lord through offering healing, comfort and sometimes merely a hand, a hug or a shoulder to cry on when things aren't all good. In the ICU, I may be a part of some hard end of life discussions and/or caring for a patient (and subsequently that patient's family) as they embark upon a long and hard recovery. While the former of these will definitely be hard for me, I think it's an opportunity for me to use what God has given me to help somebody else. Not just the book stuff, but the things that make me personable and allow me to relate to patients. I think that's a large part of my gift. I definitely don't think I'm the smartest person in the world, but I do know that I am compassionate and I have a heart for people. I'm praying that this is what is going to get me through this rotation. As of right now, I'm dreading it because it's uncharted territory for me. But that's the same way I felt about oncology and I absolutely loved it. I'm an oncology stalker to this day. I always ask about the chemo patients and go see my favorite patients when they're admitted to the hospital even though I'm not on that service. I'm hoping that I'll feel the same way after my time in the ICU.

Please continue to keep me in your prayers as I continue to navigate this residency. I am going to try my best to do better with this blog, but please continue to bear with me. Until next time...


Your Favorite MD,

Keisha B.

Mahogany Pearl: "Man is never so tall as when he kneels before God- never so great as when he humbles himself before God. And the man who kneels to God can stand up to anything." - Louis H. Evans


P.S. - Look at how big my baby is getting!