My Physician Alter-Ego

We are hardcore.

We don’t like to say it. Doctors, nurses, and other folks in the medical profession known for the long shifts, the 80-hour weeks and the life-and-death scenarios, we like to say “Ah well, it’s just what it is. We signed up for this.”

That may be true, but that doesn’t make it any less ridiculous.

I say this as someone who is on the “softer” side of the medical profession with my choice of specialty; this week I will have only worked 72 hours in six 12-hour increments. I’m in the emergency department as part of my overall intern-year curriculum, though it is not my area of study – it is expected that I be able to manage these patients with the help of my attending physician and make halfway decent decisions if I have an unstable patient while waiting for the real expert to show up. I feel tired probably 70% of the time, and when I look back on my week I wonder how in the world I made it through. It takes a huge amount of energy to go to work every morning and deal with serial emergencies (major props to my friends in emergency med and internal med – I really don’t know how y’all deal with this forever).

I’m not saying this to be all “hey, look at me,” I’m saying hey, look at us. We live weird lives compared to everyone else – that’s why they make television shows about us, along with cops and military folks. Those three groups are the fodder for countless stories because it’s just generally something that most people will not experience in life. We made some of the most critical moments in life our jobs, every single day. The majority of everyday people will not see day after day of psychosis, suicide attempts, and crippling anxiety. They don’t routinely welcome new humans into the world or watch as children die way too young.

Maybe it’s different for people from medical families, but from my perspective, this life is incredible. When I was a kid doctors were somewhat mysterious (perhaps more so for me than other people – my mother didn’t really believe in doctors). They didn’t seem like fully formed people; they were mystical folks who fixed things and knew things. Surely these people were just born this way. No one becomes a doctor, they just are. The universe declared them so.

I was almost old enough to drive when I came to the seemingly obvious realization that doctors were people who went through years of school to learn a profession which is way beyond the realm of normal experience (turns out that the few doctors I met as a kid were the most educated folks I had any contact with – who knew?). It was a shock for me to find out that I could be one – a kid who grew up in a town of 6,000 people, raised by a single mother who cleaned houses and waited tables. They let people like me into school, with the right grades and extracurriculars.

Turns out this doctoring thing really is an acquired skill, or so they tell me. I’ve officially been a doctor for six months and I still have a hard time believing I’m part of this world. “Dr. Cooper, radiology for you on line two,” the department secretary calls over the loudspeaker. Dr. Cooper, who? Why are nurses looking to me for advice and direction? Plenty of them are close to twice my age. Surely not – surely not me.

I believed every day for the four years I spent in med school that I was going to fail out, despite never failing a class. Every board exam was another opportunity to prove that my admission to med school was some kind of mistake. I was not born a doctor; any time now, they’re going to figure out that I’m a fraud dressed in a white coat, trying to pretend I’m one of them.

I passed my third and final licensing exam a couple weeks ago, and now I can’t really make that argument anymore. I didn’t just pass it, either – I did well, so well that you’d almost think I was one of those doctors spontaneously formed from the fabric of the universe.

In six hours I start an overnight emergency shift. I will bike myself up the hill, take off the tie-dye and don hospital-issued scrubs. My nametag says “Physician,” the whitecoat inspires confidence. I’ll hit the floor running in my tennis shoes, ready to take on whatever comes in. I’ve been on the service long enough that the attendings have started to trust me.

I think I’m slowly getting to the point in my life where I’m beginning to trust myself. I’m not sure that the title will ever merge with my identity the way I imagined it as a kid. Healthcare providers are people, some of them people just like me. Tie-dye, fantasy writing, and all.

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The First Reader You Disappoint

Today is a good day. Today I got my first sub-4-star review from someone who was disappointed in Broken. When I got it I paused and felt the initial punch of sadness – They read it and walked away unhappy?! – and then intrigue – What did they see in the words that they didn’t like?

I’m pleased to say that this is a new experience for me after a year and a half (ish) of positive reviews across the board. It’s hard to complain about that, so I’m not going to. I’m also not writing this post to confront the reader, as per author’s etiquette. I side with the large group of writers who feel it is poor form to get into arguments with readers over differences of opinion. I have certainly disliked books that other people loved in the past (Lord of the Rings, for one, even though I respect the story as a whole). What I’m writing about here is the thing that I love about art in general – no single piece of art is viewed the same way by all people, and that is okay. I would argue that it’s the entire point.

The same story does not have exactly the same meaning to any two people, and as a character-driven author and reader, I see those differences of opinions through the relationships we have with characters (sure, we can get bogged down in plot points and technicalities, but I find those problems much less interesting). If we look at the well-dramatized TV show Mad Men, for instance, we can find a divide in fans between those who like Don Draper and those who find him beyond redemption. Draper is an adulterer, a liar, and a drinker. He is also someone who is tormented by what he’s done and memories of where he came from; he has sparkles of kindness that show up through the lying/cheating/drinking (i.e. his care for Anna), great charisma, and a brilliant mind for advertising. What a viewer sees in Don Draper depends so much on their own experiences – to one who has been cheated on, he may be the embodiment of deep hurts. To the child of an alcoholic, he may be a reminder of a father too infrequently present. At the same time, he could actually evoke sympathy in the same person, not just for the character, but for the real-life incarnation of his indiscretions.

The prism of characterization, molded by our own experiences.

My own experiences have come into play rather prominently with the latest book I opened up, the semi-autobiographical Country Doctor’s Notebook by Mikhail Bulgakov. Mikhail is a classically acclaimed physician-writer, best known for his novel, The Master and the Margarita. In Country Doctor’s Notebook he describes his experiences as a new doctor in 1917 rural Russia. As I started reading the book I felt this overwhelming sense of kinship with a man now long dead; somehow, between the pages of an almost 100-year-old book, I met a friend. There are obvious differences between our experiences as young physicians – while Mikhail was stranded in snowy Russia with inadequate resources and no other physicians to advise him, I am working in a well-appointed hospital with supervision. Where he is expected to do everything from surgery to psychiatry, I am training in a narrower specialty.

Those obvious differences aside, in so many ways our experiences are not different at all (starting with the fact that we are both physicians who write). I think every healer has felt that sudden doomsday sensation with the first patient you see as a qualified practitioner, knowing that you are the one with the answers now, or you’re supposed to be. I laughed when Mikhail wrote about concealing a textbook on the procedure he was about to perform on top of the patient’s chart, when not a week ago I was googling the steps to procedures and drugs I was about to initiate as I was walking into a room. His desperate thoughts on his first day ‘please don’t let this be a hernia,’ are not so different than my own ‘please don’t let this be a stroke.’ Through his work I came to understand that the insecurities of the young healer are a function of who we are, regardless of when we are – all of us through time have had the same fears, and that… is kind of awesome.

As the story went on Mikhail revealed the increasingly dark side of his early years as a doctor, when he became addicted to morphine. His description of the descent into addiction was surprisingly frank for someone of his time and profession; I could not help but admire his courage. Courage aside, there’s no way to defend practicing medicine while intoxicated; what he did was not right. It was bad.

I understood it, and think what you will of me, I still felt the same connection to him. What he did wasn’t what I would ever do, and still I found him sympathetic, for whatever reason that may be.

We look at these sorts of characters in their most broken times, and for us they are so many shards of glass – tilt them one way and we see something we want to see, tilt another way and we see quite the opposite. When you have a reaction to a character, what are you seeing? Are you seeing them for who they are, or are you seeing your friends, your family?

Do you see yourself?

We will not all agree on stories, characters, or values, but what we see in them is always a part of us in some way. I could never fault someone for that. Thank you for the reviews, no matter what they say.

‘Why is she writing about Faeries, anyway?’ – and other thoughts on intern year

Those of you who come to me for the darkness in my stories – the tragic, gut-wrenching what’s-gonna-happen-to-that-character feeling, may be somewhat confused by my most recent posts. I started writing Fae and Folly with very little explanation, testing the waters of serial blog stories. After posting so much about Fae and Folly and so little about Forsaken Lands I believe I owe you internet folk an explanation. In order to do that I’m going to briefly describe my life at the present time. It may sound a bit whiny, though that is not my intent – I would merely like to give you all a little context. Here we go…

Six days out of the week I wake up at 5:34(ish) in the morning. This, I have discovered, is exactly the amount of time I need to get out of bed, dress in my business casual, check that I have my pager/phone/tablet, eat something that takes 3 minutes or less to prepare and arrive at the hospital at exactly 6 am. I try not to think too much about what I’m about to do at this time of day, because the series of events is inevitable – there’s no way I’m going to stay home or call in, because my team and my patients all need me. I choose one of my hiding places (usually the conference room or this little room off to the side on the second floor where no one goes), turn on my headphones, and spend exactly 30 minutes reading about what happened overnight while evaluating lab results. At 6:30 my day begins in earnest, and I disappear.

When I say “I disappear” I mean that in an existential sense – on internal medicine who I am, Sydney the writer, the wife, the friend who enjoys pear wine with a new episode of Sailor Moon – that Sydney disappears. I’m Dr. Cooper, and Dr. Cooper has no needs. She is who her patients need her to be, the diligent team member who reads every note, checks every lab, and asks every question she can think of to make sure that nobody is unduly harmed in the process of her training. At the hospital the person I am at home (and here, on this blog) exists only in the approximately 45 minutes per day when she is able to slip on headphones and do charting, because at least if the right music is playing all of the dry technical language tumbles out to a jaunty beat.

– at this point, as an aside, I’d like to remind you that I am not going into internal medicine. I have an immense respect for people who do, but am personally not equipped to pursue a career in which my sense of being is consumed by medical culture and jargon. Internal medicine is merely one of the requirements of my residency as a whole, the specialty of which I may release at a later date. I love the job I actually signed up for and will be able to return to it in November. End digression –

When I come home (usually between the hours of 4 pm and 9 pm, depending on the type of day we’re having) I have 2-4 hours to adjust to doing usual things: eating, showering, watching TV, and if my day was good enough, I will sit down and write. Lately every time I have a moment to transport myself to another world, I find myself in a place where faeries are real, magick is sparkly, and muses trick young humans into colossally poor decisions.

I don’t think I need to explain the connection between working 10-14 hour days in a stressful environment and happy-go-lucky escapism. The escapism is part of what has been keeping me sane as I learn to navigate the complex hospital system all while desperately trying to be a good doctor.

Make no mistake – I still love my Forsaken Lands crew. FL2 is developing into a much longer installment in the series, full of revealed secrets, ambitious (for me) action scenes and new characters who I think all of you will like just as much or more than the old ones. However… FL2 is work-intensive and many times dark. The darkness appeals to me, on the one hand, and on the other is just too much for the next 6 weeks. I’ve been getting a little done on it here and there, but I don’t expect to do much more until I’m on my neurology rotation in late August/early September.

As stated at the beginning of this post, I in no way mean to sound like someone who is griping just for the sake of griping (though I do value the therapeutic release). There are plenty of good things going on in my life right now, even at work. The people I’m working with on internal medicine are amazing. These residents and attendings are compassionate, smart individuals who do a genuinely good job caring for our patients. The hospital has a nice cafeteria, my new home is lovely, and the other interns in my program are positively awesome. In the end I will survive these next few weeks and move on to other things.

…that said, I cannot wait to go back to having two days off in a row at the end of this ride. It’s gonna be wild.

So that’s my (rather lengthy) answer. I hope everyone else is having a positively fabulous summer, and I invite you to check out Fae and Folly if you’re curious about it. Perhaps some of you, dear readers, need a little sparkly magick in your lives too. Peace.