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