{"id":2564,"date":"2018-12-20T14:19:17","date_gmt":"2018-12-20T19:19:17","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2564"},"modified":"2018-12-20T14:19:17","modified_gmt":"2018-12-20T19:19:17","slug":"medicine-robbed-me-of-my-20s","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/12\/medicine-robbed-me-of-my-20s\/","title":{"rendered":"Medicine Robbed Me of My 20s"},"content":{"rendered":"<div id=\"attachment_2455\" style=\"width: 135px\" class=\"wp-caption alignright\"><a href=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/07\/AU000_shippe.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2455\" class=\"size-thumbnail wp-image-2455\" src=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/07\/AU000_shippe-125x150.jpg\" alt=\"Scott Hippe, MD\" width=\"125\" height=\"150\" \/><\/a><p id=\"caption-attachment-2455\" class=\"wp-caption-text\">Scott Hippe, MD, is a Chief Resident at Family Residency of Idaho in Boise.<\/p><\/div>\n<p><span style=\"font-family: 'Times New Roman',serif;font-size: 12pt\"><span style=\"color: #000000\">\u201c<\/span><\/span>Medicine robbed me of my 20s.<span style=\"font-family: 'Times New Roman',serif;font-size: 12pt\"><span style=\"color: #000000\"><span style=\"font-family: 'Times New Roman',serif;font-size: 12pt\">\u201d<\/span><\/span><\/span> I\u2019ve heard the line many times in my medical training. It often comes accompanied by a long sigh, a slow sip of coffee, and a glazed stare off into the distance. \u201c<em>Imagine what could\u2019ve been,\u201d<\/em> the seasoned physician muses, \u201c<em>if I had my 20s to do over, without\u00a0medicine.\u201d<\/em><\/p>\n<p>But now, I am mere months away from leaving my 20s behind. To be completely honest, I often feel similar to those physicians I heard earlier. I see my friends outside medicine doing exciting things and visiting exciting places. And then there is my brother, a teacher, who is off work for summers and every single family holiday. Sometimes \u2014 especially on\u00a028-hour shifts \u2014 I wonder if medicine is really worth it. I wonder if the journey is leading me to my best\u00a0self.<\/p>\n<h2>Lamenting the things I&#8217;ve missed<\/h2>\n<p>We have a maladaptive tendency as humans to focus on that which is not, rather than appreciating the good in what actually is; we define ourselves by what we miss, rather than by what we catch. In this vein, I started making a list of things I missed in my 20s. Then I got depressed. But here is what I had, to\u00a0start:<\/p>\n<ul>\n<li>Missed lunch today and many days; man, am I grumpy today<\/li>\n<li>Missed going out last Friday<\/li>\n<li>Missed my alarm and a call to deliver one of my pregnant patients<\/li>\n<li>Missed calling my mum on her birthday<\/li>\n<li>Yikes, missed zipping up my fly before ICU rounds<\/li>\n<li>Missed pickup basketball on Saturday, and the Saturday before that<\/li>\n<li>Missed registering for the CME conference all my friends attended<\/li>\n<li>Missed being home for the holidays<\/li>\n<li>Missed diagnoses, including DKA, stroke, and heart failure<\/li>\n<li>Missed family weddings, reunions, and a tragedy<\/li>\n<li>Missed the chance to travel abroad with friends<\/li>\n<\/ul>\n<h2>What misses mean for resident wellness<\/h2>\n<p>Focusing on misses like this has a negative effect, not just on big-picture life satisfaction, but also on day-to-day wellness. The bitterest pill to swallow in residency for me is not the long hours. The most soul-crushing piece is being drawn away from places you want to be and people who are\u00a0dear.<\/p>\n<p>There is dissonance here: I desire to be well in my life and work, but medical training is challenging and exceedingly time-consuming. The realities of residency take me away from the things that make me\u00a0\u201cwell.\u201d<\/p>\n<p>Residencies are waking up to the idea of wellness. At my residency, we have been trying to increase dedicated administrative time to decrease charting outside of clinic. Our wellness committee puts on quarterly events to build community. We have a supportive\u00a0faculty.<\/p>\n<p>Having adequate time to sleep, exercise, and experience a loving community forms the perfect foundation. Yet without feeling good about the work, efforts to improve life outside of residency responsibilities ultimately fall short at achieving whole-person wellness. We just work too stinking much for this not to be the\u00a0case.<\/p>\n<h2>Encountering a low point<\/h2>\n<p><div id=\"attachment_2602\" style=\"width: 160px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2602\" class=\"wp-image-2602 size-thumbnail\" src=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-150x150.png\" alt=\"sleep deprivation effects\" width=\"150\" height=\"150\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-150x150.png 150w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-25x25.png 25w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-144x144.png 144w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-32x32.png 32w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-50x50.png 50w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-64x64.png 64w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-96x96.png 96w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/12\/sleep_deprivation-128x128.png 128w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a><p id=\"caption-attachment-2602\" class=\"wp-caption-text\">Mikael H\u00e4ggstr\u00f6m, used with permission. [CC0], via Wikimedia Commons<\/p><\/div>Long hours and some uncertainty about my future after residency caught up to me recently. While transient, this bump in the road put me in an anxious and sleep-deprived condition. My work felt devoid of meaning. Fifteen-plus hour workdays are long ones if you feel\u00a0empty.<\/p>\n<p>Without prompting, the wife of one of my middle-aged male patients said \u201cDr. Hippe, you\u2019re the first doctor my husband has been able to tolerate in 50 years.\u201d That hint of positive connection made me start paying attention again. The next day, two infants I\u2019d delivered in previous months came in for checkups. They were thriving, their families were happy, and I shared in their joy of new life. Unknowingly and in subtle ways, my patients helped me find my center at\u00a0work again.<\/p>\n<p>&nbsp;<\/p>\n<h2>Finding wellness at work<\/h2>\n<p>An alumnus from my residency recently sent a message about wellness. She quoted an article\u00a0published in <em>JAMA<\/em>, in which the author relates \u201cI can think of no other dichotomy so damaging to a young physician or the patients he or she will treat, than to imagine that life begins only once a shift has ended\u201d (<a href=\"http:\/\/doi.org\/10.1001\/jama.2018.9910\" target=\"_blank\" rel=\"noopener\"><span class=\"meta-citation-journal-name\">JAMA\u00a0<\/span><\/a><span class=\"meta-citation\">2018; 320:343).<\/span>\u00a0This former resident then added her own thoughts: \u201cHow can we re-frame and experience work as an enjoyable part of life rather than something entirely separate from who we are and how we\u00a0live?\u201d<\/p>\n<p>What I appreciate most about the question is that there is no singular best answer. Personally, I often find wellness at work through connecting with my patients. Other times it has been support from my resident community, or the exhilaration of becoming competent at a new procedure. The answer to the question will be different for everybody, and can change along the\u00a0way.<\/p>\n<p>I am sure of one thing, though: the answer to what makes us well at work is worth pursuing, both individually and as groups of residents and\u00a0physicians.<\/p>\n<p><a href=\"https:\/\/resident360.nejm.org\/\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-926\" src=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2017\/03\/genMedRes360Ad540x250.jpg\" alt=\"NEJM Resident 360\" width=\"540\" height=\"250\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cMedicine robbed me of my 20s.\u201d I\u2019ve heard the line many times in my medical training. It often comes accompanied by a long sigh, a slow sip of coffee, and a glazed stare off into the distance. \u201cImagine what could\u2019ve been,\u201d the seasoned physician muses, \u201cif I had my 20s to do over, without\u00a0medicine.\u201d But [&hellip;]<\/p>\n","protected":false},"author":1294,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[17,33,34,37,42],"class_list":["post-2564","post","type-post","status-publish","format-standard","hentry","category-about-residency","tag-chief-resident","tag-reflections","tag-residency","tag-resident-experience","tag-thanks"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v17.1.2 (Yoast SEO v20.8) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Medicine Robbed Me of My 20s - Insights on Residency Training<\/title>\n<meta name=\"description\" content=\"Dr. Hippe talks about resident wellness, and what it means to be a young medical professional.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/12\/medicine-robbed-me-of-my-20s\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Medicine Robbed Me of My 20s\" \/>\n<meta property=\"og:description\" content=\"Dr. Hippe talks about resident wellness, and what it means to be a young medical professional.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/12\/medicine-robbed-me-of-my-20s\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2018-12-20T19:19:17+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/07\/AU000_shippe-125x150.jpg\" \/>\n<meta name=\"author\" content=\"Scott Hippe, MD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Scott Hippe, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/12\/medicine-robbed-me-of-my-20s\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/12\/medicine-robbed-me-of-my-20s\/\",\"name\":\"Medicine Robbed Me of My 20s - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2018-12-20T19:19:17+00:00\",\"dateModified\":\"2018-12-20T19:19:17+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/ee4340cb1857fa1b3e172e9572bf210a\"},\"description\":\"Dr. Hippe talks about resident wellness, and what it means to be a young medical professional.\",\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/12\/medicine-robbed-me-of-my-20s\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/12\/medicine-robbed-me-of-my-20s\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/12\/medicine-robbed-me-of-my-20s\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Medicine Robbed Me of My&nbsp;20s\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/ee4340cb1857fa1b3e172e9572bf210a\",\"name\":\"Scott Hippe, MD\",\"description\":\"Scott is from a small town in western Washington called Snohomish. 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