Saturday, November 17, 2012

A Fortuitous Fracture In Time

     Browsing through Facebook this morning, I came across an e-card that several of my compadres in healthcare simultaneously posted. It features a surgeon, holding a scalpel, and reads: "I work long hours. I wear bodily fluids that aren't mine. I work weekends & holidays. I get screamed at & have my hands in other peoples' orifices. Tell me again how hard you work?" Aware that I was breathing a sigh of relief, I grabbed my second cup of coffee. The realization had just hit me...I've spent the last 27 years providing patient care in various capacities as a tech, nurse, and physician, and this is the first year I won't be barricaded inside a hospital for Thanksgiving, Christmas, or New Year's. As long as I've been working, I've worked nights, weekends, and holidays, while everyone else important to me got to enjoy being at home and sleeping in their own beds. No one wants to be on call. No one enjoys call. Therefore, I feel no shame in admitting that I've hated every minute of it, especially anesthesia call, where you're always someone else's bitch.
     One year ago, I was recovering from what I then considered the catastrophic loss of my job. On November 2, 2011, just five days before my 49th birthday, my boss, a physician-attorney, nonchalantly informed me by telephone that I had to leave our practice because A) a surgeon had complained I was too rigid, and B) the overpaid CEO of The Miracle Center* didn't approve of a humorous Facebook post I'd written about the computerized medical record software the hospital had recently adopted. Why and how Kurt Stinkypants** was alerted to my Facebook page remains a mystery. Although I was never privy to the identity of that whiny surgeon, my best guess is that it involved a cancelectomy*** of some sort. In fact, I'm relatively certain it was the same general surgeon who wanted me to put a non-toxic appearing two year old boy to sleep for incision and drainage of a thigh abscess, even though the boy had a stomach full of chicken biscuit and didn't require emergent surgery. He didn't want to postpone the case until later in the evening, so he cancelled it, and then went crying to administration. Waaaaaaaaah! 
     Although I'd just been disposed of like a used nitrile glove, I was expected to continue working for the next 90 days, until a more suitable replacement could be found. I agreed to this under one condition: that I would no longer take any call. Right after hanging up, I sent my boss, who quelle surprise! was out of town, the following email:
     Just to clarify, my understanding is that the administration is upset with me over a FB post regarding Cerner, and that some of the surgeons think I am rigid, and that is why I am being asked to leave the practice. This essentially equates to a hostile work environment, and obviously, I have grave concerns about continuing to provide services there. I will be willing to work the remaining 90 days, provided I do not take any call, effective today. I think it is shocking and wrong that a benign FB post about an electronic medical record, which is not unique to this hospital, leads to me being asked to leave without an opportunity to defend myself.
     I checked and re-checked my e-mail and cell phone a zillion times that evening, but never received a response. My next scheduled 24 hours of call was Saturday, November 5th, and as far as I was concerned, Boss Man was looking at some major restructuring of on-call responsibilities because I was DONE! I don't know how I did it, but I went into work the next morning. I was still in shock. Everything felt mechanical, a slow motion masquerade of once-familiar faces and surroundings, suddenly distanced by a fortuitous fracture in time, the discontinuity of which threatened to vaporize every last shred of dignity I possessed. Somehow, I made it through that day. I told a few co-workers about what had happened, and it wasn't long before word got out that, come January, I'd be leaving Rome. I spent the remainder of that afternoon and evening, crying inconsolably and freaking out. What was I going to do? At my insistence, Spartacus had just quit his job, and in three months, I would be unemployed as well. Rome was a small town, saturated with anesthesiologists, and unless I wanted to commute like I did when we were still living in Atlanta, we were going to have to move again. 
     On November 4th, I finally received this e-mailed response from my boss:
           I cannot permit this. You are obligated to cover your call as scheduled. You cannot simply announce to your colleagues that you’re not going to take your call and lay the burden at their doorstep. The consequences of this action will be dire! 
     Long story short, I immediately plunged into a mercifully brief, albeit suicidal, depression. I showed up for my 24 hours of call the next morning, and I've gotta say, there's nothing quite like Saturday anesthesia call at the Miracle Center to make you seriously consider jumping off a bridge. It's like picnicking in hell. My emotions were all over the place, vacillating between rage, humiliation, and utter despair. I couldn't stop crying. I was literally running on fumes from the few hours of crappy sleep I'd managed to snag, courtesy of my last remaining 10 mg Ambien tablet, which I'd desperately rationed into four nearly inert fragments. I've never been that distraught before, and it scared me. I think it scared my partner, Steve, too. Because my boss had called all the partners in our practice, telling them I was refusing to take call, Steve had taken it upon himself to cover for me in case I decided not to come in to work. Someone had to take care of the patients. He took one look at me, and my anguished hysteria, and told me to go home. On November 11, I formally resigned.
     My last call was Thanksgiving weekend, the oh-so-delightful Friday/Sunday combo. As you might imagine, it was a suckfest, but by then, I'd at least gotten through the worst of my depression, my anger having begun its dissolution into a resolve so transformative and compelling that life hasn't been the same since. It finally dawned on me that I wasn't trapped. For years, Allen, my dear friend and former  colleague had patiently listened to me complain about feeling trapped, like a caged bird, both personally and professionally. Even though I wasn't happy, I'd convinced myself that I couldn't be happy anywhere else, that I was stuck. "Sweetheart," he'd say reassuringly in his refined South Carolina drawl, "you are never trapped. You can do whatever you want to do! You just have to believe it." 
     I'm not sure why it took me so long to grasp the importance of Allen's message that indeed, I was indomitable. Better late than never, I suppose. In my case, it took a life-altering event for his wisdom to crystallize into awareness. As I walked out of The Miracle Center on that chilly November Monday morning after completing my last call ever, two things occurred to me: I wasn't trapped, and perhaps even more importantly, I've always been free. 
The Reverend Dr. Allen N. Gustin, Jr. (left), who became ordained just to marry me and Spartacus!  This photo was  taken moments before our wedding on October 24, 2009. 


*facility name changed
**CEO's name slightly modified
***cancelectomy: when a surgical case is cancelled for various reasons, not the least of which is concern for patient safety

24 comments:

  1. It's like a person at the top of a hill looking across the valley to a high mountain. In order to reach the mountain peak, they must first descend down into the valley. The only way up is down sometimes and it is not until we have reached the bottom that we can begin to climb. Apologies for going all motivational speaker on you ;).

    I've heard that many employers like to track their employees FB so that they can see what type of people they are and what they are doing. One employee got sacked for making a comment about gays on his FB account but won his appeal against his employer this week. Loved the photo, you look so relaxed and happy.

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    1. RPD, I think it's a violation of free speech for employers to use anything on FB to discipline employees, a real invasion of privacy. I like your mountain-valley analogy...I think the important thing is the journey itself, the going there vs. the getting there. Sometimes, it takes hitting bottom to gather yourself together and get back up. Re: the photo, yes, it was such a happy, fun wedding day! Allen wrote a wonderful ceremony for us.

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  2. pretty good post :D
    and I agree that a doctor's job is the toughest one. An old joke -
    A car mechanic was fixing a doctor's car, he said "So, Doc, look at this engine. I open its heart, take valves out,
    fix 'em, put 'em back in, and when I finish, it works just like new. So how come
    I get such a small salary and you get the really big bucks,
    when you and I are doing basically the same work?"

    The surgeon paused, smiled, leaned over, and whispered to the mechanic, "Try doing it with the engine running."
    ;)

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    1. Sudarshan,
      I love this joke...am gonna steal it!

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  3. It pains me to think back on those happenings, however I am so proud of you for being a survivor! And cheers to your freedom, now and forever...

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    1. Emily, it seems like ages ago, doesn't it? My life has really taken a 180 since then. It was wonderful working with you in the outpatient center...I felt so supported by everyone there. It was nice to be away from the main OR.

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  4. That's awesome, thanks for the message of empowerment.

    I admit I did stumble and reread the following line a few times, but once I was able to move on, I was delighted. :)

    "I get screamed at & have my hands in other peoples' orifices."

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    1. That line really makes you stop and give pause, doesn't it? Unfortunately, it's true, and even worse, the being screamed at usually occurs while you have your hands in other peoples' orifices!

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  5. A painful story to tell. I wonder if it felt therapeutic writing about it. I discussed today in the BC discussion on random acts of kindness how I was fired recently under unjust circumstances. I don't know if it was therapeutic because I still want to strangle the bastards. Why can't everyone just be kind? That's life I guess, but I really empathize with your story and feel your sense of loss and betrayal. The betrayal for me is the worst part and the hardest to forgive. You are courageous, and they are assholes.

    First do no harm, right?

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    1. Darin,
      I need to check out your discussion. I'm sorry to hear about you losing your job; that just sucks. It took me awhile to get over the anger. I was able to resign, so my CV remains "unblemished," but it doesn't change the way things went down with that job. The sense of betrayal is the most difficult to forgive and overcome, but you will get there. Best of luck to you!

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  6. This was a great post. You always have great posts. It is good you know you are free to come and go as you please, many people aren't given the opportunity to feel the same way. I can relate, however on a way different scheme of things, to the being on call 24/7. I did it for 12 years in the Air Force. It made it hard, at best, to ever make plans. I always felt as if my life wasn't moving yet watched my families move by fast. It is one part of the military I do not miss.

    It sounds like you have good people in your midst, something one should always cherish.

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    1. IM,
      Since this incident, I've structured my life to decrease stress, and that meant eliminating any positions which require me to take call. I've always hated it. Being a good doctor doesn't necessarily involve doing something I hate (e.g. taking call)...I felt I had to be an advocate for myself in that regard. I am much happier making a lot less money...the trade off is having my life back.

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  7. Whew! I'm so glad you came out of that painful experience with such a profound, positive message. And have a WONDERFUL Thanksgiving with your family and friends. You have certainly earned it!

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    1. Janene,
      Happy Thanksgiving to you and yours as well. It's been a year of incredible insights and changes for me; good cause for celebration!

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  8. Great article. In the end, I've known a few people in health care, and have known for a very long time, that its probably one of the most mentally unhealthy things you can do. It bleeds into everything, and it can completely overwhelm your life. I'm always amazed at how retired nurses are some of the craziest, yet joyful people in the world. Somewhere along the way, they learn that life is to be enjoyed, and not to let anyone else drag you down.

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  9. How messed up, Helena, that they would fire you so abruptly, not to mention by phone! No due process...that's not right. No wonder you fell apart.

    Due to circumstances I won't cite here, I am stuck in my job. My options are incredibly limited. I hate it.

    Thanks for another great post!

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    1. Believe me, June, I totally understand your situation. Don't forget about your option to be a fabulous author!

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  10. Losing a caring professional over a "benign facebook post" is a symptom of a serious problem. Well maybe a few problems...privacy.... not putting the patient first. As a Mom, I cringe at how they wished to proceed with the 2 year old. I'm sorry you went through this but am happy you are no longer in this toxic environment.. And that you have so much to be thankful for this holiday!

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    1. Gina, It's clear to me that it wasn't about the FB post or the surgeon; my ideals regarding medicine (first, do no harm) differed vastly from that of the administration's (profit before patient care), and I certainly didn't keep my values on the down low. It was a good learning experience, and yes, I am thankful to be where I am today.

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  11. Kris, you're one of the most dynamic and free-spirited people I know. So whatever came before in your life was just preparation for the joy and fulfillment you feel today. We are never trapped; we are always free; but sometimes it takes a little push from fate to help us realize it.

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    1. Thanks, NP. Realizing that I wasn't ever trapped and that I've always been free was incredibly liberating. I haven't been quite the same since.

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  12. Congratulations on your well-deserved freedom! I know that you and your family will enjoy this holiday season. Sending you wishes for a happy Thanksgiving from Wyoming. :)

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  13. great post kris! glad you are freed from it and will always be free.
    i forgot to mention, the biggest trap in my life had been my career. it made my life in this country so difficult, more than i could imagine when i was in china. i wanted to change my career, but immigrating to this country, almost every step i made had to be accomplished by art, which means without doing what i hated, i could not survive!
    well, i freed myself by negotiating, accepting my fate, doing thing once i thought i would never do. i think, like you, since then i have always been free.

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  14. Kris, what happened with Stinkypants (that name made me laugh out loud!) and the whiny doctor was wrong (especially wrong to dismiss you in a phone call), but “a fortuitous fracture in time,” indeed. Leaving that place really seems to have opened up new avenues for you, and given you joyful freedom. Thankfully, this Thanksgiving, you did not have call. What a difference a year has made for you! Trapped like a caged bird, it’s a feeling I can personally relate to all too well. I like your friend Allen’s advice. Beautiful photo from your wedding day and a belated happy anniversary!

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