Finding Rest & Rhythm

If I’m not careful it’s easier for me to start planning 5-10 years in the future and lose sight of something due next week.  For example, as a first-year medical student, I planned out options for housing and daycare at all four of my top Pediatrics residency spots – the thing is my son wasn’t even conceived at that point!  It is important to have long-term goals and direction for your life, but sometimes those long term plans don’t actually happen.  I went to a different medical school than I expected.  We had our son earlier than expected.  We didn’t live in the housing and my son didn’t attend the daycare that I neurotically planned for as an MS1.  I mean, I even entered a specialty I never imagined I would be in!  No joke, during my intern orientation we had a group breakout session and one of the leaders introduced herself as a Sleep Medicine Fellow and I clearly remember thinking, “that sounds so boring. . . Who would want to do that?”  Apparently, I did!

Who I became by the end of residency is different from who I was starting it.  Life gives us opportunities for a path we don’t expect.  So, while long-term goals have their place it may be more beneficial for you to focus on how you walk life’s daily path while in residency.  

A frustration arises here because there is much you cannot control in the daily life of a resident.  Your call schedule & rotations prevent any semblance of consistency.  And just when it feels like you are getting into the flow of the rotation it’s over and you have to start all over again.  Then there is the revolving door of patients, admissions, and procedures to both manage and learn from with a particular unpredictability.  Try as we might, we cannot control when a patient takes a turn for the worst.  And with that sudden change, you’re obligated to ensure the patient has needed care from you or someone else.  

This lack of control can lead to despair.  But for you to move toward rest & rhythm in your daily life, we need to bring attention to how you are spending your time.  As Annie Dillard puts aptly, “How we spend our days is, of course, how we spend our lives. What we do with this hour, and that one, is what we are doing.”  Life doesn’t stop in residency.  The hours and days in this season are important toward who you are becoming for the rest of your life.  

I know this can be discouraging to some.  I can almost hear myself as an intern yelling, “You mean how I spend my life is coordinating the discharge of a patient and completing their discharge note, just to spend an hour to find a pharmacy that will compound a liquid formulation of their anti-epileptic, just to find out that they won’t have it ready until tomorrow.  Which results in getting a lecture about a patient unnecessarily taking up a hospital bed and I should have had some foresight to have the medication ready today somewhere with all that “free time” I have in between managing all my other patients!  That’s how I will spend my life?” 

Deep breath.  Yes and No Intern Ben.  But when you are being crushed by the medical machine it is hard to see the purpose and value in your daily life at work.  

During this series we’ll explore how to redeem your time during residency.  Only you can decide how you will respond to this lack of control & what to do with the pockets of time within your domain.  And by that I mean the margins at the beginning and end of your day which is the place where you have the greatest control, and as a result – I think – the best place to start.  In the coming months we’ll discuss a sustainable & simple model to conceptualize your margins.  And with practice, the rest & rhythm you create in your margins will impact each step you take in life’s daily path.  But first let’s get you some data.