You Can't Do That When You're There

"Eating healthy will be impossible when you're a resident. Trust me, I ate well until residency started and then it was all cafeteria food and cookies from the nurse's station."

"Med students never sleep, just expect to deal with that. It's impossible to learn all the material without pulling all nighters on the regular."

"You are absolutely CRAZY for planning your wedding during med school."

"Good luck trying to exercise when you're in medical school, you won't have any time!"

"Good luck trying to exercise during residency, you won't have any time!"

"Say goodbye to friendships and relationships. You're married to medicine now."

"You're starting residency? Hope you know how to sleep walk."

All of the above quotes are real things that have been said to me over the years, and general themes of "warnings" given to people pursuing medicine. With each of these statements it added to my nerves about my upcoming endeavor. You're telling me that not only am I about to start something incredibly challenging for a number of reasons, I'll also lack the ability to enjoy life and take care of myself? While this advice could be heeded as somewhat useful in anticipating inevitable physical and mental hardships (no one should believe balancing career and personal health will be easy) but for the most part, it's all just not true.  I'm sure the same can be said for other jobs or the decision to have children-- there will always be people telling you that your own happiness/health will decline with irreparable circumstances. 

Reflecting back on the past seven (SEVEN?!) years of medical school and residency, I can honestly say that a commitment to a healthy amount of exercise has been the single most important self-care decision I have made.  It's kept me centered, helped me sleep better, and influenced other ways I approach self care.  Some weeks I move in a way that is intense and heart-pumping, while other weeks my approach to exercise is completely restorative and stunted in duration.  Thinking back to my tough weeks as the CCU senior in January, I was doing at-home yoga exclusively, with the majority of the time spent in deep stretches and breath work.  Other weeks when on a lighter schedule I enjoy lifting heavy weights and spending a whole hour in the gym for a workout. As summer emerges I can't help but soak up every ounce of sunshine during long walks outside with my husband.  The point is how and how much has been a fluid adjustment to my circumstances but never completely neglected.  

The most important patient we have to take care of is the one in the mirror.
— AMA President Robert Wah, M.D

Certainly sleep was less than optimal some weeks (read: Night Float) and I felt it. But I made it a priority to optimize sleep hygiene and can say that my sleep during residency was vastly better than undergrad days (why did I think it was ok to go out until 2 am, then wake up 4 hours later for rugby conditioning??) Same with nutrition-- during residency I have eaten in a way that best serves my body and healthier than any other period of my life because (you guessed it) it was a priority to me.  

When I look back on med school and residency, the only thing I wish had been tipped in one direction more frequently, was leaning in more to social engagements. It's all a balance of the time you're given in a day, and often sleep was such a great priority that I'd pick it over driving into the city.  I'd stay in my suburb to catch up on research rather than driving up for a Saturday in New York City with friends. That's not to say my social life hasn't been rich with amazing friendships and experiences, but rather carefully chosen to optimize other parts of self care. In hindsight I don't regret these decisions individually, but collectively I know what I'd like to change moving forward (read: more Philly SIPS!) 

That old advice (mostly from barely acquaintances or strangers) creeps up again as fellowship is right around the corner for me.  "First year of fellowship is just crazy, expect to be miserable!" "Yeah good luck doing all that yoga when you're getting hammer paged for consults." "You'll be sleeping less than intern year."  I get it, and appreciate hearing perspectives from others that are a reflection of their observations or experiences. The nerves about starting this next step in training are inevitable-- little bits of imposter syndrome reappear, concerned I won't live up to my own and others' expectations, nervousness mixed with the excitement of opportunity. On top of the concerns related to my work, I get nervous about how this change in training will influence the other parts of my personal world. But I fully believe that once again, the aspects of wellness and life outside work that are important to me, will be maintained.

  I'm writing this here for me AND for you, we can choose to do all the things that make our life feel whole. We can be flexible with the ebbs and flows of work and life so that they're no longer 2 separate entities but rather a constant flow of intention. Priorities happen because we make them happen, it's just knowing what they are. 

Because you CAN do that when you're there. Promise :-)

Love,

Shanny DO