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It seems as though many of the year-end posts I’ve seen on social media are glad to see 2012 go, but I can’t say I feel the same way. As much as it has held some dark moments for me, this year was the one which brought me my son and all of the amazing moments that come with him. I am a little sad to see it go, when it comes down to it. Still, time marches on, and now is the point in the year where we all tend to take stock of where we are.

I love being a mother more than anything in this world. I was made to do this, and I feel more whole and balanced in my life now than I ever have. I am amazed at where I am now, and I am so happy to be here. My goal in the new year is to stay focused on where my son is right now, of being present with him as much as I can, and treasuring his little moments as much as his big ones. I don’t think that one will be all that difficult, really. 2012 will always be the year that made me a mother, the year that made me James’s mama. Anything else is really just a side note, when you get down to it.

Of course, there’s the really big side note. For years, my driving (career) goal has been to become an OB/GYN. 2012 is the year that broke that dream into tiny little pieces. I keep looking down at all the little fragments and trying to figure out how to put them back together again, but it occurs to me that first I have to figure out what shape I want them in. It’s true that if I am still determined to deliver babies, I can (probably) make that happen for the summer of 2014, which then leads to the question of whether that’s actually what I want anymore. To be honest, I don’t know. There are so many emotions and complications around the whole issue now, among them that I am very, very burned out on fighting tooth and nail in my career. This year I will have to come to some resolution with all of this, or at least begin to make sense out of what I want to be when I grow up (again). For now, I am trying not to worry over it and instead giving God and the universe time to work on untangling and putting back together.

In the meantime, I have determined that this year I want to get my creativity back. My job has me working “normal-people” hours, albeit with an annoying commute thrown in for good measure, and I get TWO WHOLE DAYS off every single week. I hardly know what to do with myself. Our new(ish) house has a dedicated craft space, and this year one of my goals is to carve out time to journal, to write, to work on memory books (I am a huge fan of Project Life), to knit, and to quilt. I have so many I need to finish, and so many I want to start. I want this year to be the year I make time to make things again.

My other goals for 2013 are the typical ones: get fit, pass (and then improve on) my fitness test, run another half marathon and maybe tackle a full, continue to hammer down (and then improve on) our financial status. Win the lottery. You know, run of the mill New Year’s resolutions.

When I look at the overall picture of where I am right now, I’m really in pretty good shape. I’m happy, for all the foibles and pitfalls of the last year. I want to stay happy, and improve on it. At the same time, I feel that I am at a significant juncture in my life, stable but with many options about where I can go from here. It’s not a bad place to be, but I need to think hard about what the next step is. It seems as though I have the seeds of good things planted where I am right now, and this year is about nurturing them, letting them grow, and seeing what fruit comes of it.

Here’s to a fruitful 2013 for all of us.

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Two weeks ago I left my training hospital for the last time. I had one month to make up after my maternity leave, which I completed, and then I turned in my pager and my badges and checked in with medical records about unsigned notes, and then I left the building.

It is surreal to think I won’t be a resident there anymore. It’s more surreal to think I won’t be a resident at all anymore, at least not for a few years. I’m waiting for my application for a medical license to finish wending its way through the maze of bureaucratic red tape it has to go through and then I will be a licensed physician. When I practice, I will be on my own, making my own decisions without someone supervising me. That is, quite frankly, terrifying.

Don’t get me wrong — my program has trained me very well and when push comes to shove I am confident in my ability to know how to help people and/or know when I need to ask for help in order to help people, it’s just that moment of realizing that even if you don’t need them, the training wheels are completely gone. Even though I don’t think I’m going to crash and burn, the possibility exists. That is scary. I suppose I could make the argument that it should be scary, and that if I were to be cavalier about the part where I have someone’s trust and health in my hands I might want to re-think my profession.

When I think back to where I was in July of last year, I can hardly believe how much has changed. Set aside my personal life (having a baby is completely cheating when it comes to major life differences over one year), and I still hardly recognize the intern who cried every day on the way to work for most of the first month. At my exit interview, my program director told me he had been very concerned that I was so shy that I would wilt and fade, those first few weeks. I didn’t. I bloomed. I am not generally a poster child for self-esteem but I really am proud of my work this year, and my evaluations over the course of the year back me up. I learned so much about being a good doctor, and a good resident, and also I learned some medicine while I was at it. I still have a lot to learn, heaps and piles of it, but when I look back over this year I will always be able to say that I did very well. I am grateful for that.

Sufficient unto the day, as they say, so I am trying not to worry too much about all of the challenges which are going to crop up over the next few years. It’s hard to do, since I am a worrier, but I have to try and focus on one step at a time. Next, I will worry about what to wear and where to go on my first day at my new job. Then I will worry about what comes after that. What a blessing it is to have this year to think back on and realize I have already made it through some rough waters, and come out better for it. As one of my favorite Pinterest pins says, I can do hard things. It’s been a very long year in very many ways, and it’s over now. Time to move on.

I. You know. Or your body knows, even if your brain does not yet comprehend; your body knows and begins to prepare in small ways, subtle changes of your breath, the energy in your limbs, there’s something restless and exhausted brewing in your bones. Your body knows, and as you look up at me with question in your eyes I see the answer there too, at the bottom of your soul or the pit of your stomach or somewhere equally deep and hidden, somewhere a still, small voice whispers calmly: yes, it says, yes, it is time.

II. Your daughter is clutching. At your hands, your bedsheets, the crochet yarns and hooks, her heart, her shirt, her husband’s hands, his shirt, her hair, your IV pole as she helps you to the bathroom. Her hands are tight around anything and everything as she twines her fingers into your life and will not let you go, not for a second, not for a breath, not for anything in this world or any other.
It is her husband who yells, under his breath in the hallway when he follows us out the door, closing it behind him, screaming in harsh tones as quietly as he can so you do not hear him (although you know what he says, you always know, but you don’t let him know you know, because he needs to be angry right now) — his fury is upon us when we do not control your pain, when your pain medication makes you too tired to speak, when you do not eat, when you do not like what you are eating. He is too clever for us, he knows our language of palliative care and hospice is code for giving up and throwing away, and he will not hear it. He is the one who yells, and he will sue us, all of us, and this hospital, he will sue us all until you are not dying anymore.

III. It is the time between when your body knows and when you know and when your family knows, it is the time between when I am shredded. To play God in that time for me would be first to fix it, miracle cure or laying on of hands or amazing self-healing fix it, but if not to fix it then to turn the clock forward days or hours to the time which follows. When your eyes understood what your body had known, and the papers are signed and the family is weeping and you are waiting, in that time there is healing of a different kind which is needed, so needed, but I am not God and I do not want His burdens, and so I cannot move you ahead to that time any faster than you can move yourself. But you move me, in the time between, waiting for you to catch up to yourself. You move me, and I am grateful.

Note: there is not an actual Ann, which I feel I must explicitly state for depressing legal reasons. Or rather, there is not one Ann, but have been many over the last year, and I am grateful to all of them.

Dear God,

I am angry at you right now.

Two weeks ago today, I was supposed to be getting an email which would assure me that BWB and I would be settled in this little house, in this little city, for the next four years. Two weeks ago Friday, I was supposed to get the email confirming that assurance. Neither of those came.

Instead, I received an email which turned everything on its head, again, and found myself scrambling to re-make a plan, again, and trying to figure out how I am going to make everything okay, again.

God, I am really, really tired of scrambling. I am really tired of thinking things are going to work out, and then having them not. I am really tired of being thrown curve balls. I am really tired of having to be strong, of having to be flexible, of having to be creative, and of having to roll with the punches. I’m tired of getting through it, of making the best of it, and of trusting that things are going to work out.

I want things to work out for more than a few months. I want some certainty about where I am going to be living and what I am going to be doing for more than a year at a time. I want to know that my husband will be able to have his job and career undisturbed by the insanity of my luck. I want not to have to leave the friends we have made here, and the hospital we have grown familiar with.

I want not to feel like my dream of being an obstetrician is crumbling in front of my eyes.

But I don’t get any of that right now.

Don’t get me wrong, God. I am really grateful for the amazing man you have given me. It is not every woman who is lucky enough to have her husband’s response to a bombshell like this be, “Well gee, I guess I might end up staying home with the baby for a year or so, huh?” His unconditional support and steadfast determination that we will stay together geographically as a family in the coming year, no matter what that means in terms of his contract and career plans, is unbelievable. I’m also incredibly grateful for the tiny little person currently doing yoga inside my belly. He is a miracle, without question, and I can’t wait to meet him and get to know who this little boy is that you have sent us.

I also recognize, grudgingly, that the church I found myself sitting in last week, with the priest and the parishioners who said exactly the right things, gave just the right number of hugs, and embraced me as if I had been attending services there for decades, that may have had your handiwork all over it.

But still. I’m angry. And I’m sad. And I’m confused, because I thought I saw where you were taking us, God.

I’m more calm about it than I was two weeks ago, and I’m sure in another two weeks I’ll be better than I am now. A year or two from now, I’ll see what it was that you were working on and understand a little better why you had to throw us off again. I just hate that I have to go through this again, the confusion and the doubt and the anger and the grieving. I’m tired of grieving.

I’m really angry at you right now, God. Really angry.

Love,
WHG

I am not dead. Just in case that was in doubt. Sometimes I feel like I am dead, of course, or very near it, and there have been a few painful moments over the last two months during which I wished I were dead, but all of that aside, I am decidedly not dead.

I have been an intern for almost two months. That means there are approximately ten months standing between me and no longer being an internal medicine intern. The fact that I think about it that way has nothing to do with anything except that intern year, as a rule, sucks. Now, the program I am in is wonderful. The team I am currently working with, I wish I could keep for the rest of the year because they are truly wonderful people. The work is interesting, to a point. It’s just that it keeps coming, and coming, and coming. The thing is, there’s always more to be done, always a test I’m waiting for, always a consult pending, always something that, if I let it, would keep me in the hospital. I hate being there for nearly 80 hours a week, but there are so many days when it takes a colleague telling me flat out that I should leave in order for me to do it.

The reward of hearing a patient tell me that I’m a good doctor, or that they wish I could be their doctor after they leave the hospital, or that they want to hear what I think about a situation — that is immeasurable. It’s everything I told myself it would be while I was fighting my way through the last ten years. And yet, I am exhausted, and there are still ten months of this to go, and then the rest of residency.

It was the best of times, it was the worst of times. Yeah, I think that about sums it up.

Intern year does suck, bigtime. But it’s also amazing. How crazy is that?

I should be in bed, but I’m still awake and it seemed remiss to not comment on tonight, if only briefly.

In the morning, I will get up and put on what BWB and I affectionately call “grown-up clothes”, also known as work-appropriate attire. I will then go to the hall closet and take out the coat I spent most of the evening prepping. It is a long, white lab coat with my name embroidered on the right side with the initials MD after it, and the name of my hospital on the other. My ID badge is already attached to the lapel, my prescription pad is in one pocket, a pocket reference text in another, and still another holds a granola bar, my wallet, and some chewing gum. Other than looking terribly new, it is a bona fide doctor’s coat, and it is mine.

My friend C recently graduated from nursing school and has been having approximately the same experience as I have during orientation the last few weeks. We’ve been texting each other photographs of ourselves in our new attire, pictures of our ID badges that indicate our new positions, and sharing virtual glee over being given our signature stamp — because the stamp makes everything official.

Today I sent him a photo of myself in my coat, following one from him in his nursing uniform. He responded back, “So official and profesional!! Do you think they can see our fear deep down?”

“I sure hope not!!”

Because it’s true. I’m quaking in my cute yet sensible flats. Today I was introduced to a patient as “Dr. Girl” for the first time, and I think my heart skipped a few beats with shock. What if I can’t remember anything I’ve learned in medical school? What if the senior doctors think I am an idiot? What if I AM an idiot? What if I screw up someone’s medication? What if I make a mistake? There are so many systems in place to prevent anything major from happening that I know it’s not really worth worrying about, but the part where I look like a fool? That seems less unlikely.

Don’t get me wrong, I’m excited, too, and proud to have made it to this point. But tonight my nerves are reigning supreme, and that is why I am still awake at this late hour. I am afraid of letting everyone else down, but I think even more than that I am afraid of disappointing myself, having come this far.

But there’s no getting around it. In a few very short hours, the time will arrive and so will I, in whatever condition five hours of sleep and the butterflies in my stomach allow.

Tomorrow morning, when I walk into the hospital as doctor (a lowly intern, but still a doctor), it will be the end of a very, very long road. Through that door, I will take the first steps into the next phase of the journey, in my very new, very long coat.

When I say that the events of this weekend were a decade in the making, I am not exaggerating. As I started to reflect on how long it has taken me to get here, I realized that it was almost exactly ten years ago that I was finishing my EMT-B certification and starting work in a rescue squad with one of my best friends. Out of that grew my decision to go to medical school, the post-baccalaureate pre-medical program, and a year of lab work.

Four years later, I started medical school. It’s taken me another six to get through, for reasons ranging from the enormous tragedy of Katrina to much more personal struggles. There were so many times I asked myself whether it was worth it, whether I really wanted this. I felt as if I was flinging myself at a brick wall repeatedly, wondering which was going to break first, the wall or me.

(Spoiler alert: It was the wall.)

I am still adjusting to the idea that I am really finished. Right up until we walked down that aisle, I was waiting for some member of the administration to come running over and tell me that they had found a mistake, that I wasn’t actually finished. It seems surreal that this battle I have been waging with every fiber of my being for years now is finally over. I can breathe again, relax a little.

Of course, it’s a brief respite, more like a rest stop than a finish line. The next marathon starts in a month, when I’ll be pouring myself into residency and all of the challenges which come with it. In truth, I’ve already started studying for July and for the next (and last) USMLE board exam, which I plan to take in the fall. It would be easy for this victory to be lost in the shuffle of moving on to the next thing, both literally with our upcoming inter-state transplantation and on a more metaphysical level, but that wouldn’t be right. It wouldn’t be fair to myself. And it wouldn’t be much fun either. To honor that, I’ve taken a few days to celebrate and really soak in this moment.

Today, I am standing on the rubble of that blasted wall and planting the triumphant conquerer’s flag on top of it. I’m doing my victory dance. I am shedding tears of relief, and shedding my skin to reveal the new me that has been growing inside for the last decade. Today is all about the finish line.

Tomorrow, the journey continues.

Note: Identifying details in the following post have been changed.

I saw my patient’s mother this morning.

My patient, the one I had three years ago when I was on Pediatrics. The one who, at the ripe old age of 12, was a survivor of the levees breaking and a sexual assault, had been pregnant, had miscarried. The child who looked up at me with ancient eyes, wary of my concern for her well-being. Suspicious.

Her mother, exhausted by life, kept a thin vigil from the large armchair of the room, trying to say the things that the doctors wanted her to say. She barely had enough energy to pull herself out of a post-Katrina haze to speak with us, much less help her daughter. The medical issues at play were not complex; it was this case that taught me how much of my job was going to be social work in nature. Still, by the time they left the hospital, I wasn’t entirely sure we’d managed to help them much at all.

I’ve looked for them ever since then, one or the other, hoping I’d see one of their names on my patient roster for the day. I’ve kept an eye out for them in the clinics and hospitals, thinking they might turn up again and I would have another chance at making a difference. No luck, though.

Then I saw her this morning, my patient’s mother, walking down the street as I was driving. She was wearing a work uniform and looked healthier than she had back in the hospital. Her eyes were not as sunken, her gaze less vague. I wanted to stop and get out and chase her down. I wanted to ask how she was doing, how her life was. I wanted to ask if she had married that guy, if her house had been repaired yet. I wanted to ask if her daughter was still in school, if she hadn’t had a baby yet. I wanted to ask if they’d both gotten the help they needed. I wanted them to know that they affected me, the wide-eyed medical student on her very first rotation. I wanted to ask if they were both okay.

But there are boundaries.

So I didn’t stop the car, didn’t chase her down, didn’t ask any of the questions that have been bothering me for three years. Instead, I just kept driving.

Nearly two weeks ago now, we received the incredibly good news that we have both matched into residency. Not into our first choice, but in a program which is doing amazing, innovative things and which felt like one of the best options for us. The interviews I had there were among the most up-front and honest of any I experienced on the interview trail, and I am certain this program will be an exceptional place for us to learn.

It was not our first choice, however, because it is not in New Orleans.

It is a little ironic to me that I am immediately following my previous post declaring New Orleans as home with one about having to leave it, and yet here I am. It has been such a roller coaster of emotion, glad to be moving forward, glad to be in a program I liked so much, excited about exploring a new place, but then it occurs to me that I am leaving this place and my heart aches.

It is 80 degrees here this week, mostly sunny although a storm is rolling in tonight. The trees and plants have fluffed out into the proportions of spring, and the tourists seem to be getting in a few more good weeks before the heat gets too bad. French Quarter Fest is two weeks from now, and since we’re close enough to walk this year I’m planning on soaking it up. We still haven’t finished sorting the last of the Mardi Gras beads, and I guess the plans for next year’s costumes are going to have to be on hold. We have invites from friends for dinner, lunch, puppy play dates, and/or coffee every week. I get to feed random friends on a semi-regular basis. We’re finally making inroads at synagogue, and I’m going to miss both our priest and our rabbi.

I’m going to miss New Orleans for its quirky spirit, for the glorious weather, for the community of friends we have here. I’m going to miss walking the dog down to Cafe du Monde for beignets, running in City Park, and knowing that when we go out to dinner, we’re going somewhere local and eating food we can’t find anywhere else. I’m going to miss St. James Cheese Co. and the Creole Creamery and Sucre. I’m even going to miss the bizarre roads that go in strange directions, are full of potholes, and have names that only locals are sure how to pronounce.

We’re determined to come back here as soon as we can, but there’s no telling if it’s going to be next year or ten years from now. I really am grateful for the opportunity ahead of us, and I know we’re going to discover amazing things about the new city, but I’m still sad about leaving this place I’ve come to call home.

Most of the blogosphere has been writing about their New Year’s Resolutions, and I have been thinking a lot about mine as well, but I’m also mulling over the other meaning of the word. Resolution, as in bringing to a close, wrapping up, ending.

There was supposed to be a great deal more resolution in 2011. Resolution of the cloud of uncertainty about my course into the residency program I ultimately want to end up, in particular. The end of 2010 was hopefully going to leave me with an answer, but instead I find myself with more questions, and the prospect of re-entering the match process next year. Not exactly the resolution I was looking for.

Living with uncertainty is very high on my list of least favorite things ever, and yet here I am in the middle of it, again. I often joke about having chosen the most difficult path possible through life, but sometimes the most difficult part seems to find me even when I’ve taken great pains to avoid it. Realistically, there are probably things I could do to stop feel like I was constantly throwing myself at a brick wall, but when my goals in life are on the other side of the wall, it would be a pretty big decision to just walk away. I’ve come this far, I might as well continue flinging for a while longer. I’m just starting to get sore, that’s all.

Of course, there will still be plenty of resolution this year — barring any further unforeseen disasters, BWB and I will graduate from medical school in May. I am working hard to remind myself that this alone is forward movement. After May, for better or for worse, we will finally be able to stop referring to ourselves as medical students (although I can’t say either of us is really going to be ready to tell people we’re doctors). It will be gratifying to finally discard forever the short coats that signify our student status. Forward movement, baby. Forward movement.

It’s funny because BWB and I love taking road trips together, and one of the things we both like most about our relationship is how well we travel with one another. At this point, our careers are proving to be the ultimate road trip. While the path isn’t as straight as we had hoped it would be, we’re still walking on down the road. I am intensely grateful that there is someone walking beside me at this point; even the longest road is a little less taxing when one has good company.

A somewhat belated Happy New Year to everyone, and may your roads be a little bit smoother, no matter the twists and turns.

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