“Who am I? Who was I? Who am I becoming?”

This is my inaugural blog post!  I’ve accumulated thousands of dollars in school debt to earn the letters after my name, but this exercise is a bit awkward.  I suppose it shows that having a lot of education doesn’t stop us from needing to figure things out as we go.  So why am I writing a blog?  Because over the past year, I’ve had my brain turned inside out.  It’s been turned inside out in a way that I know will help hundreds (thousands?) of people like me.  Since you’re reading this (thank you!), I first and foremost hope it helps you.       

I am a pediatric intensivist and clinical ethicist at an academic medical center in Nashville, TN.  I’m white, cis-gendered, heterosexual, and use her/hers pronouns.  I was raised by two parents and had a generally uneventful middle-class upbringing in the Midwest.  My spouse and I have a tiny gray cat who can be pretty sweet but also caterwauls at all hours of the day and night.  Five years into my first faculty position, I found myself crying multiple times a week: at work, outside of work, when happy, when sad, when frustrated, with others, or by myself.  When with others, I explained that “all of my emotions are connected to my tear ducts.”  Nope. It was generalized anxiety disorder diagnosed by my institution’s employee assistance program.  I had referred myself for evaluation when I was getting burned out.  A prescription for Lexapro and weekly cognitive behavior therapy got me to appropriate moments of tearfulness.  That’s me.  How alike are we so far?  

That’s also who I was in May 2021, but with several differences.  I was 80lbs overweight.  I thought I was handling the pandemic well but was also eating to the point of being uncomfortably full at every meal.  I took full advantage of medicine’s “eat when you can” mentality, frequently helping myself to any number of snacks in between meals.  I drank at least half a bottle of wine every night because “I deserve it,” or it would “Help me sleep.”  I wore my long hours in the ICU as a badge of honor and inwardly beamed with pride when a patient’s parent would look at me in disbelief while asking, “Wait…have you gone home in the past day?!”  No, sir, I have not.  Yes, madam, I am still caring for your critically ill child.  I held some patients and their parents close and completely depersonalized others.  I had sadness and pain all around me, but I realized that I hadn’t cried for a long time.  I found that it wasn’t because I was handling things well.  It was because I was wholly and utterly numb.

I was plugging my way towards the promotion my division head wanted for me, all while feeling (at best) ambivalent about whether I wanted it for myself.  But I was showing up ready to work, teaching learners, checking off academic medicine boxes, and telling myself that this was what work/life balance was.  I said to myself that I would always have intermittent periods of burnout.  My saving grace was that I’d gotten good at seeing them coming so I could ramp up the self-care to avoid the descent into the full-on charred briquette level of burnout I’d recognized in myself before.  I was fine.  And my largest-sized scrubs pulled uncomfortably across my belly and upper legs.  And I was always sore and achy, even when I stretched and was well hydrated.  And I was always tired, even when I’d slept.  And I was wholly and utterly numb, at work and outside of work too.

It turned out that’s not what coping well looked like for me.  Frustrated that I found myself at my all-time highest BMI (and in the obese range by a comfortable margin), I started listening to Dr. Katrina Ubell’s “Weight Loss for Busy Physicians” podcast.  I learned about her journey as a pediatrician and then through weight loss.  So much resonated.  The traits that made me a good student made me a good medicine trainee and eventually a hireable pediatric intensivist.  But those traits also made it so that I could not lose weight, no matter my diet or exercise regimen.   Her podcast showed me how so many of us have come to value our (expensive!) thinking brains over our (free!) wise emotions.  I saw how the din and chatter in my brain had become routine, despite how horrifically uncomfortable it was.  Some number of episodes in, I heard Dr. Ubell suggest that working in medicine didn’t have to be this way (and that it may be vitally important that we change it if my profession is to stop chewing up its providers).  After listening to her podcast for a few months, I joined her Weight Loss for Doctors Only program.  I got in for the weight loss (60lbs and counting!) but am using the skills I learned to improve every single part of my life.  That’s what’s turned my brain inside out.  That’s what I’m going to write about every week.  And I sincerely hope you’ll join me as I keep figuring this out.  Even if I’m only a couple of steps ahead of you, I hope you’ll come along with me on my way.  Because the more of us that get better, the more we can change medicine for the better.  And the more we can create the reality that practicing medicine does not have to be this way.

Take care.