For some reason, working at night makes me hungry. So hungry that I can't seem to stop snacking. It's bad. I don't get hungry like that at home. Why must I be so hungry at work? Tonight I found myself scrounging at the bottom of my lunch bag and I came up with stale fortune cookies. I won't lie. I ate them. I'm not proud.
One fortune said "You will be successful in whatever you do." Really? That's good to know. I was worried about that. Especially since i'm starting a new job this summer. Maybe I should actually start training for that triathlon i've been planning to do for the last 8 years. Sweet. But how do I make sure that this fortune cookie is not just blowing smoke...in my face? After all, what does it have to lose? I was going to eat it one way or another so why not just lie? I'm paranoid like that. Don't judge me. I decided to look into this whole idea of success. Where did I turn? To the business world. Those people do nothing but focus on being successful. Here's what they taught me.
Success is a choice we must make daily. In other words,
1. Decide to do the different every single day. Ever notice how much more you see when you take a different route to work? The different is a minefield of discovery. Leave your comfort zone, if only for a little while.
2. Just ask. You can't win if you don't play. When you don't ask for what you need, the only answer is no.
3. Learn something new everyday. Kindergarteners do it. Why can't you?
4. Be active. This one is my personal favorite. I love exercise and being healthy. I've never found it especially motivating to lounge on the couch for hours watching tv, much to the disappointment of my husband!
5. Choose carefully who you hang out with. Surround yourself with people who you admire and respect. Do a quick friend and colleague check. Do they make you a better version of yourself? If not, consider seeking out those who inspire you and minimizing interaction with those who don't. I know, it's easier said than done.
Wednesday, April 28, 2010
Wednesday, April 21, 2010
When Everyday Feels Like Wednesday
For those of you who don't know, the ACGME and RRC began enforcing resident work hour (also called duty hours) limitations in 2003. The highlights are that residents can admit new patients for no longer than 24 hours straight but can continue to work another 6 hours to finish up their work and/or participate in educational activities for a total of no more than 30 consecutive hours worked. The weekly work hour limit is averaged at 80 hrs/wk over a 4 week period with one day off in 7. I got used to the look of horror when I told non-medical people that the new work hours were great, we only had to work 80 hours a week now.
I happened to begin residency in 2003 and was therefore part of the "80 hour workweek" class. Defending ourselves against the onslaught of disdain from our senior residents and attendings became the norm our intern year. We were seen as privileged, lazy, and not concerned about patient care and learning. We, however, didn't know any differently. We were forced to compress our considerable intern workloads into 80 hours a week without the support of faculty members and try to learn how to be a compassionate physician at the same time. Oh, and learn enough pediatric medicine to not look like a buffoon on the wards. Although I championed the benefits of the duty hour regulations, over the course of my 3 year residency I realized its shortcomings as well. It provided an easy cover for those residents who wouldn't have valued educational initiative anyway and evened the playing field between those residents who would not walk away from 'loose ends' and those who had no qualms about doing so on a regular basis. Now we all had to be comfortable signing out work until we could come back in the next morning.
Now as an attending, I see a permutation of the duty hour regulations affecting the residents I currently supervise. They seem to have lost the pride in patient ownership that I remember feeling as an intern. Residents now have been forced to evolve into number crunching, note writing, order entering and work hour tracking doctors in training who actually spend the shortest allotment of their time at the bedside. I am constantly amazed at how much medicine is now practiced in front of a computer screen.
The reason I bring this up is not to play the "when I was a resident" game and disparage those trainees coming up through the ranks. It isn't their fault the duty hour regulations exist, just like it wasn't ours in 2003. But I heard something disturbing the other day. On a listserv to which I subscribe, a post was written about new regulations that will further cut down on the number of hours residents work. In that model, more of the daily work will fall on the attendings so the residents will still have time to attend educational activities as well. I fear that if this keeps happening, a pediatric residency will need to be extended to 4 years from 3. And from what i've been reading, this fear is warranted. However, I fear more the pediatrician who graduates from residency and is adept at studying and attending lectures but has no idea what to do with a difficult family or an acutely ill patient!
This issue will be revisited again and again in this blog in the upcoming year, especially as I transition to an academic pediatric hospitalist position and work with residents and medical students full time. And yes, I did just say that I will be writing this blog for another year. Thanks for your support!
I happened to begin residency in 2003 and was therefore part of the "80 hour workweek" class. Defending ourselves against the onslaught of disdain from our senior residents and attendings became the norm our intern year. We were seen as privileged, lazy, and not concerned about patient care and learning. We, however, didn't know any differently. We were forced to compress our considerable intern workloads into 80 hours a week without the support of faculty members and try to learn how to be a compassionate physician at the same time. Oh, and learn enough pediatric medicine to not look like a buffoon on the wards. Although I championed the benefits of the duty hour regulations, over the course of my 3 year residency I realized its shortcomings as well. It provided an easy cover for those residents who wouldn't have valued educational initiative anyway and evened the playing field between those residents who would not walk away from 'loose ends' and those who had no qualms about doing so on a regular basis. Now we all had to be comfortable signing out work until we could come back in the next morning.
Now as an attending, I see a permutation of the duty hour regulations affecting the residents I currently supervise. They seem to have lost the pride in patient ownership that I remember feeling as an intern. Residents now have been forced to evolve into number crunching, note writing, order entering and work hour tracking doctors in training who actually spend the shortest allotment of their time at the bedside. I am constantly amazed at how much medicine is now practiced in front of a computer screen.
The reason I bring this up is not to play the "when I was a resident" game and disparage those trainees coming up through the ranks. It isn't their fault the duty hour regulations exist, just like it wasn't ours in 2003. But I heard something disturbing the other day. On a listserv to which I subscribe, a post was written about new regulations that will further cut down on the number of hours residents work. In that model, more of the daily work will fall on the attendings so the residents will still have time to attend educational activities as well. I fear that if this keeps happening, a pediatric residency will need to be extended to 4 years from 3. And from what i've been reading, this fear is warranted. However, I fear more the pediatrician who graduates from residency and is adept at studying and attending lectures but has no idea what to do with a difficult family or an acutely ill patient!
This issue will be revisited again and again in this blog in the upcoming year, especially as I transition to an academic pediatric hospitalist position and work with residents and medical students full time. And yes, I did just say that I will be writing this blog for another year. Thanks for your support!
Wednesday, April 14, 2010
Even Uncle Sam Wonders When You're Getting Married
I've been married for a year and a half. I told a friend this weekend that I feel more passionate about my husband now than I did 2 years ago. And I plan to feel even stronger 2 years from now. Yes, I plan that sort of thing. You know the saying "Failing to plan is planning to fail"? I might as well have that tattoed on my arm. Where did I learn how to be married? I don't remember ever hearing about marriage in school. My pediatrician certainly never brought up the topic of marriage during my yearly well child checks, even as an adolescent. So where do children learn how to be successful married people as adults? The popular vote would be that we simply learn by watching our parents. But what if our parents are divorced? Are we simply doomed then to be unsuccessful at marriage ourselves? It seems to me, as a pediatrician concerned about the future wellbeing of the children for whom I care, that I should be imparting some sort of guidance on thriving in a happy marriage. But does it even matter? As it turns out, it does.
Research has found that children raised by parents in healthy marriages have certain benefits not seen in those from unhealthy marriages. Those benefits include the following:
More likely to attend college
More likely to succeed academically
Physically healthier
Emotionally healthier
Less likely to attempt or commit suicide
Demonstrate less behavioral problems in school
Less likely to be a victim of physical or sexual abuse
Less likely to abuse drugs or alcohol
Less likely to commit delinquent behaviors
Have a better relationship with their mothers and fathers
Decreases their chances of divorcing when they get married
Less likely to become pregnant as a teenager, or impregnate someone.
Less likely to be sexually active as teenagers
Less likely to contract STD's
Less likely to be raised in poverty
A healthy marriage benefits society as a whole too. Consider this. The Deficit Reduction Act of 2005 provides funding of $150 million per year for healthy marriage promotion. Healthy marriage promotion awards must be used for eight specified activities, including marriage education, marriage skills training, public advertising campaigns, high school education on the value of marriage and marriage mentoring programs. I've seen this campaign in action in the form of posters on the bus that read "He's not always Prince Charming, but he'll always be your prince" under a picture of a man yawning in a woman's ear while spooning in bed. Sweet. I've often wondered about the point of that poster. Now I know.
For more information, check out the Healthy Marriage Initiative on the Administration for Children and Families section of the Health and Human Services website.
Research has found that children raised by parents in healthy marriages have certain benefits not seen in those from unhealthy marriages. Those benefits include the following:
More likely to attend college
More likely to succeed academically
Physically healthier
Emotionally healthier
Less likely to attempt or commit suicide
Demonstrate less behavioral problems in school
Less likely to be a victim of physical or sexual abuse
Less likely to abuse drugs or alcohol
Less likely to commit delinquent behaviors
Have a better relationship with their mothers and fathers
Decreases their chances of divorcing when they get married
Less likely to become pregnant as a teenager, or impregnate someone.
Less likely to be sexually active as teenagers
Less likely to contract STD's
Less likely to be raised in poverty
A healthy marriage benefits society as a whole too. Consider this. The Deficit Reduction Act of 2005 provides funding of $150 million per year for healthy marriage promotion. Healthy marriage promotion awards must be used for eight specified activities, including marriage education, marriage skills training, public advertising campaigns, high school education on the value of marriage and marriage mentoring programs. I've seen this campaign in action in the form of posters on the bus that read "He's not always Prince Charming, but he'll always be your prince" under a picture of a man yawning in a woman's ear while spooning in bed. Sweet. I've often wondered about the point of that poster. Now I know.
For more information, check out the Healthy Marriage Initiative on the Administration for Children and Families section of the Health and Human Services website.
Sunday, April 4, 2010
From Farm to School
Remember the days when you could (and did!) eat anything you wanted and not give a hoot about nutrition, your carbon footprint, your pant size? I remember those days well. I'll confess...I was never one for healthful eating. Thankfully I was always active in sports so my weight was never a problem. But I think about the way I ate as a child and teenager and I cringe.
Once or twice a month my school had "hot lunch" days. We didn't have a cafeteria so we all brought our lunch routinely except on those days. Those days you could bring your money in a sealed envelope with your name on it and get a nutritious choice of Burger King or Pizza Hut. Wow. I guess they thought since we brown bagged our lunch most of the time we could afford a little artery clogging fat lest we forget the joys of empty calories and processed, overpriced, low quality food. In high school, my friends and I routinely ate fries, chicken nuggets, and this mysterious deep fried bean and meat burrito thing. From the school cafeteria. Am I the only one disturbed by the idea that our schools are promoting eating this way??
Millions of children everyday eat lunch and sometimes breakfast at school. The government invests only $2.68 per day for each school lunch. Some of us remember the "four food groups" model of nutrition: meat, milk, fruits and vegetables and breads and cereals. Meat had it's own quarter of the pie!! Thank goodness we've graduated from that 1958 embarrassment to the "food pyramid" of today. But we're still a long ways off from impacting the eating habits of children in this country. Although I cringe at the crimes i've waged against my body with my poor noshing past, I am committed to lead my children to another way of living and eating. That is why I am very much behind the goal of Chef Ann Cooper and The Lunch Box initiative to lobby Congress to invest one more dollar in every child. Without a change in the obesity epidemic affecting our children, they will have a shorter life span than you and I. Shameful.
Once or twice a month my school had "hot lunch" days. We didn't have a cafeteria so we all brought our lunch routinely except on those days. Those days you could bring your money in a sealed envelope with your name on it and get a nutritious choice of Burger King or Pizza Hut. Wow. I guess they thought since we brown bagged our lunch most of the time we could afford a little artery clogging fat lest we forget the joys of empty calories and processed, overpriced, low quality food. In high school, my friends and I routinely ate fries, chicken nuggets, and this mysterious deep fried bean and meat burrito thing. From the school cafeteria. Am I the only one disturbed by the idea that our schools are promoting eating this way??
Millions of children everyday eat lunch and sometimes breakfast at school. The government invests only $2.68 per day for each school lunch. Some of us remember the "four food groups" model of nutrition: meat, milk, fruits and vegetables and breads and cereals. Meat had it's own quarter of the pie!! Thank goodness we've graduated from that 1958 embarrassment to the "food pyramid" of today. But we're still a long ways off from impacting the eating habits of children in this country. Although I cringe at the crimes i've waged against my body with my poor noshing past, I am committed to lead my children to another way of living and eating. That is why I am very much behind the goal of Chef Ann Cooper and The Lunch Box initiative to lobby Congress to invest one more dollar in every child. Without a change in the obesity epidemic affecting our children, they will have a shorter life span than you and I. Shameful.
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