|My first day of doctorhood|
As a medical student, surgical intern, and anesthesiology resident, I ate, slept, and breathed medicine, and every one of those rites of passage came topped with the cherry of long-awaited and hard-fought-for success, the kind where you're supposed to say to yourself afterwards, "Looks like I've made it." When I graduated from medical school, I must've written "Kristyna Mazur Landt, MD" a zillion times, practicing my signature which now resembles the Loch Ness Monster. I was the first person from Mercer University School of Medicine to be accepted into Emory's general surgery program, and it was kind of a big deal. You don't get to pick where you go for residency; you're matched through a national lottery.
Emory had been my first choice for surgery residency. Vanderbilt was second. No one, not even your academic advisors or the programs themselves, has any idea where you'll end up. That's what makes Match Day so exciting or disappointing, depending upon how you were ranked by each program. On the morning of Match Day, you sit with your classmates in an auditorium, waiting for your name to be announced. When your name is called, you walk up to the podium where you receive a sealed envelope. At least, that's how it happened at Mercer. Anyway, I could hardly believe it when I opened mine and saw "Emory." To congratulate me on that accomplishment, the chairman of Mercer's Department of Surgery gave me his first edition copy of "The Papers of Alfred Blalock." I was on Cloud Nine. Well, that is until July 1st actually rolled around.
|My surgery internship class|
Internship was a rude awakening into the organized slave labor trade known as residency. My intern year occurred a year or two before the legislation mandating an 80-hour limit on resident work hours was passed; there were plenty of weeks where I worked 100-120 hours. Think about that for a moment. There are 168 hours in a week, and if you're working 100 of them, you're left with approximately 9.7 hours per day for your remaining activities of daily living, at least six to eight of which ideally should include sleep. Based on those working conditions, my house physician salary of $32,000 averaged out to about a dollar above minimum wage. Economically speaking, my college degree and four years of medical school didn't amount to jack squat.
I switched from surgery to anesthesiology after my intern year, and it was a very wise decision. There's a mindset among surgeons that there's operating, and then there's everything else. At the young old age of 39-about-to-turn-40, I knew I couldn't commit to that lifestyle. I missed my kids terribly. I missed being at home. I didn't want to miss out on any more of our lives together. Faye, a friend of mine who'd gone through three years of surgery residency before switching to anesthesia, convinced me to consider changing paths. At that point, I was less than six months into my year of internship.
|My very special set of skills? Test-taking!|
Test-wise, I could have easily had surgery in the bag. Even as an intern, I passed the mock board exam that we all had to take each year, and was one of ten from a residency of about 75 to earn $200 in book money. That meant there were chief residents who didn't pass. I was so disillusioned, though, and I don't think my misgivings were strictly a by-product of sleep deprivation. I was actually thinking about dropping out of medicine altogether, maybe getting a research position of some sort, but seeing as how I'd never done any research, that was a long shot. I felt stuck. It was while I was on my super-sucky Grady Hospital emergency room rotation in January of 2002 that I ran into Faye. Seeing her so relaxed and happy was kismet. Thank goodness my program director, Dr. Dodson, was so supportive of me. Not only did he go out of his way to secure me a spot in Emory's anesthesiology program for the following year, he never criticized me for my decision to leave surgery. When our mock board score letters were released, he'd inscribed an addendum: "You will do well in anesthesiology, and they will be lucky to have you."
For me, the study of anesthesiology was much more difficult than that of surgery. Being an anesthesiologist means you have to have a solid grasp on internal medicine, cardiology, pediatrics, obstetrics, pharmacology, as well as the intricacies of airway anatomy and the complexities of cardiac, respiratory, neurologic, endocrine, renal, and maternal physiology. As if that's not challenging enough, you have to be able to integrate all of that knowledge to formulate a safe anesthetic plan for your patient in ten minutes or less.
|Emory Anesthesiology Class of 2005|
My three years of anesthesia residency weren't exactly a piece a cake. Eight months into my first clinical year, my father died suddenly. That catapulted me into a serious depression, and I ended up having to take an antidepressant just to be able to function. I went back to work only a week after he died, and spent every private moment I had, crying in the call room and trying to remember the sound of his voice. To make matters worse, not all of my attendings were aware of the situation, and some of them gave me a really hard time about being spaced out. I did everything I could to keep it together, but by that point, my marriage was falling apart. Being at home wasn't a refuge; it was a battleground.
|Ahmet in 2003|
The last eight years of my life as an anesthesiologist have been a push-pull affair. As hard as I've tried to push away from my identity as a physician, I keep getting pulled back into it, whether I like it or not. There is just no escaping that part of who I am. For some time now, I've rejected Dr. Me, as if it were some sort of embarrassment, an albatross that I've tried my best to ignore. But, I'm realizing that it's really our collective workaholic "I'm a physician, therefore I exist" identity I abhor, not mine individually. I am a physician, but it's not who I am. It doesn't define me.
I've never been one to float the mainstream. Why would my brand of doctoring be any different? Four years of medical school, four years of residency, and eight years of being an attending anesthesiologist have reinforced my suspicions that there's wisdom in being lazy, that committing to my own personal happiness and freedom, as opposed to revolving my entire life around medicine, is what's prevented me from becoming a burned out and cynical physician. Working part-time is pretty amazing. It's like having the best of both worlds. I enjoy practicing anesthesia again, instead of dreading what each day has in store. Long gone are the days of eating, sleeping, and breathing medicine; now, I'm channeling Hippocrates. It comes naturally. Intuitively. And, I do love it. Doctor, there's everything else, and then there's medicine.
About my friend, Ahmet: Ahmet, Interrupted
Self-explanatory: The Day I (Almost) Got Fired From Residency
A funny story from anesthesia residency: Boo
Why I hated my emergency room rotation: Asthma and Detention
A taste of what it's like to be a surgical intern: A Special Kind of Bedlam
The social aspects of cadaver lab: Elegance and Horror