Almost forty years ago, this was me. I was the top of my class, with the most awards, in both Junior High and High School. I had been accepted to the University of California, Berkeley, as an undeclared major. My 4.0 GPA was enough to get me in even though I wasn't sure yet what I wanted to do with my education.
I transferred into the College of Chemistry to do a Chemical Engineering major my first year. Why? Because I didn't want to stop learning about Chemistry. It was my favorite subject. And the Engineering? Because of mom and dad. I could major in anything I wanted, but if they were going to support me it had to be some form of engineering where I could get a job upon graduation.
I worked for five years at The Clorox Company in Pleasanton. I married and tried to get wanting to be a doctor out of my system. I'd wanted it since I was four, but the finances weren't right for me to go. I saved my money and looked forward to a future with my college sweetheart Mark Loren Shalz.
Then I got sick.
I had a pituitary tumor and needed surgery. The wanting to be a doctor got worse. I was thrown into a terrible depression from the surgery's affects on my hormones. And kindly, my therapist, a UCSF grad, helped me to find my way through the application process and start a new life.
My marriage wasn't perfect. We fought. A lot. But we loved each other. I had changed because of his irritability and need to control. I needed to control too. With two engineers, that's not easy. But he was the one who learned to 'put his foot down' and he most certainly did it well. He did it well enough to break my spirit.
So if you can imagine, medicine became my escape from an unbearable life.
I got in to UCSD. I prepared for the big move. I realized once I had been there a few weeks that my husband and the men who were my classmates differed. And my husband was mean.
I asked him for a divorce and at first he said I had every right to ask for it.
Then he tried to get me back.
So in essence, I had been raised by a mother who had anger management issues and frustration, married someone not much different, and took off to embark on a career helping people and using my heart and my mind together.
I got into UCI for Categorical General Surgery. Actually, the secretary didn't follow the list the chairmen had submitted for the match. She switched things. And we ended up with three women and four men. She was always very kind to me, and told me I had the same birthday as her daughter, and she thought I was so beautiful. So I'll never know for certain if she bumped me up a little or if I earned it. Either way, it was out of my hands.
In surgery the hours were grueling. And it wasn't suited to my personality. If the patient didn't drink all of their prep, it was somehow MY fault that they didn't.
In surgery everything you do well is expected. And anything you do wrong, well, that's what is talked about.
We even had grand rounds on Saturdays!
So with the long hours, and everything else, I switched over to anesthesia. I enjoyed working part time where I had done my residency, and working in the community the other part of the time. I had been Chief Resident, the department was very supportive, especially with my pregnancy as a single mom.
Anne Wong another cardiac anesthesiologist would give me breaks in the heart room so I could pump milk for Anthony. When she wasn't there, I had to stand in the anteroom called the 'pump room' for the Bypass machine was stored there when not in use, look through the window at the monitors, and watch my resident as I pumped standing up.
If you can see where things are going, that's good. This should be the first red flag.
It's a violation of the law to deny a woman who is breast-feeding adequate time and space to pump.
A rule was passed due to Libby Zion in New York to limit resident work hours. These limits did not apply to me in my training, or to anyone after their training was complete. I trained before the laws went into effect.
This is red flag number two--physicians in practice are not protected by the same work hour limits to prevent mistakes due to fatigue--as they are in residency.
Yesterday I could barely talk. I caught a bug in Spain and my Asthma was totally out of control...my coughing due to that tickle in the back of my throat that only responds to albuterol--my coughing was so violent I threw up on myself twice. Once in the car on the way to work. And once when I had just lay down to bed.
When your patient is working too hard to breathe, the speech becomes like a telegram and they use the fewest words possible in order to breathe. And also, when people are working too hard to breathe, they don't want to eat because between air and food, air wins.
Why didn't I go to the doctor?
Why didn't I call in sick?
It's because I can't.
If I get sick I have to find someone to work for me. There are only fourteen people I can ask. They all have busy lives.
My group has nothing in the system to account for illness. One woman broke her arm in the shower and was out for two months. We covered for her. But I had to work a lot of post-call days because our group is too small. She told me yesterday she is not allowed to request summer vacation because she had been gone for too long, a few months.
I also didn't go to the doctor because I don't have one. I don't know how my friend makes her physical therapy appointments. I have no control over my workday and when I go home. Our policy is to ask for a short room and to make the appointment for late in the day. Or post-call but that's not always a guarantee.
I haven't had my thyroid checked in years because of the combination of high copays and difficulty to access care. Not just getting off work. I mean getting the appointments, the insurance authorizations for the tests, for everything. My thyroid is huge and it makes it difficult for me to breathe.
Once the house sells, I will invest in my health.
But even with that, I haven't been to the dentist or periodontist for two years. With something recently--a new sonicate toothbrush, I noticed little pieces of hard things, possibly teeth? breaking off.
I long for a job where I can stay home if I am sick.
I long for a job where I don't have to work nights and weekends and be away from my family.
Yesterday was the first day since March where I didn't have to go pack things at the old house or manage things like cleaning or snacks for the workers and water--while Anthony was at baseball practice.
I slept with a little bell by my nightstand. Anthony has asked me, mom, on a scale from one to ten, with your lungs being totally closed and tight as ten, where are you right now?
I was a seven.
He said mom, I am taking you to the hospital when it gets to be an eight.
I was to ring if I had trouble.
We did a test run to make sure he could hear me.
I did something I've never done before, ever, last night. I crossed a bridge that there's no turning back. I took the prednisone. This is a very strong steroid asthmatics take. My body responded to it.
Here's what I've done besides lots of Reiki and healing codes:
- honey, lemon and warm water (honey is about as effective as dextromethorphan in clinical tests)
- albuterol puffers
- zyrtec antihistamine
- anesthetic throat spray
- vicks vapo rub
- saline nasal rinses twice daily
- antibiotic (I started it last night--there wasn't any signs of purulence, but the viral infection was so lingering I was starting to head in that direction)
- Airborne fizzy drink
- oregano oil capsules
- all the supplements my friend a physician sends me--probiotics, vitamin C, and adding immune boost and long-acting vitamin C.
- put in a Reiki Request with Team Doctors With Reiki
- asked Ross and Raphael to help me find my way with this health challenge
- albuterol nebulizer treatments
- keeping the window open in my room at night--the air somehow is soothing to my lungs
I've also been unpacking all of the medications because they have still been packed up from the move. I can't find anything.
I slept well.
My respiratory rate is high.
It's high normal though, not like forty per minute or anything.
My chest isn't tight. I am coughing a little, but it's not like before and it's a lot less.
I slept in my clothes last night just in case I had to go to the hospital.
Today I'm first call.
I was given the choice of assignments, and I chose the lower-paying one that has pacemakers in it at the surgery center. Why? Because the patient has to stay at the facility for three hours after the case for monitoring. My colleagues hate to stay, unpaid, for three hours. But for me? It's just the rest I need before I go to the main operating room and continue my duties through the night. (Anthony will be with his dad for the weekend).
Ross says for me to take lots more vitamin C, my kidneys will be okay. And to plan to stay in bed all weekend. He didn't say to get a hotel room or not, he said to see how it goes through the night.
If I had known anything about medicine, I would have put two and two together with my maternal grandfather on theophylline and having almost died of pneumonia in Chicago (that's why they moved to California from Italy instead of to where the family was in Chicago)--and with all my allergies growing up--that I was at risk. My dad had eczema and also pulmonary fibrosis at the end.
In my career planning I should have realized that by going to medical school five years later than most, that fuzzy tail end of my career could have benefited from more attention.
In Doximity, a website like Facebook for Doctors, there's articles about physicians leaving medicine because it's a toxic lifestyle. And how to 'leave' medicine (work locum tenens--substitute doctors basically--to avoid call and only accept assignments where you work short days, or have a side gig as a blogger, or be a speaker or consultant, have medicine be your 'hobby'...yada yada yada). People share about how frivolous lawsuits that were dropped still cost them eighty thousand dollars in legal fees. And the debt incurred in training is really making it that new physicians can't even buy homes.
That's what's going on out there in my world--both my immediate world--and my peers who share online.
At my work, I know administration of the hospital would love to step in and take over our contracts. Then they could pay us salaries, collect our billing, and pocket the difference.
To be honest I would rather work for my group than to work for people whose main focus is money even more than my group's focus is on it. It would be nice on the one hand to be an employee with a 401K and breaks and full legal protection. But it would be a huge drop in income to gain that.
Why did I choose my group?
I was offered a career at a local trauma center and doing hearts. It was a dumpy place kind of. But a friend knew someone and got me in. What bothered me was the nurses told me that when the one female physician was pregnant no man colleague EVER came in and gave her a break.
That hospital ended up getting bought out, and that group was taken over anyways.
I came to where I am now because of a friend who looked out for me. He heard I was between jobs, and he knew a cardiac anesthesiologist was needed. He put in a good word for me.
Do I make good money?
Yes, I could say that I do.
Would I point out that good money comes with huge expenses like malpractice insurance, having to pay for my own healthcare and dental insurance (total for month is $1500 every month, just to be able to go and pay huge deductibles and copays. There's licenses, DEA licensing, associations--that is pricey too.
I never in a million years thought of this when I was applying to medical school.
I am truly thankful as an anesthesiologist I don't need to manage an office and everything that goes with it. It's just not my personality to do this. Too much real-world business 'stuff''.
Ross tells me he will get me out of this. I know I will find my way.
Did you know a lot of female physicians retire early in their careers? The female ophthalmologist yesterday said some go into pediatrics because they like kids, then they have a bunch of kids, and then they stay home to take care of the family. She remarked, 'then why did they go into medicine anyway?'.
I don't know.
I do know Polly McClosky another ophthalmologist who has a nice specialty--ocular plastic surgery to help drooping eyelids and stuff--hired full-time nanny to take care of her kids for everything. This is the kind of arrangement where the nanny goes on vacation with you and you buy the nanny a car.
She bought a wife, basically. Polly's husband was an eye doctor like her.
Elsy, the best eye scrub tech EVER, confessed yesterday that in her whole career, she longed for the opportunity to pick her son up from school. She never got it. But she stopped doing cases at the hospital because it was just too much of her son's life she was missing out.
Medicine needs change.
The average wait time at a California ER is five and one half hours. People had thought that with access people would be proactive with their health. But like myself, lots of people find that approach frustrating and expensive. You can't see a doctor for two days when you get sick. They are all booked. In New York and some other states, the wait time in the ER is even longer. Many thousands of people LEAVE the ER waiting room before they are ever seen.
Our system is broken.
I am run-down, and in need of some major life change, to be honest.
But you know what? The more I think about it, the more similarities I see between the book on Irish slaves--and workers now.
Hours are crazy long like in medicine, but now, outside of medicine too.
We wear badges that even can track our physical location. My sisters work had the personality type coded (INFJ would be lilac, etc) on their badges at Ditech. That way 'workers would know how to interact more successfully'.
ER nurses sign contracts saying they won't pee, poo, or eat during their twelve hour shift. I'm sorry, but what if a nurse is on her period? You have to change a tampon or sanitary pad--overnight ones don't really work.
We are not machines.
We are humans.
And even though in the movie, Freddie Mercury said the human condition is one that requires anesthesia to cope with it--I disagree.
We need Nature.
We need nurturing, warmth, love and compassion to function.
Newborns will die if they are not touched. They fail to thrive when denied nurturing, warmth, love and compassion.
We were once newborns.
Healers need time to heal themselves, and to be a full cup in order to heal others. My ophthalmologist friend sees patients EVERY FIVE MINUTES in her office. She has no free time. That's why she loves the O.R., hates office, and loves to sew while she's doing surgery. How can any time of healing and lasting change take place in five minutes?
Yesterday we had a miracle.
She helped a blind man to see.
I was a part of it.
He had a growth over his eye called a pterygium. But back in in the old country, they took it out in the office and did a retrobulbar block (eyeball numbing) with no anesthesia. He was traumatized. So this time it grew back. It always does when you just cut it.
We reconstructed the eye surface, taking steps to insert medicine layers so it won't grow back.
Another opthalmologist had seen him, refused to touch it because it was so severe--and he had gotten depressed. Badly depressed. But his primary care doctor sent him to my friend.
The blind can see.
It was so beautiful in the bible when that happened with the mud, wasn't it. So much nurturing, warmth, love and compassion in that moment. The mud was mixed with spit, the healer's own essence and work to make the poultice. It probably was just to help the people understand the cause and effect of the healing, because other miracles had been without such actions too.
But even though the miracle for the blind man yesterday, took years of training, lots of hassles, loans and debt--politics in the workplace from day one--and even working sick--it still makes me feel in my heart the same joy and wonder as when I read the story in the bible. I love healing. I love to be a part of it.
I hope Medicine heals.
I hope everyone heals.
It's worth the effort to get it right.
We are almost there.
Thank you for listening.
I have to get ready for work.
Please note I only coughed twice in the hour while writing this. My respiratory rate is totally normal too.
Please also note that Ross asked me to write this.
Aloha and Mahalos,
Ross and Carla
Part of your Family of Heaven
Ross sends this video and our countdown is only seventeen!