Hospitalist x critical care x pulm/cc lifestyle

[Oso]

Somebody call the cops because I just witnessed a verbal murder. Didn't even get a response from @jdh71 or @DetectiveAlonzo ...Couldn't agree more with this sentiment.

OP, I'm sorry everyone was such a dick to you. I hope you got better career advice from somebody more helpful.

Not only was it one of the most beautiful pieces of writing I've seen in years, but it was also that poster's one and only post on SDN --- LEGEND.

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[appalachian_man]

Not only was it one of the most beautiful pieces of writing I've seen in years, but it was also that poster's one and only post on SDN --- LEGEND.

I'm so glad I decided to pop in this forum for the first time.

 

[jdh71]

Somebody call the cops because I just witnessed a verbal murder. Didn't even get a response from @jdh71 or @DetectiveAlonzo ...Couldn't agree more with this sentiment.

OP, I'm sorry everyone was such a dick to you. I hope you got better career advice from somebody more helpful.

You mean the post where a guy misses the point, fails to understand a simple analogy all the while making up a bunch of untrue assumed things about me? That post? I found it too stupid and incorrect to respond too. You can't talk to some people. If you thought it was "murder" that says a lot to me about your ability to think. I'm ok if you stay away from my patients too.

 

[appalachian_man]

You mean the post where a guy misses the point, fails to understand a simple analogy all the while making up a bunch of untrue assumed things about me? That post? I found it too stupid and incorrect to respond too. You can't talk to some people. If you thought it was "murder" that says a lot to me about your ability to think. I'm ok if you stay away from my patients too.

No I mean the post where a guy calls you out on your toxic and over-compensatory hypermasculinity and inability to to respond like a normal human being to somebody asking a simple question about lifestyle.

If you found it too stupid and incorrect to respond "too," that says a lot to me about your ability to think.

 

[DoubleBogey]

... and believes that taxes are stealing from the strong...

.

Ummm...this isn’t true?

 

[jdh71]

No I mean the post where a guy calls you out on your toxic and over-compensatory hypermasculinity and inability to to respond like a normal human being to somebody asking a simple question about lifestyle.

If you found it too stupid and incorrect to respond "too," that says a lot to me about your ability to think.

I'm not compensating for anything. Why would I need to, especially here. I've made my bones. I work in these trenches. Nothing hypermasculine. I think my female partners who work this same job would find the distinction laughable. The long hours and hard work are the job. It's what you sign up for. I don't despise anyone who want to work less in general. You simply can't have "that lifestyle" and work this job. You can't. I know because I work it. I'm one of those naive SOBs who still thinks this is a calling. My patients and their families deserve my best and that means the long hours and nights and weekends and holidays and missing my kids sporting sometimes. I dip out early when I can.

Have I been grumpy old man at times in the past? Too much maybe? Sure. I try not to respond the same way I did a few years ago.

The bottom line though was he missed the point. Failed to understand an analogy. And just made crap up about me. Really classy.

 

[It's lupus!]

So as I'm kind of lurking through the form I thought I might add my useless two cents and see what bounces back at me.

I get jdh's analogy. It's not necessarily hypermasculin outside of the theme. I get it. It's hardwork. On the other hand, does that mean it necessarily needs to be exactly how it is? Improvement means acknowledging issues and working through solutions. Undoubtedly there is a need for CC physicians and there are plenty eager to start but it seems often many are driven away by burn out and similar factors. Is that really ok? Is there not something we can acknowledge and work toward solving? An appeal to tradition doesn't make it the right thing. It just means that is how it currently is and keeps us from making positive changes, and arguably fits the idea of learned helplessness. You can love your job and even go into knowing there are serious issues but isn't it counter productive if it's met with a "deal with it" mentality? I'm not saying you shouldn't have tough skin or be prepared for sleepless nights but is it wrong to be in search of or ask for movement that removes or lessens those stressors? As someone who was in the military and was in the mud, we didn't actively seek or decide to sit in it. We thought up creative solutions that lessened our exposure to it. We sought to improve our situation no matter how poor it was. The guys who didn't do that unfortunately ended up doing poorly in the field, developed mental health issues, or eventually we're kicked out through disciplinary action. (Just to stick with the military analogy).

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[jdh71]

So as I'm kind of lurking through the form I thought I might add my useless two cents and see what bounces back at me.

I get jdh's analogy. It's not necessarily hypermasculin outside of the theme. I get it. It's hardwork. On the other hand, does that mean it necessarily needs to be exactly how it is? Improvement means acknowledging issues and working through solutions. Undoubtedly there is a need for CC physicians and there are plenty eager to start but it seems often many are driven away by burn out and similar factors. Is that really ok? Is there not something we can acknowledge and work toward solving? An appeal to tradition doesn't make it the right thing. It just means that is how it currently is and keeps us from making positive changes, and arguably fits the idea of learned helplessness. You can love your job and even go into knowing there are serious issues but isn't it counter productive if it's met with a "deal with it" mentality? I'm not saying you shouldn't have tough skin or be prepared for sleepless nights but is it wrong to be in search of or ask for movement that removes or lessens those stressors? As someone who was in the military and was in the mud, we didn't actively seek or decide to sit in it. We thought up creative solutions that lessened our exposure to it. We sought to improve our situation no matter how poor it was. The guys who didn't do that unfortunately ended up doing poorly in the field, developed mental health issues, or eventually we're kicked out through disciplinary action. (Just to stick with the military analogy).

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Yeah. Tell me how to do that. When a patient needs your time they need your time. You can't just dip out.

I left late Tuesday for instance because I accepted a young male out of hospital arrest. Dilated cardiomyopathy. Profound cardiogenic shock. Multiple pressors. Lactate of 15. And when 7 o'clock came around it wasn't like I could just be like "good luck bitches!! I'm going home" only to become a critical care doctor at 7am the next morning. This isnt some kind of "tradition" I do because I'm so "hard core" and I just love that tradition nonsense for traditions sake all the while hating myself. I stayed around because the kid was 22 and he needed me to be a doctor. Unworthy cranky ass hole I might be, he needed me. Cardiology was being stupid and he needed an Impella. So I needed to make that happen. And I did. I needed to make his oxygen sats higher than 72% and I did (it took a quick bronch and flolan on top of the other normal vent tricks). I needed to talk to the surgeons about ECMO in case it came to that. The guy needed arterial and central lines. The family and girl friend needed updating. This was done not because I'm a hero. This isn't some kind macho nonsense. It's what the situation and my patient needed.

Often doing the right thing doesn't follow my clock in and clock out schedule. You don't get to work this job without that willingness to sacrifice of yourself. There. Is. No. Other. Way. To. Do. It.

The kid is on his way to the university hospital today for heart failure/transplant eval because he woke up and followed commands for me this morning. His mom couldn't stop crying while she hugged me and thanked me for never giving up on him. And THAT is why I do this.

 

[It's lupus!]

Yeah. Tell me how to do that. When a patient needs your time they need your time. You can't just dip out.

I left late Tuesday for instance because I accepted a young male out of hospital arrest. Dilated cardiomyopathy. Profound cardiogenic shock. Multiple pressors. Lactate of 15. And when 7 o'clock came around it wasn't like I could just be like "good luck bitches!! I'm going home" only to become a critical care doctor at 7am the next morning. This isnt some kind of "tradition" I do because I'm so "hard core" and I just love that tradition nonsense for traditions sake all the while hating myself. I stayed around because the kid was 22 and he needed. Unworthy cranky ass hole I might be, he needed me. Cardiology was being stupid and he needed an Impella. So I needed to make that happen. And I did. I needed to make his oxygen sats higher than 72% and I did (it took a quick bronch and flolan on top of the other normal vent tricks). I needed to talk to the surgeons about ECMO in case it came to that. The guy needed arterial and central lines. The family and girl friend needed updating. This was done not because I'm a hero. This isn't some kind macho nonsense. It's what the situation and my patient needed.

Often doing the right thing doesn't follow my clock in and clock out schedule. You don't get to work this job without that willingness to sacrifice of yourself. There. Is. No. Other. Way. To. Do. It.

The kid is on his way to the university hospital today for heart failure/transplant eval because he woke up and followed commands for me this morning. His mom couldn't stop crying while she hugged me and thanked me for never giving up on him. And THAT is why I do this.

I never claimed to have the solution to the problem. I only think making the argument that's there's no other way discourages people from looking for solutions. I get what your saying. I'm really not against it in action, but the idea that you can't improve anything. It just seems a little fatalistic. I don't know. Like I said, just my useless two cents.

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[jdh71]

I never claimed to have the solution to the problem. I only think making the argument that's there's no other way discourages people from looking for solutions. I get what your saying. I'm really not against it in action, but the idea that you can't improve anything. It just seems a little fatalistic. I don't know. Like I said, just my useless two cents.

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There isn't a solution. People have looked. Medicine is full of smart people. Sometimes you just eat cold dinner and kiss your kids at night after they've been long asleep.

No plan survives survives first contact with the enemy.

I think the way most of us currently work is about the best you are going to get. And lots of days you do wander out in time or even early. But you need to be prepared. This job isn't about "you" or "me" it's about the patients who need us to do what needs to be done for them.

 

[It's lupus!]

There isn't a solution. People have looked. Medicine is full of smart people. Sometimes you just eat cold dinner and kiss your kids at night after they've been long asleep.

No plan survives survives first contact with the enemy.

I think the way most of us currently work is about the best you are going to get. And lots of days you do wander out in time or even early. But you need to be prepared. This job isn't about "you" or "me" it's about the patients who need us to do what needs to be done for them.

I don't think anyone here is arguing your last sentence but I think the course is dead. So I'll leave it be. Haha

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[jdh71]

I don't think anyone here is arguing your last sentence but I think the course is dead. So I'll leave it be. Haha

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It's cool. I'm not here to berate you. But if I could make this job easier. If any of us could we would!! I like not living in the hospital. I like free time. I like time off.

 

[It's lupus!]

It's cool. I'm not here to berate you. But if I could make this job easier. If any of us could we would!! I like not living in the hospital. I like free time. I like time off.

Agreed. I'm not afraid of hard work. For me, giving a part of myself in the work I do comes with a unique satisfaction. That doesn't mean I want it everyday though, and as someone not working that job yet it does make me hesitant. How does one gauge from the outside whether they'll be able to handle it or not and if they'll be able to improve their situation once there? My life experience always suggest that there is something we can do to improve our situation, but you also can't build a sand dune if the tsunami hits at the same time.

 

[ArteryStudyPainting]

TYFYS

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[jdh71]

Agreed. I'm not afraid of hard work. For me, giving a part of myself in the work I do comes with a unique satisfaction. That doesn't mean I want it everyday though, and as someone not working that job yet it does make me hesitant. How does one gauge from the outside whether they'll be able to handle it or not and if they'll be able to improve their situation once there? My life experience always suggest that there is something we can do to improve our situation, but you also can't build a sand dune if the tsunami hits at the same time.

Good questions. Hard to answer. Hard to know even in training. I think it's a calling. I know that sounds quaint but if you're not feeling called don't force a wrong shaped peg through a wrong shaped hole. At minimum train in a primary specialty first so you will have that always. You can regulate your hours much more effectively in the primary specialty. Especially pulmonary.

 

[Bobblehead]

And when 7 o'clock came around it wasn't like I could just be like "good luck bitches!! I'm going home" only to become a critical care doctor at 7am the next morning.

Who covers your units at night?

 

[jdh71]

Who covers your units at night?

We do.