Residency Part 2…

———– Work vs Learning ————-

During one of my interviews for residency one of my interviewers said something very poignant to me that I always am reminded of when I think of residency.  This was a Program Director of an Emergency Medicine program who said to me, “Chris, residency is a balance between learning and work.  There are some places where the residents are put to too much work, and their learning takes a hit.  There are also some programs, where learning is over-emphasized and they do not get enough work.”  Most residents feel over worked[1] even though most interventions in the past several years has been put in place to protect against this notion of overworking residents.  Hence the job of finding this delicate balance between work and learning becomes the responsibility of the program.

Funny cartoon summarizing residency
Funny cartoon summarizing residency

 

—— The Tumor and the Program ——

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I remember it vividly, it was a Wednesday morning and I was scheduled for clinic that day. I finally decided to pay a visit to my Family Physician to tell him of my double vision. I remember that I had volunteered to help teach the MSU medical students that afternoon. Upon being told of my MRI and appointment with Dr. Kaufman, I quickly left the clinic, only telling my supervising physician that an emergency had arisen and that I had to leave. I left in such a rush that I left both my hat and gloves on my desk. With questions swirling and rumors flying surrounding my absence, I emailed the program to clear the air. The email was as follows:

Dear Friends,

As some of you may know by now, I am having to take an unexpected leave of absence due to medical reasons. I consider you all my family and would like each of you to know what is going on. The last 3 days have been a bit of a whirlwind between testing and seeing specialists etc that I haven’t had a chance to tell everyone individually. But you are all like family to Fleur and I, so we want to let you know what is going on: Starting this past week I have had disturbing symptoms of progressive double vision. I finally told my PCP (Dr. Pearson) on Wednesday who without hesitation sent me for an emergent neuro consult w/ Dr Kaufman. An MRI of brain/brainstem was done that day which showed a brain mass in the cerebellar region/posterior fossa. Dr Kaufman quickly referred me to Dr. Smith the neurosurgeon. We also saw a neurosurgeon at U of M today who recommended expeditious surgery. Our understanding thus far, is that the lesion is likely benign (epidermoid cyst vs subependymoma), but will have to wait for the pathology to rule out malignancy (ependymoma). I am currently scheduled for a craniotomy w/ resection this coming Thursday. The recovery is expected to be somewhat slow, with initial stay in the ICU, and hopeful discharge within 5 days, however the surgeon indicated it could take 4-6 weeks until I could consider returning to work. I know this is a challenge from a scheduling perspective and greatly appreciate everyone’s understanding for his. Fleur and I are especially grateful to Megha and Greg for dealing with all the last minute schedule changes this has caused and to all those who have offered to do upcoming calls and inpatient coverage for us. Fleur has been incredible throughout this whole ordeal, but my only fear is that this is distressing her more than she is letting on- my only plea to you all is that if you are in contact with her and notice that she is not handling this as well as she lets on to me that you let me know or someone know. The outpouring of support from everyone has been amazing, I have long considered you all my family and going through this experience has only solidified this belief. I will keep you up to date on the latest.

Chris[2]

Everyone in the program emailed me back with their support. Even though part of the reason for the e-mail was to quell any false rumors regarding my absence, I meant every word in that e-mail. I considered everyone in the Sparrow FM residency program to be part of my family—I had grown close to each and everyone in the program and wanted them to know of my situation.

It has now been almost 15 months since that day, and I am still yet to return. I know that while this process has been tough for me and my family, it also has been hard on the program, not only dealing with technical issues such as replacing my calls and covering for my patients but also in having to handle a missing team member.

 

[1] In fact check out this great, brief article on work hours: http://www.npr.org/blogs/health/2012/12/04/166477987/medical-residents-work-long-hours-despite-rules

[2] You’ll notice in the e-mail I predicted a return to work in 4-6 weeks. Did I mention I’m always too optimistic when it comes to my recovery?

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