May 8, 2009

Wrote in my diary last night:

Am considering quitting. The hospital's ethics and mine don't match, especially the see a person for only one thing, the continual pressure to hurry, continual meetings and the 18 patients a day. If I think the hospital doesn't rise to my ethics, I'm out of there. I'll give them some options.
-me learning cesarean sections, think I could train with my favorite perinatologists in Seattle.
-I won't do obstetrics with the other group. I don't like their culture, the care they give, how they treat each other or how they treat me.
-I'm ready to do consults about death and dying, POLST forms, weird stuff and dementia. But I want 40 minute visits.
-I would like to do group visits and approached the hospital 2 years ago; they didn't support it. Interestingly I hear that they are going to support it for someone else.

I don't feel loved. I'm the senior woman doctor in the hospital and I've done the most high risk obstetrics. I feel valued and loved by the community, by my friends, by the nurses and hospital staff and by the many specialists I've worked with for years. However, what I am hearing from the administration and my peers is that I should conform. I am told that my practice style is not valued and I am scolded over and over for taking the time I need with complex patients. Yet at the same time three of them have said that I'm an amazing clinician in the last month. Guess they'd just like me to be amazing faster. My partner in Colorado said that she stayed there by "picking her turf and guarding it." and I have been forced to do the same here. My hospital is not an organization that is supportive.

1. If I resign will they pay me the extra RVUs they owe me.
2. Our CEO has always maintained that the no compete clause is to keep big comglomerates out but he wouldn't apply it to us. Is that true?

I am grieving that I may need to quit. Though the other doctors doing obstetrics want me to help them with call, so will be interesting to see what the administration does.

Those hot-chocolate winter nights were what drove us outside, beneath the canopy of rambling trees with branches so thick that the blanket of the stars and the sky was but an afterthought, and it was there that we found our miracles, our haven, our tiny dancing girls with fresh drew in their hair. we held hands as we faced this brave new world, tiny unspoken questions still on our lips, and we watched as the sky lit up with things we could not understand but loved nonetheless, and when the howling of the wolves and music of the night finally faded into silence and the electric light of their hopes and dreams faded into a sweetly dim reflection of the stars, only then did we go inside, dizzy and drunk with the magic of that winter night, wondering from behind sleepy lids if maybe it was just a great and curious dream.

You don't know what you've got 'till it's gone.  If ever there was a trite adage about life, that would certainly be at the forefront.  Over the past year and a half, I have been reeling myself in from double heartbreak, the onset of epilepsy (albeit minor, thank God), losing a semester of school, getting cut-out of a trust, and having two car accidents.  

The first accident can be considered the aforementioned "onset," as one minute I'm heading down the highway rocking out to Elenore by The Turtles, then after a brief period of white flashing light and violent thrashing I found myself sprawled across my front seats - having torn out my Nissan Altima's center console in the process.  After a few twitches, I realized I had been in an accident and quickly checked to see if anyone else was involved.  Luckily, it was just me and a concrete guardrail.  A hispanic gentleman was peering through the window and seemed a bit startled to see me upright; and after I assured him that I was fine, I attempted to drive-off.  The car started, but wouldn't move out of first gear.   Inquisitively, I exited the car, only to realize my passenger-side rims (custom anthracite BBS, at that *sigh*) had literally been ground in half.  Plus there was the marked frame damage from having collided-with and ultimately sliding down the rail for at least 100 yards before losing forward momentum.  For reasons inexplicable, I don't wear a seatbelt.  There's no reason I shouldn't have gone through the windshield. I walked away unscathed... and with a shiny new Altima, too.  This time I chose black.

Then, a few months later in my new black Nissan, a Lincoln Towncar and I attempted to occupy the same space at the same time while changing lanes.  Again, no injuries, except to my car - which is barely over one year old - but now relegated to piece of shit status given my refusal to pay the $1000 deductible to have the front bumper and quarter panel replaced (one of these days I'm just going to take a hammer and attempt popping out the dent... it is plastic, after all).  The funny thing is that amidst the damage, my right headlight remained unscathed.

A few days ago, I began packing-up my downtown loft in preparation for a move to a nice, quiet place the suburbs.  I've since dropped out of law school, and all job prospects have left me progressively disheartened... as well as teetering on the edge of financial disaster.  There I can return to my pre-grad school logistics job (so long as the Somali's quit taking over the vessels) or perhaps get my MBA from The University of Texas via the local "satellite college" and fulfill my (since race car driver and rock star are seemingly out of the equation) dream of being a professor. 

As I finish stacking the myriad boxes of CD's I'll likely never listen to again (but absolutely cannot discard, for some reason), temporarily leaving out my LP collection... which I listen to quite frequently (it doesn't make sense to me either)... I begin to pull shut my venetian blinds to block the orange sodium freeway lights and skyscraper beams.  Suddenly there's a snap, and I'm laying on the floor half-covered in cheap velour window covering and looking at my left leg lie in a 45 degree angle in a way which God had not designed to be positioned.

"Luckily," this is the 5th time I've dislocated my knee, so I know the drill.  In a state of shock and rush of adrenaline, I snap it back into the socket and narrowly avert heaving the Hot and Spicy McChicken from earlier.  I don't have health insurance, so I'm unable to see a sports medicine physician in order to have the fluid drained from out of the socket.  As with the previous two times, the joint produced an orange-sized mound of fluid.  This causes a veritable tear-inducing amount of pressure and naturally, immobility. 

So, I sit here, dormant and alone... lamenting to an anonymous group of individuals like a child.  But I will persevere.

As I round the corner the air raid sirens go off. The sound is terrible. Huge. It penetrates me like a pole run through my chest; it makes me choke. It bounces between the houses; it grows.

Every year, the first Wednesday in May, I take the day off. I go into the center of Copenhagen, preferably close to Kongens Nytorv (King's New Square), get a cup of coffee, and sit outside a café and listen. At noon the air raid sirens sound. The systems are tested every night to make sure the sirens are online, but only once a year the actual sound systems get checked. And that is the first Wednesday in May.

The intense howl rises and falls, rises and falls, bidding me to run and hide, crawl into shelter with my hands covering my ears, eyes closed. Cower.

This year I was running a little late, and I was only halfway to the café when it started. Right beside me was a school, and behind me a church. There was a siren on top of the school, and it went off just as the church bells started tolling. The effect was overwhelming. I almost lost a step, and, as always, I got a lump in my throat.

(It speaks of bombs and rain-soaked nights, and fear).

And it tells me to remember things I never knew. It is coming down like a blanket; rising like a dome over the city. The country.

The reason I do this every year is the same as the reason I try to always remember to look at the sky every night when I come home from work, and remind myself that my loved ones and I have made it through another day, alive and as happy as can be. The sirens remind me that my children live in a country without war, and that they have never known real hardship. They remind me how incredibly lucky I am.

At this precise moment this whole nation, as one, hears the same sound.

I look at the people going by. They don't seem to pay any heed to the horrible warning blaring overhead. One woman halted her steps briefly as the sirens went off, but now she is continuing her stroll, smiling into her phone. Nobody else.

I walk down the street towards my favourite coffee place, thoughtfully. The "All Clear" signal is intoned, picked up by siren after siren until it colours the sky lead.

There is nothing to fear here. Not any longer.

Not yet.

I need coffee.

The sirens never go off all at the same time, and the slight delay drags out the sound, until it seems to go on and on and on. In fact each burst lasts only nine seconds, repeated four times, and then a pause. The "All Clear" goes on for some 40 seconds. But the experience lasts for so much longer.