Mahogany Pearls: The Residency Chronicles of Keisha B., MD: June 2015

Hey Y'all,

Long time no blog, huh?? Y'all know the deal by now. I've been super busy, as always, so it has been approximately 4 months since my last entry. When I last blogged, I was about to begin my rotation in Hattiesburg, MS at Forrest General Hospital. I was nervous as I always am when I'm starting something new. I was concerned about it because I'm an extremely introverted person and I don't feel I do well in new social situations. To my surprise, it went extremely well. The people I worked with there were so warm, welcoming and friendly. I walked into the building meeting strangers and walked out for the last time with friends. The experience was such a wonderful one. I operated Monday through Thursday doing 4 cases a day on average, sometimes up to 7 or 8. This was another reason I was nervous because I wasn't as confident in my GYN surgical skills as I was with my Obstetrics skills. Most programs are OB heavy in the first years and I had not had a lot of gynecologic surgery experience. I walked into that hospital feeling like a novice and walked out feeling very confident in my skills. The rotation was priceless. However, I don't feel that I was able to enjoy it 100% because I had to drive there and back every day, 182 miles a day. I was getting up before the crack of dawn to get there in time to round on patients and be ready to operate by 7:30. It was taxing on me, my vehicle and my pockets. So, instead of truly enjoying my "time away" I was counting down the days until it was over. In spite of this, I still wouldn't trade the experience for anything. It was something that I really needed.

During my time away, I also started my job search since I will be graduating from residency in 353 days, but who's counting?? Those of you who know me well know how I am about timeliness and doing things early. In this situation, being timely has only added to my anxiety because most of the recruiters I spoke with said that I was too early, as they were still placing 2015 graduates. I've decided to move away when I graduate, as I have ALWAYS been in this city. I've NEVER left; not for college, masters, doctorate or residency. I want my little family to experience the big city life for a little while, so I'm trying to get us to Texas. I've also put my feelers out in Georgia and Tennessee. However, my goal is to get to one of the big cities in Texas (Houston, DFW, Austin). Though most people said I was too early, I did get an interview in Corpus Christi, TX. I went in May and I think it went well. The practice was wonderful, but I also want to see what else is out there before committing to something, as this will be at least a 2 year commitment. Please pray for me and my job hunt because, as always, I'm worried about it. I would like to have a job locked in by December of this year so that I can make plans for moving, getting Jai in school, buying a house, etc.

After those four long months traveling to Hattiesburg, I have come back to my home hospital. Those of us who are away last have to come back a couple of weeks early to cover the outgoing seniors' labor and delivery shifts after they graduate. So I returned as the acting senior on labor and delivery days. Y'all know how much I love obstetrics so I was so excited to get back to my first OB/GYN love: labor and delivery. Returning as the acting senior has meant a big change for me. Instead of actively managing the patients, going from room to room checking people, interacting with the patients and delivering the babies, I'm in more of a supervisory role. I'm chart checking to ensure things are getting done, supervising deliveries and teaching the lower level resident. I'm "in charge" of everything. It's been a big deal for me because, while I'm advancing as the program is designed, I feel a little sad because I'm losing a lot of direct patient care which I enjoy so much. I have to step back and allow the lower level resident to actively manage the patients while I lie low in the background ensuring that everything is being done appropriately. It's a lot like being a parent. Initially you do everything and at some point, when your children grow up, you have to step back, offer guidance and lead by example. I'm working with a really great intern who is fun to work with and eager to learn. So, this past week as acting senior has been a good experience. It's just been different.

Today was my last day as the acting senior. Tomorrow, I become a REAL senior resident. Tomorrow, I will begin the last leg of this residency race. While I have an appropriate level of fear and anxiety about stepping into that role, I also have a lot of excitement and joy. It seems like I just started residency yesterday and now I'm a SENIOR! I can hardly believe it! I feel so blessed and I'm so amazed at how far I have come. Lately, there have been times when I have been operating and I found myself staring at my hands in awe of what they can do now. In those times, I just thank God because it is truly amazing. It's a gift. This year I will have an opportunity to grow. I'll be emerging from my cocoon with my new wings and learning to fly on my own. This year will be preparing me to go out into practice on my own. I pray that I take full advantage of every opportunity I'm given this year to learn, to grow, to teach, to reach higher than I ever have.

I will also go from being the chief resident elect to the actual chief resident, which is also a great responsibility. As with anything, I want to give it all I have and do the very best job I can. I pray to be fair, consistent, hard working and efficient and to lead by example. I hope to make the people who thought I could do this job proud, but most of all I want the job I do to be pleasing to God, as he is the one who truly chose me. I have to remind myself that before I was born he knew me and laid this path out for me. Thus, he is always in control and nothing happens, good or bad, without his approval. So, he has been preparing me for my chief year over the last three years.

I will be starting on nights as the captain of the night float ship. There are only 3 residents, including myself at night and one staff. There is a 2nd year on labor and deliver and a 2nd year in our urgent care who is also first call. So that's only 3 people covering the whole hospital. It's kind of scary to think that I will be in charge, but I know deep down that I have been properly prepared for this. I will be working with a great team of girls, who are very hard working, smart and care about patients. They're pretty awesome to say the least. I pray that I am a good leader and teacher for them in their first months as second year residents. I call us the #1 night team and I hope that we live up to that name. I will do nights for 2 months straight, which also means I'll be away from home every night 6 nights a week, which also stresses me out. Every senior has to do 2 months of nights. I scheduled myself for nights first because my baby girl is out of school for the summer and doing it first means I won't have to be away at night while she's in school. I'll only be on nights the first 2 weeks of school. Last time I was on nights, my mama basically moved in and helped me take care of her. Now that she's moved away, the situation is much more difficult. But I'm praying the plans I've worked out run smoothly.

After the two months of nights, I will do two months as the Chief of the obstetrics service, running labor and deliver with a brand new intern and ensuring the antepartum and postpartum services run smoothly, AND being 3rd call for the hospital. Much to stress about? I think so! The senior you work with on labor and delivery during your intern year truly helps mold you into the obstetrician you're going to be. Many of the things I do now are how my senior did them. Of course, you find your own style, but the people you work with during your lower level years truly help shape you. The first things you learn either come from a book, staff or your upper level. So, again, I must lead by example. I must ensure that I really take time to teach her not only about what we do, but why we do the things we do. Just like last year, I'll be wholly responsible for the lower level resident. Any mistakes they make are my mistakes as well, so there's a lot riding on all of the 4th years' shoulders. On top of all of that, I have my chief resident duties. I'm absolutely not complaining, because I'm thankful for every opportunity. I just have a healthy level of anxiety and fear.

As you can sense, I am very excited about what's to come but I am also praying that it goes by quickly. As people say, the struggle is real. It's not easy being a resident and a single parent. My baby girl has sacrificed so much over the last 7 years (medical school and residency). Many are sacrifices that she doesn't even know she's made. This lifestyle is all she knows. When I started medical school, she had just turned a year old. She became well known to my medical school classmates because I would bring her with me to the classroom wing to study. I would bring her sleep mat and a DVD player and we would stay there for hours studying. Now she's well known by all the residents, attendings, scrub techs and nurses because she's spent a lot of time at the hospital, hanging out in the residents lounge. It's not the average life of an 8 year old (she turned 8 on June 21st!). I can't go on field trips, I miss special events, we don't make half the birthday parties, etc. However, I know that what I'm doing is for us both and I pray that when she is older she will understand that. The last 6 months have been particularly difficult for me, but I have tried to remind myself that I only have one more year and God didn't bring me this far to leave me. Residency has been hard both emotionally and financially, but now the finish line is in my view and I'm running toward it with perseverance.

Thank you all for continuing to follow me on this journey. I appreciate your support more than you know. As always, I ask that you continue to lift Jai and I up in prayer. I put a few pictures of my baby girl throughout our medical school and residency journey. Looking at them brings back great memories makes me smile. I love her so much. :-)

Until next time,

Your favorite MD, Keisha B.

Mahogany Pearl: "When you enter his presence with praise, He enters your circumstances with power."