Four Kids and a Funeral

Today was my grandmothers funeral and my children's first experience. I have to say everything went so much better than I imagined.

A few years ago I lost a grandfather while out of state for residency, and just getting to the funeral proved dramatic. In fact, it is the first and only argument of significance I remember having with my husband. It was ugly. But I traveled alone and the children were none the wiser.

This time, I traveled only a few hours and did so with just my children. I suppose that is just another one of the sacrifices we make when your husband takes 5 days off at Christmas time, you must return to work. And when you partner is on vacation, it is what it is, no arguments. So me, four kids, road trip and funeral.

I think the worst part might have been getting the kids up and dressed before daylight by myself. I am not a morning person and typically do not sleep with an alarm. If I know I have to be up early I do not sleep well. I value my sleep and therefore refuse to wake before my body says I must. While that makes me happy and proves successful 99.9% of the time, those rare occasions that require early rising are anxiety inducing. But we got up, were dressed, and even arrived on time. It was miraculous. And my kids though the funeral was "awesome", and that is a direct quote.

Kids aren't scared of death. They don't mind talking about it. They don't treat the words "dead" or "death" as a bad thing, they are just words. Maybe they know something more about the process of living and dying than we give them credit for. To them it made perfect sense that Grandma was born, lived, died and we will see her again.

On our ride we talked about what would happen at the service, and what they might see, where we would go for the burial and lowering of the casket, and what that means. They were great with all of it, but what they will probably remember is getting to see all of their cousins and meeting cousins they never knew existed.

Funerals for our family seem to be one big reunion and during the eulogy I thought to myself that we were involved in a very special reunion. One her on earth with her living friends and relatives and another reunion was happening with my grandmother, her husband, her daughter, her parents, and all of her friends and family who have gone on before. It was a beautiful image and one that I believe with all of my heart. Pure joy.

What a life she had, and I wish I would have known her better. Because she was ill for most of my life the context in which I know her is one of pain and suffering. Today I learned so much more about her and hope to continue to learn more about her life. What a source of strength our families can be if we really know them, even if it comes after their passing or generations after they have lived.

Life is amazing. The whole process from beginning to end. Even the ordinary and uneventful life holds truth, treasures, and miracles. In reality there is no ordinary life - every life is amazing.

A Baby Was Born...

Christmas. We have been thinking about it all month. Some days I have thought of the coming holiday with less than celebratory feelings. But something happened yesterday that made me think a little differently about it all. Life is an amazing gift and Christmas is a celebration of life!

A baby was born in a stable over 2,000 years ago and changed the world. And on the very day that we celebrate His birth, in the middle of the afternoon, a woman died. My grandmother. In her own way she changed the world too.

My Grandmother had six children. One passed away when only 3 years old. The other 5 are all living and collectively have 27 children. Those grandchildren have given her 52 great grandchildren. What a debt of gratitude I have for my very life to her. Families are amazing even when they don't function like we think they should.

My grandmother has been in poor health for as long as I can remember. The kind of failing health that leaves a person confined and immobile. It has been that way for decades. I was a small children when I remember her walking on her own. Her husband passed away almost 20 years ago from a debilitating illness. I don't know how she was able to go on for so long in her condition. It is really astonishing.

I have often wondered why God allowed her to live so long in such a state. The conclusion I have arrived at is maybe it had less to do with her and more with us. During the time that she has been ill she has lived with each of her children relying on them for her care and maintenance for varying periods of time.  Eventually, that arrangement became insufficient and she required professional care in a managed environment. I know that decision was difficult for her children and for her. She must have known what that would mean. Her mental faculties were intact up until the last month or two.

I am ashamed that I didn't see her more often, but am so glad that during the last few months I was able to visit her at least once a month. The last time just days before her passing. I think that is the closest that I have ever been to seeing death. I am so grateful for the kind and patient people who work with those that don't have much time left on earth. They do a remarkable work and are angels in my eyes.

A baby was born in a stable, and because of His life and death I know that my grandmother will live again. I know that her struggles on earth weren't cruel or in vain, they were lessons. Lessons for her and for me. I know that with God we can endure and accomplish anything. I know that life can be difficult, and seem unfair but that is only a matter of perception. I know that we are never alone even when we are in solitude. Death is not the end.

There is a hymn we sing at church called "Each Life That Touches Ours For Good". I can't help but think about the vast influence each of us have during our lifetime. You never know who will cross your path, or what seeming insignificant event will mean to another person. We are all tied up together in a pretty (and complicated) bow. We each have a purpose and contribution to make. 

This next year I hope to live with more purpose in honor of my grandmother.

'Tis the Season to be....

'Tis the season to be busy. It seems that everyone is busy around the holidays. The stores are packed, and the restaurants are too. The roads are crowded and the lines are long. Nobody is home, and no one is blogging. Things need to be bought, made, wrapped or baked. It's that time of year. There is just too much to do and never enough time to do it.

Just another example of what happens when you don't plan and execute the plan:-)

Each year I tell myself that I am going to have all the shopping completed by Thanksgiving.

Each year I tell myself that I will schedule a family picture in September, print the cards in October, then address and mail cards in November.

Each year I tell myself that I will make some fantastic gift for my family, and usually end up not sleeping for the week before Christmas to finish it because I started late. I actually thought I had enough time, I always do.

Each year I promise to think of a Christmas list I can share when the question is asked. What do you buy the woman who doesn't want anything that can be purchased at a store or wrapped under the tree? How can you box "silence", "sleep", "getting along", "naps", or "potty training"?

I am actually torn over Christmas lists. I like getting what I want, but I also like being surprised by what people think I might want. It is possible to miss out on many wonderful gifts when you tell the giver what it is that you want.

For example, my mother in law recently told me that one of the best gifts that she uses all of the time is a pair of pot holders that I crocheted during the super-lean years. We didn't dare ask people what they wanted because we knew very well that we wouldn't be able to get them what was on their list. But who would have thought to ask for crocheted pot holders? If I didn't give what I thought they could use and what I was able to make my mother in law would have been denied her favorite pot holders. They really are amazing. In fact, I may need to learn that pattern again because I never made a pair for myself. That year we gave them all away.

Now there isn't much that I want. So this year I am telling whoever asks to surprise me. There really are so few surprised left that I want to enjoy them when they come.

But if anyone needs a little help here are three suggestions:-) Babysitting! Babysitting! Babysitting!

Before things get to crazy, don't forget Medical Monday's is coming up again January 6, 2014!  It will be a New Year and a new guest co-host. By January we will all be feeling more like ourselves, maybe even better.

The Holiday Anxiety Edition

I don't think I am the only one who has conflicting feelings about the holidays. They are wonderful one minute and the next they aren't.

Over the years I've come to realize that I have issues with my family members around the holidays. It just happens. I don't know why. I don't know how. I just know they exist. And even though I  have been trying to identify their source for some time, I have been unsuccessful. I thought that maybe being near family for the holidays would help soften the angst, but it has actually compounded it. Who was I trying to kid? There are so many people to see. So many people who will be upset if we don't see them. So little time. So many people to disappoint. So many expectations set to high - mostly by me.

Holidays create pressure. Let me rephrase that: I create pressure around the holidays, the holiday itself is totally innocent and shouldn't be blamed. I do it to myself. Pressure to purchase gifts the recipients like. Pressure to attend parties. Pressure to send cards (too late). Pressure to decorate (haven't started). Pressure to buy, buy, buy. Pressure to be everything to everyone. And of course the pressure to get it all done in time. It's not going to happen.

One of the areas that I create unrealistic expectations around is my family Christmas party. In the past I was also disappointed that we couldn't be there, and now that we can I'm thinking I'd like to be somewhere else. But I would never really do that. And I suppose it is only fair that since I have missed the last 7 Family Christmas Parties that I should be put in charge of it this year. That is fine by me because I like being in charge. But, that also means being in a position where inevitably people are going to be disappointed with something. And there will be many things to choose from. In fact, the party is still two weeks away and I am already feeling the disappointment or irritation.

Some will be upset that I discontinued the gift exchange.
Some will be upset with the menu.
Some will be upset over the photographer selection for a family picture.
Some will be upset that we are even taking a picture.
Some will be upset over the date and time.

I am quite happy with all of the choices - that's what happens when you are in charge. Maybe that is the lesson - when it is your turn to make the decisions do it however you want and don't complain when it's not your turn. Just show up and put a smile on your face and have a good time and hope no one complains when it is your turn.

Having a family, especially a large one, means making a lot of compromises. Some people are better at compromising than others. But the truth remains that you can't please everyone. And an even larger truth is some people refuse to be pleased no matter what you do.

I recently read a blog post that suggested we all have "scripts" that we write for the holidays and that the people in our lives play the part we give them. Like my sister whose husband is never happy with anything we do even though it was his idea last year. There probably is some truth to the script I have written for the holidays, and I am trying to re-write it and give room for something different to play out.

So how do you handle the stress that comes with extended family at the holidays?

You've Got A Friend

I know most of the Thankful posts were written in November, and rightfully so. But I am joining the trend late and celebrating Thanksgiving in December. This months always seems to bring about a lot of personal reflection and this year I am particularly thankful for a husband who is a "helper". He helps so many people in so many ways. The most obvious is his patients, but I'm not writing about them. I am writing about the people outside of the hospital.

This past year I have had a friend with a brain tumor, another with major back surgery and a cousin with adult onset seizures. All people I love and people that needed some reassurance and someone to ask the questions they forgot to ask their doctor.

The first was my friend that I meet during residency at the gym of all places. We were in the same Zumba class when I used to shake my tail feathers. We would dance, and laugh, and because we weren't done talking would go and walk on the treadmill until one of us HAD to leave. She was always so happy and just cheerful perpetually. No wonder I liked being around her.

She was pregnant and had her baby just after we left residency. Shortly thereafter, she developed a fast growing tumor that was causing problems with vision, tactile sensations, and memory loss.  Her baby was only a few months old. The tumor needed to be removed and she was terrified. Her husband called and wanted to talk about the surgeons in the area who could perform it, and what the success rates would likely be. Because my husband knew the surgeons in the area he was able to get them to the best one for her type of tumor. He was able to look at her MRI and explain things in a way our friends understood, outside of a hospital setting. Because of his relationship with the hospital he was able to talk with the surgeon after surgery and look at the final MRI's. Our friends needed to hear things from someone they knew and trusted. Our friends needed reassurance that everything was going to be alright and coming from a friend they believed it. She has made a full recovery.

Since then there have been others, big and small who have needed some reassurance from someone that they know (or at least knows me - who does a doctor really know). I've always said I hope to never need the services that my husband provide, but I am so thankfully he is able to provide this service to my friends and family and that I get to be the link that connects them.

As I thought about this over the week, I realized that everyone should have a friend who is a doctor (or spouse of one). Unless they are going to be "that" kind of friend, you know the ones.

Medical Monday's In December

Hello December! I hate to break the news to you, but Christmas is going to be here in 3 weeks and 2 days. Did you get your holiday shopping done? I see why people gradually shop throughout the year, if you wait until Thanksgiving you've waited too long. It happens every year.

Before the holidays are gone let me say how thankful I am for people like you who understand and recognize the sacrifices that medical families make in every stage. Where else would anyone understand this? Thank you for coming. Thank you for sharing. Thank you for supporting those who participate in this blog hop. Thank you for being you. Let's get started!

Are you confused if you qualify for the party?

If you have a pager interrupting your life... you DEFINITELY qualify!

Do you work in healthcare?

Doctor? Nurse? EMT? Chiropractor? Vet? Dentist? Therapist?

MA? NA? PA? DA?

Are you the spouse or SO of a healthcare worker/student?

Are you a nursing student? Medical student?

Intern? Resident? Fellow?

You get the picture, right? Come on, now... don't be shy! Let's keep growing and meeting new bloggers, so we can build a community of support and friendship, learn from one another, and share our stories.

LINK UP YOUR POST!

Here are the rules:

1. Follow your co-hosts via Bloglovin, GFC (if you are Blogger), FB, email or Twitter.
2. Link up you medical/med life blog. If your blog name does not clearly state how you fit in to the med/med life world, please write a little intro or link up a specific post which clearly demonstrates your connection.
3. Visit at least 3 other link ups, comment, introduce yourself, and tell the your stopping by or following from MM!
4. Help spread the word by using our button on your post or sidebar, tweet about Medical Monday, or spread the word on Facebook! The more the merrier for all of us.

Complete step one by following your co-hosts:

• Emma at Your Doctor's Wife
• Jane at From A Doctor's Wife

Want to be awesome? Help us spread the word by grabbing and posting the Medical Monday button on your post or sidebar...

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Want to co-host next month? Shoot Emma an email at yourdoctorswife@gmail.com and be sure to write "Medical Monday Co-host Request" in the subject field.

Now, link up below and have fun! The link up is open through Friday, so be sure to come back during the week to check some great reads!

See You Monday

Ladies, it is that time of the month again.... Medical Mondays is on December 2nd and that happens to be just 2 days away now. Even less if you are one of those that wakes up early:-)

Thanksgiving was great. Who doesn't give thanks for good food, homemade pies, friends and family? Black Friday I ignore because I like bucking trends, but it turns out that not buying is now the trend this year so I was left in a bit of a pickle. Or were they just promoting not buying anything on Thanksgiving day? Either way I hate shopping when someone tells me I must shop. I shop on my own terms and preferably alone. There is no alone on Black Friday.

There are now 25 days left until Christmas, and that means I need to find some great gifts that actually get used, unlike the apple TV i purchased for my husband for our anniversary that is still wrapped in cellophane. Maybe I can re-gift it this year.

So that's the spill. This post is a pure plug for Medical Mondays coming to you in 36 hours. See you then!

Thankful I Wasn't the Main Character in a Horror Film

Just in time for Thanksgiving, I received a little wake up slap. You know the ones you get after feeling sorry for yourself for too long, or getting mired down in the details of you.

I received a call last week from a member of our congregation who was coordinating meals for a young woman who had recently miscarried her first child at 4 1/2 months. Heartbreaking. After the call, I tried to forgive myself for yelling at my four children who are healthy and conceived without difficulty or delay.

My husband was home (thankfully) so I set out to make my delivery. I was happy I was able to help someone in need. I was happy I was getting out of the house alone, even for just a few minutes. I was happy this call to serve meant my family would also have a good meal that night. I has so happy that I had an extra homemade pumpkin pie in my freezer that I could share with them. I was happy that I could think about someone else. I needed it.

The apartment complex I was going to was indeed complex with duplicate numbers, one set for East and another for West. I was turned around and lost. I had never been there before and decided that rather than call and ask for directions I would find it on my own. At this point I was only 15 minutes late from my delivery time.

I thought I was walking in the right direction. I saw a man approaching me with a black garbage bag. I have never been comfortable meeting men alone when it's dark. Too many bad movies with that plot. But I also remembered something I had read once about looking your attacker in the eyes and letting them know you aren't afraid. I decided to be pleasant and say hi and admitted that I was lost and if he knew where apartment 48E was. I was only trying to be pleasant... I didn't know what was going to happen after that. I thought for sure he would just say "hi", and "I don't know".

He said, he didn't know but that he had a map in his apartment.  Cue spooky music.

What was I supposed to do?

Not wanting to be that girl who is afraid of her own shadow I began to follow him back to his apartment. What was I doing?????

And then I had visions of what could possibly be in that black trash bag that he was just taking out. Was it pieces of the last girl who got lost in the complex.

I wasn't stupid enough to follow him into his apartment, but I stood outside a ways. It wasn't very far from where I was standing. He let me look at the map for a minute so I could get my directions right and I thanked him for his help.

He walked with me for a few yards until the turn off for the garbage drop off. And then I thought, he knows where I am going! What if he follows me?

What an easy scare I am. I know it is good to be vigilant, but it also feels good to trust people.

Thankfully, I didn't wind up the star of my own horror film. Thankfully, he wasn't a murderer tonight. Thankfully, I was able to help in a family in pain that I cannot fathom. Thankfully, I returned to my family safe and sound.

I hope you and your family enjoy a safe and Happy Thanksgiving this year. Don't forget to join us next Monday for the last Medical Monday of this year!

Here is Your Box, Climb Inside, Make Yourself Comfortable

One of the things that I find so frustrating in my life is that despite trying to live "outside of the box", my decisions seem to be putting me firmly inside the box. It's almost as if someone else has created the box, lead me to it, sold me on the benefits of living in the box, and then shut the lid on me all the while giggling that they caught another one.

But, I know that is a lie. I am the only one responsible for the box. There might be enough of us living in the box, that we think someone else created it - but it is ours alone. The choice then becomes will you make the most of living in the box, or will you try to escape? Escaping takes more courage than you think.

We weren't going to be those doctors. We weren't going to be the ones living at the cusp of their income. We weren't going to be the ones that make minimum payments on their student loans. We weren't going to be the ones that drive new cars. We weren't going to be the ones that had to work past retirement age. We weren't going to be the ones that still had a mortgage payments and student loan payments 15 years after starting practice. We weren't going to be the ones that .... fill in the blank.

There is a reality that I don't think I can impress upon upcoming doctors and their families enough, and it is this:

What you thought was waiting for you at the end of the rainbow, isn't what you think it is. 

The TRUTH is that your disposable income, the amount that you actually get to use for your day to day living and saving, isn't going to be as great as you thought it was and everything is more expensive than you imagined. Both are influenced largely by what part of the country you live in.

The TRUTH is that your husband, despite being his own boss, is still ultimately at the mercy of his patients and the hospital and their needs. He is a well-paid servant in a highly bureaucratized system. He carries a pager and jumps when they say jump.

The TRUTH is that you are not done sacrificing. Hard decisions still await you. Long hours and nights don't disappear. Loneliness may still be your friend.

The TRUTH is that your friends and family will still misunderstand your situation in terms of finances, time, and abilities. They will always think you have more of all three.

The TRUTH is income guarantees have expiration dates and so do contracts.

The TRUTH (especially for those of us on the 40 side) is that time isn't your friend. If you want to pay off your house before you retire you have 20 years, not 30. If you want to retire at a normal age you have 20 years to save, not 40.

These are hard facts to face. But they must be faced at some point. Sooner than later. Every one's variables are unique. Do you know yours?

My family has always joked that my mother was the original Debbie Downer. She can't help but interject something like "did you hear so and so passed away, so sad, bless her heart" in the middle of an otherwise pleasant conversation. I may have inherited some of that from her.

There are plenty of things that are great about being done and getting a paycheck this is commiserate with your husbands skills, talents, and education. This post in no way is meant to diminish that. Your situation is probably different, they all are. I guess that may be the point. Just because you know a doctor that ........ doesn't mean that it is going to work out that way for you.

If you are expecting magic, you may be disappointed.  Know what your priorities are. Know what you want today to look like and what you want your future to look like. Know what you have to work with. It's never to early to start making a plan.

Don't be disappointed, be prepared. That means having a trusted financial advisor who will tell you the TRUTH about what your unique situation for the present and future look like. The plain and simple truth. You might not want to hear it, but we all need more of it.

I understand the phrase "the truth hurts" much better now.

A Good Book Can Do That

Every now and then I begin a book casually and then find myself sucked into a black hole and missing for days. A good book can do that to a person. I should have known better. It was a perfect storm: dealing with difficult situations and a great book. It was as good as a vacation!

My latest gem is Malcolm Gladwell's David and Goliath: Underdogs, Misfits, and the Art of Battling Giants. I highly recommend it, otherwise I wouldn't admit to having been virtually kidnapped by his work. I am a fan of all his books: Outliers, Blink, Tipping Point, What the Dog Saw.... I have them all, and could read them again and again. One day I will when I finally unpack the boxes they have been living in. I miss seeing my books. If only I had a house to put them in. I have an eReader, but I rarely buy an electronic book because I like the feel of pages and seeing them lined up on shelves makes my heart flutter. I love going to the library, it feels like a piece of heaven.

One of the reasons I am excited about his writing is that he makes you think about things in a different way.  He tells you how you usually see things and then shows you how you may not be right all of the time. He challenges the way you think. His books are very humbling and at the same time empowering.

This particular book, David and Goliath, had so many sections that translated (in my mind) directly to medical training. And even one of the sections talked specifically about medicine and how challenging they way we think about situations can result in huge advances. Read the book!

My favorite concept was that of the inverted "U" curve. There is this sweet spot in just about every thing we do. We often think that if something is good for us than more of it is better. That isn't always the case. You can have too much of a good thing - and at some point that "thing" can actually begin to do harm.  Fascinating.

I apologize for my absence, you now know where I have been.

Along the same lines, thank you for your comments on my last mistake post. Whenever a post gets that many comments I know I have hit on something that people are thinking about and not many people are talking about.

Before I start another book (reading is one of the ways I cope with stress) I will make sure I follow up on that post. It's a new week - anything is possible!

Making Mistakes: Part 5

I wish you could see me right now. It's 8:30 am. I am in bed. My wrinkled pajamas and bed head clearly indicate I haven't traveled far in the few hours I have been awake. I got out of bed long enough to get the laptop out. The iPad is streaming a show next to me, and my 2 year old is watching a movie on my phone cuddled up to my side. I almost made a commercial for Apple with this image. All I need is a runny nose and cloudy weather outside and it would be justified. I think I am getting sick.

But I am stalling.

This is the mistake that really got the entire ball rolling on this series, and I don't know if I am ready to tackle it. Oh, I've been rolling it around in my head for months, but am I ready to make it public? In a way I already have long ago, under different circumstances, but here it is again.

Deep breath.

I hope you believe it when I say I do believe every situation is different and what may look like a mistake to one is exactly the right choice for another. It's up to each of us to decide what is right for us. I really do believe it. I hope you do to. Age and experience does that to a person. Lots of experience.

Now that all the appropriate disclosures have been made, read on.


Mistake #5: Buying a home.

There I said it. Before you disagree with me, keep reading. Buying a home is a mistake IF the timing is wrong. My history with housing has produced fairly strong feelings on the subject. Buying a house is always a big decisions, but now that we are at this junction in our lives it is huge. It's not something to rush into or take lightly.

What is the first thing that everybody wants the minute they graduate from school and move for residency, or pass from residency to the real-life? What you had before was real too, but you know what I mean.... that life that everyone told you was waiting around the corner and would be a shifting point in your experiences. Everybody wants a house. There isn't anything wrong with that. Or at least I hope there isn't. I have been carrying around a photograph of a house and floor plan that I saved from a magazine from the year 2007!

After fellowship we were completely unprepared to buy a house. Of course, we wanted one. By all accounts we deserved a house, and not just any regular house: we deserved a dream house. The word deserve drives me nuts. And we can certainly afford one. Can't we?

Yes our income skyrocketed, but most of the time you still need a down payment to buy a house. (Yes, there are some loan products available for doctors with zero down - but don't be fooled, there is always a catch, like higher interest). Unless you are going to buy a house identical to the one you lived in in residency - it is going to take time to get it together. More than a month. The more you put down the more favorable your rates, and the more leverage you have.

You may be wondering how this mistake is my mistake? Well I don't know if it is a mistake yet or not. We sort of bought a house - but that story is too long to tell today.

Here is a warning, given in love, from someone who was very, very recently there:

Nobody likes moving twice. So buying a house directly after residency/fellowship is tempting. Take your time. You have waited so long already, can you give it another 6 months?

Get a feel for your new city. Yes, you can research online but there is nothing that compares to being on the ground and getting a feel for a neighborhood. Listen to the sounds, watch the traffic. Notice the location of grocery stores and schools and power lines. It can't be replicated through online research.

Get a feel for your new income. There are going to be some shocks (taxes) and other expenses that you never dreamed of. You may not actually have as much to work with as you think you will. And even then you might be surprised to find out that what you have doesn't buy as much as what you thought it would. If you have deferred your student loans you will also be adjusting to that expense that wasn't previously a consideration. There is an adjustment period that will take place before you know what is really your disposable income to work with.

Do you plan on giving generously to worthy or unworthy causes? Do you plan on traveling extensively? Do you want to buy furniture one day? Will your children be attending private school? How do you image utilizing the money you earned?

If you buy a house before getting your other ducks in a row you will be working around a house, possibly at the expense of your retirement future, and the lifestyle you want for the present. If you put your plans for the future in place first you can confidently plan for a house that works for you not against you. 

Banks are eager for the business of a new doctor. They will always lend you more money than you need. They aren't interested in whether or not you are able to save 20% of your income after the house payment is made... they just want you to make the house payments. They don't work for you, they work for the bank. What's good for the bank may not be what is good for you.

Suggestions:

Retain the services of a financial planner that you trust and who understands the unique circumstances of your profession several months before you start the "job". 

Most of us are starting careers at least a decade, or more, after our counterparts in other professions. The majority of us have no speakable assets and an abundance of liabilities. The hole is really deep and we are significantly behind the curve. Not to mention we have a limited window of earning opportunity for savings before desired retirement.

Do not trust the bank who is lending you the money to tell you how much you can afford. You need a third party who knows your spending/saving goals to help set a realistic budget for a home.

Only a professional can help you make sense of what this means for you. You have stepped into a new world and need help. You DO need help. This is not the time to do it yourself.


P.S. Yes, I will write about our potential house experience soon.

Medical Monday's In November

My goodness, it is time for Thanksgiving, and I haven't even finished all my Halloween candy yet! Somebody please explain how the year can be winding down so quickly. I am amazed, and terrified, and of course grateful. 

Recently, I have been reminiscing on mistakes I have made this past year. I am thankful that I have mistakes to make and that the ones I do make aren't the end of the world. When all is said and done, life is really good. I mean how could it not be - the training years are over! They weren't really as bad as you think they might have been or are. We have so much to be grateful for.

And I am grateful for you. Thank you for coming each month and sharing posts with us. Let's get started!

******Insert your post or intro here*******

Are you confused if you qualify for the party?


If you have a pager interrupting your life... you DEFINITELY qualify!
Do you work in healthcare?

Doctor? Nurse? EMT? Chiropractor? Vet? Dentist? Therapist?

MA? NA? PA? DA?

Are you the spouse or SO of a healthcare worker/student?

Are you a nursing student? Medical student?

Intern? Resident? Fellow?

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Making Mistakes: Part 4

Just when I think I am nearly running out of mistakes I make new ones! But that is all part of the improvement phase of life which I am understanding to mean the improvement phase of your entire life.  I really only have a few left in this series.

This one isn't necessarily the most painful mistake, but it was costly. Most mistakes cost something in terms of money, relationships, emotions, physical harm - if there wasn't some visceral consequence of making a decision how would we knew we could have made a better choice?

Sadly, not all decisions are logical ones - sometimes they are purely emotional ones that you can't argue with even though you know what the consequence will be.

Mistake #4: Taking an entire month off before starting the real job

This is one of those mistakes where I knew it wasn't a good idea, but how do you tell the man/woman who has spent the better part of two decades being told where to go and what to do that they need to start work sooner than later. They have an entire career of work ahead of them. It seems like an eternity and this is the last rest stop on the road.

I think everyone I know looks forward to taking a month off between the end of training and the start of a new job. It is almost expected and is one of the "prizes" we think we all earn. When will there ever be another time that you can take 4-6 weeks off and just do what you want before embarking on a career of long hours, stress, and life saving work?

So when he signed the contract and I looked at the start date I knew it wouldn't be rainbows and flowers. I knew because as part of my homework two years ago, so I would not make a tragic mistake, I ran across this article  appropriately titled Two Big Mistakes Graduating Medical Residents Make. For a time I even had this link on my sidebar so I saw it often. Didn't matter! I forgot all about it in the euphoria that is signing a contract!

Sure, that month off was nice to spend with my husband and children. Yes, it was nice to sleep in and not listen to a pager go off in the middle of the night for an entire month. Absolutely, we had a great time!  We took a couple of weekend trips, visited family, and just relaxed. We did everything we felt we couldn't do during training.

Here is a warning, given in love, from someone who was very recently there:

That time off has a fixed cost. In fact when you look at it from a financial perspective that month off may have been the most expensive month of our entire lives. Think of how much that month off will cost you in terms of dollars. I don't always think about money, but money is important and learning how to tame it is a survival skill.

The larger your salary the greater the opportunity cost of taking time off will be. Let's say your salary will be $400,000/year. If you divide that amount by 12 you are looking at a gross income opportunity loss of $33,333 for that one month that you will never get back or make up. Of course the net amount will be vastly different (love taxes), but even then the net loss would be somewhere in the neighborhood of $20,000. What could $20,000 do for you?

Can you afford to miss out on $33,333 in earnings and approximately $20,000 in cash? Is taking a month off worth that much money to you? If the answer yes, then maybe taking a block of time off is the right decision for you. If the answer is no, maybe starting work sooner than later and then taking a vacation after you have worked for a few months is the right decision. You know doctors get vacation time, right:-)

Suggestion:

Spend some time as a family deciding how much time off is needed or appropriate for your situation and financial goals. Have the conversation and consider the financial implications. Are you buying a house, want new furniture, must have a vacation now, just want do do nothing? Once you can identify what your priorities are, you can determine what portion of your income you are willing to miss out on to have it. Maybe all you really need is a week, not a month.

For me, I wish we had started work earlier. In our case, it would have been well worth it for me to move our family in and unpack all by myself. I would have gladly done it alone, in the pouring rain, barefoot, in exchange for the amount that we missed out on.

Now, almost 3 months after starting work, we finally feel like we are catching up from that 1 month we took off. Was it worth it? It was nice, but it wasn't worth missing out on $xx,xxx. One week or two would have been sufficient, a month was too long.

Decide what is right for you and your situation. Decide.

Here is one mistake you don't want to make - Medical Monday's is coming on this next week. Monday November 4th. Yes, the bad news is that it is November and the good news is that you can start the week off right by joining with us!

Making Mistakes: Part 3

If you haven't noticed I am much harder on myself than anyone else is. As I have been thinking about mistakes made this last year I can't help but see some of them as only half mistakes. After all, every time I drive my van I am not cursing the darn thing. No, I actually love it.  And while "it" doesn't necessarily make me happy, I do derive some measure happiness from it.

The same could be said for all those celebrations. I still wish I would have used a different word for those extra times we ate out because we were just too lazy/tired to cook that day, and suddenly had the option of doing something different.

Occasionally, I look at two presents my husband bought me and wish he wouldn't have. But I don't necessarily want to sell them either. I suppose with a real mistake I would be selling them right?

He likes to give gifts, and has excellent taste, and might have gone a little overboard. We all know those kids whose parents don't allow them to eat sugar and than they get invited to a birthday party and gorge themselves on sweets. I think that is a fair description of what may have happened to him (and I went along for the ride). And this is a little confession within a confession: I might have hurt his feelings with my demand to stop buying things which might explain why for the last 9 months the gifts have been, well, like they always were before.

So where is the mistakes? My ramblings above probably should have made the previous post.

Mistake #3 - Not Being Prepared for End of Training Expenses.

This one may seem like a no-brainer, everybody knows the last year is the most expensive. Maybe. But here is something that really stinks: when you do a fellowship is like having two "last years" and that most certainly stinks.

Our last year of residency was expensive partly because of a house I don't want to write about, but must. My feelings on owning a home during residency are nothing if not strong. Owning is a huge risk. Only you can decide if those risks are worth it. If I had to do it over again I would have rented.

Our fellowship program didn't provide any assistance for moving/relocation, the fees, the licensing, the DEA, all those agencies that require documentation and approval before you can actually begin. It was a brutal year.

By the time we received the stipend things were bad. We had made a vow to not carry balances on our credit cards and this was the first time that it looked like there was no other way. We had already liquidated everything we had. There was nothing left. And then the stipend came and saved us from breaking a vow we had made and successfully kept for years.

Then you discover it is all gone. through a combination of spending/celebrating and more fees/licensing/boards  Yes, you read that right. Gone. In 10 months it feels like it just evaporated. We had a few things to show for it and a great vacation, but that's it. Not a dime was saved.

By the time my husband received his first real paycheck we were broke and putting our groceries and gas on a credit card because we knew he would be paid before the statement came due.

It is an interesting feeling to be so poor and so rich at the same time. We still had our humor and laughed at the situation. My husband is removing a brain tumor in the morning and then listening to his wife cry in the afternoon over not having any money in the checking account. It is funny.

We kept asking ourselves, how is this possible? Well it is. Money is like sand through your fingers - you have to make an effort to keep it from spilling out. We received the stipend and gave up our hold and it slipped through our fingers. It was an expensive lesson.

Here is the warning, given in love, from someone who was recently there:

Nothing compares to the feeling of security and comfort that comes from being prepared. It is truly priceless. And isn't that one of the things you are looking forward to having when you are "done"? The good news is you don't have to be done to have a sense of security. Unless you make an actual plan (that hopefully you and your spouse agree to) you are going to come to the end of your journey in utter disbelief.

You are going to need money in the bank at the end of training, not just promises of money on paper to be paid at a later time.

Although this isn't our particular situation, you don't want to be in such a financial mess that you take the very first offer you are given because you need the money. Desperate people do desperate things. Don't be in a desperate position.

Suggestion:

Before you start a spending frenzy or relax your hold, talk about what you want that stipend to do. Are you going to buy a house out of residency? Are you taking an extended period of time off? Are you having a baby? Are you buying furniture? What are your priorities? Make a plan, allow for the unexpected, and then work the plan! Its not enough to just make the plan, you have to discipline yourself to make it happen. Two different banking accounts are a good idea for things like this too.

Do some quick research into licensing fees for your state and set aside whatever amount you need. They are always more expensive than you think. Better yet, have those fees worked into your contract!

Don't forget money you might need for expenses between your last training paycheck and your first "real" paycheck.

It never hurts to have more saved, but it does hurt to have saved too little. Which side do you want to err on? Start saving now, it will be good practice.

Making Mistakes: Part 2

Thank you for all of your kind comments on my previous post. Once you make certain mistakes you know that they will never be made again. And speaking (writing) them out loud almost certainly insures that they never will be. I think we all know people who bought brand new cars from the dealership once and never again. And we probably all know people who always buy new cars. Neither decision on it's own it necessarily a mistake. That is what continually amazes me... the variables among individuals when making decisions is infinite. These are my mistakes, using my variables.

Mistake #2 - Celebrate Good Times, C'mon (dance with me now)

I previously confessed that once you start spending money it is harder to stop than saying no in the first place. Strange isn't it? But true. You can trust me:-)

Celebrating an accomplishment as long awaited as this, we are talking decades, is an important part of the journey. And I would never discourage a celebration.

Years before we actually signed a contract we talked about what we were going to do to mark the culmination of years of training and sacrifice. We decided that we would take a family vacation. A real family vacation.

What do I define as a vacation? A vacation is a place you travel to that is farther than a 3 hour car drive; it lasts longer than 3 days and 2 nights; includes experiences that you cannot repeat every 6 months; the lodging is better than what you have at home, and the food is better than 95% of the restaurants you have eaten in in the last 6 months; selection of activities appeal to the entire family and doesn't include sitting around watching cable tv. 

Up until this point we had not had a vacation as a family that didn't include traveling to see family once every other year and sleeping in guest rooms with children spread out on sleeping bags; eating at the kitchen tables that we grew up at; hanging out at home visiting grandma and grandpa, aunts and uncle, cousins, previous neighbors, etc. Oh, and one time for our anniversary we crossed state lines for a long couples weekend, alone. Once in ten years.

My children looked forward to this vacation since they could talk. Years before we would actually go they were telling people we were going. I was afraid that it would lose it's magic, but it never did.

Yes Magic! That was the name of the ship we were destined to sail on. It was going to be amazing. It actually was pretty amazing. It was 7 days at sea traveling to Cancun and The Grand Cayman Islands. It was pampering, it was entertainment, it was obesity inducing food (I did gain 5 lbs that week), it was everything we thought it would be and more. The looks on my kids faces was priceless and every day was amazing. They still talk about it. It was the best celebration we could have planned and money well spent. And it felt good to spend that money for this experience.

So how does this post make it into my series on mistakes? You must surely be confused.

Here is the warning given in love from someone who was very recently there:

We had chosen our "celebration" in advance, and then proceeded to name every other purchase that was out of the norm as a celebration. So what was the celebration? Was it the new cars, the actual vacation, the watch, the purse, the necklace? When everything becomes a celebration nothing is.

The night we signed the contract, we celebrated by going out to dinner. The night we mailed the contract back we celebrated. The day the stipend was deposited we celebrated. The van my husband bough me was a celebration of our good fortune. The car my husband purchased was his personal celebration. The necklace my husband bought me while taking his boards was a celebration of my hard-work and long suffering and his acknowledgement of it. The watch my husband bought me while on vacation was a celebration of our vacation celebration and a souviner. The extra pizza we eat each month was a celebration. Do you see what I mean?

A proper celebration happens once, it doesn't repeat itself every week, or every month.

When my husband came home with the van and then his car, and we had called those purchases celebrations,there was a moment when I was afraid our true celebration that we had been waiting for might not happen. It seemed ridiculous to take on credit card debt for our vacation that was supposed to be a celebration of having excess cash when before there wasn't. Thankfully, it didn't come to that. Don't jeopardize your planned celebration.

Suggestion:

Celebrating a major accomplishment is important, and please celebrate! Use the word celebration sparingly. Decide what that celebration will be, and enjoy it. Don't call delivery pizza a celebration. It's not (unless that is what you decided it would be).

Give yourself a small raise. If you have opened a separate checking account for your stipend to be deposited to, give your budget line items a raise. Increase your food budget 10%, set aside some money for a special date night out once a month. Decide how much of our stipend you will "use" and make a direct transfer to your household account once a month. Don't abandon your budget because you mistakenly believe you no longer need a budget.

There you have it, but there is more.

Making Mistakes: Part 1

About the same time I started this blog, I also began researching common mistakes, that we in the medical family make, so that I could prepare a personal defense sufficiently strong enough to prevent such unfortunate events from befalling my family. Quite an undertaking, I know.

I was going to be the best prepared and most informed spouse in history. I was going to be Super-hero ready! There would be no mistakes. I would not be tricked or deceived. Our performance would be flawless.

Guess what? Even knowing what pitfalls might be up ahead I walked straight into them. Not blindly, but fully aware of what the consequences were going to be. And for that moment I didn't care. Had I been able to look ahead to the next 12 months maybe I would have. That's life for you -  you don't get to see around the bend.

What do I define as a mistake? A mistake is something that happens because you did something that you knew you shouldn't have. You intentionally ignore logic and reason in the hopes that the consequences will not be as bad as you imagine them. Or better yet, that the consequences are imagined!

So let's begin. The mistakes are plentiful and I only recount them as part of my many confessions.

Mistake #1 - Making large purchases immediately following the long-awaited stipend.

Some residents secure jobs long before they are ever qualified to work. If you have a signed job contract 2 years before you can work, your stipend will be $XX,XXX divided by 24 months. If you obtain a job later in your training with say 9 months to go your stipend will be $XX,XXX divided by 9 months. The longer you receive the stipend the smaller the monthly installments are. The shorter the payment duration the larger the amount. (Depending on your speciality you may or may not receive a stipend and stipends very greatly among specialities.)

Immediately after signing the contract my husband marched off to the dealership. I was preparing myself to be mad... how dare he look for a car for himself. We talked about this, we weren't going to buy anything. And when we did we would replace our family van. I knew he hated the car he was driving, but it was reliable fuel efficient. We had a plan - but he was just window shopping. Where is the harm in that?

Perhaps he knew I wouldn't be too mad when he drove up in exactly the van I wanted. Every detail perfect. How can a girl say no to that gift? What was I supposed to do, ask him to return it? I am so weak! I think he was counting on me being in bliss for a good while so I wouldn't notice what happened next. Three weeks later he came would come home with his new wheels. And how could I say no? He has worked hard. I had a new van, why shouldn't he have something he liked.

This is how it happens. Once you start spending you can't really stop. If one of you gets something nice the universe demands that the other get something as equally nice. Messed up.

It is never a good idea to start spending money before you actually have it. I know that! We had to empty our savings account to pay for the title/licensing fees.

My defense game up until this point had been rock solid. I watched those dollars like a hungry hawk watches a mouse. I didn't blink. And then something happened. I looked away for just a moment, and it only takes a moment. I was distracted by beautiful things. I wasn't prepared for the euphoric feeling that would come with a signed contract. Hormones were released into my brain that made me agree to things I never would have considered under normal circumstances. My vision was blurred, my thoughts were cloudy, the words coming out of my mouth weren't the same ones I was speaking. It was an out of body experience.

The numbers on the paper were amazing. We had been saved! Our problems had been solved! I could take a break from my hawk-like ways! Money was coming our way! And the best part is that it would be there before the first payments on our two new cars were due. Spoken like a person who knows they just spent money they shouldn't have.

If I had to do it all over again I would stay focused like a hawk. That money would have helped considerably with a down payment, and that is what I really want. Our cars were just fine. Yes, they were old. Yes, my husband didn't like his. But they were cheap. And saying no to one purchase makes it easier to say no to the next. It is true. Sadly, the opposite is true. Saying yes to one purchase makes it easier to yes to the next.

Here is the warning, given in love, from someone who was very recently there:

It is going to be hard to get that check(s) and not do something with it. You will be tempted by 100 things every day. Keep your eye on the ball. What is it that you really want? What are you willing to sacrifice to get it? What is a few months longer in the whole scheme of things? I can tell you it isn't long at all! Look at how far you have come.

Don't fall into the trap that you've worked hard and deserve this, whatever this is. Yes you have and you do, but you deserve more - and there is more. Make a plan, and stick to the plan, and then forgive yourself when you don't follow it exactly and try again. Don't give up on the plan just because you didn't follow it exactly one day.

Suggestion:

Open up a new checking/savings account at another bank before you sign your contract. When the HR office asks for a deposit slip for  your stipend give them the new account. Don't let it get mixed into your everyday checking account or it will get lost (spent). Unless your plan is to spend it all, then don't go through the trouble of opening up an account at another bank. That's a waste of time:-)

There you have it. The first of many mistakes. Stayed tuned next week for mistake #2 - I am coming clean!

Time For A Bigger Ring

Every now and then something unexpected happens to put a smile on my face. This weekend gifted me one of those such moments and it happened at the car dealership of all places.

Due to an unfortunate event (another story) I needed to take our van in for some emergency work and some regular maintenance. Fortunately, my husband was violently ill and couldn't work. How sad that I was ecstatic that he was home, even if it was because he was so sick he couldn't stand up straight or be more than 10 feet from a bathroom. It's the small things that make me happy:-)

A trip to the dealership could not have waited. We are talking embarrassing sounds, and something dragging on the pavement. This isn't a mechanical blog so I won't try to explain. I am glad that whatever my husband ate the previous day decided to wreck havoc when it did. Again, sorry he had to suffer, but his suffering was my bliss. That sounds bad too.

But imagine for a moment going to the dealership with 4 kids. Yeah, no fun!

So I am at the dealership all by myself on a beautiful morning. I sat outside and talked on the phone to my friend from two moves ago and I am having a great time. An uninterrupted phone call! All the while feeling guilty that I have left my kids with a sick man who won't be able to do anything if they need him. The house could burn and he would be in no shape to save anyone, not even himself. It was the same as leaving my children alone, but without a crime being committed. But I'm alone.... finally!

And it just gets better. My car is finished and ready to go in less than 2 hours. As I get in my car and ready to pull away this young man walks over to my van and motions for me to roll down the window. I wonder what I have forgotten or what it could be. This is what it is:

Him: shyly. "Um, hi. I don't usually do this .......... but, are you married?"

Me: flattered. "Yes I am".  In my head thinking do you see the huge van I am driving? Unobservant, not my type.

Him: fumbling for his business card. "Oh, well. Um, my name is X and if you ever need anything and the dealership is closed you can call me and I can get you in touch with whoever you need. I don't work in the service department, I work in sales, but I'll do what I can to help you out".

Me: creeped out, but take the card. "Thank you, X. I appreciate that. Have a nice day."

Yes, it was a little creepy, but come on I am nearly 40 and can't remember the last time I was hit on. Maybe this doesn't even qualify as being hit on, but that young man was in his late twenties, a good decade younger than I am. Either my beauty products are doing what they claim to or he needs glasses.

Driving a mini van may not be enough to advertise my marital status, maybe I need a bigger ring. My husband would say I just need to wear the ring he gave me. Yes, I should but my hands are in a permanent state of swollen. So maybe I do need a bigger ring.... just not the kind I was originally thinking.

So Now You Tell Me!

It was an ordinary day in my ordinary life. I was making a trip to my local Walgreens to pick up a print order and my monthly visit to the pharmacy counter. I finally ran out of those samples, but my previous insurance covered them 100% - so awesome of them. My new insurance doesn't and at $95/month I am rethinking some of my options. So I found a coupon online and only pay $45/month. What exactly is it I am paying for? Oh, yeah.

This isn't a post about the price of birth control. It's a post about all the other stuff no one has ever mentioned to me until today. Technically two days ago.

The elderly man behind the pharmacy counter at 9:30 pm innocently asked if I was taking a multi-vitamin daily. I thought that was a strange question. I would have expected something related to taking the actual pills he was handing me. I told the honest truth - no, I am not taking a multi-vitamin. He then tells me that oral contraceptives can deplete the essential vitamins (B6, C and Folic acid) in your body causing you to be tired, fatigued - and I stopped listening right there. Oh my goodness, I don't have to be tired forever!

I am not a blind drug user. I read the information packets that come with them. Never once did I read about tiredness or needing to supplement with vitamins. If the vitamins are being depleted with the pill itself, why not add the vitamins to the pills! C'mon people.

"Side effects may include: breast tenderness, headache; nausea; stomach cramps or bloating. This medicine may cause dark skin patches on your face. If you wear contact lenses and you develop problems with them, contact your doctor. Contact your doctor immediately if you experience breast pain, lumps, or discharge; calf or leg pain, swelling, or tenderness; change in amount of urine produced; chest pain or heaviness; confusion; coughing of blood; fainting; irregular heartbeat; left-side jaw, neck, shoulder, or arm pain; mental or mood changes (eg, depression); migraines; missed menstrual period; numbness or weakness of an arm or leg; one-sided weakness; persistent, severe, or recurring headache or dizziness; persistent vaginal spotting; severe or persistent trouble sleeping; severe vomiting; swelling of the fingers, hands, legs, or ankles" - and the list keeps going.

Of all those things, that are rather serious, I have dismissed all of them as being crazy - but when my pharmacist mentions tiredness I get all concerned about that! Why, because energy is what rules my life. Without it, nothing gets done. With it, I can do anything. I have been complaining about being tired for years. I feel like I haven't been on top of my game for a long time. Did you notice?

So I have been tired for the last two years and no one thought to tell me that maybe I should be taking a multi-vitamin. Not even the doctor who I am married too! I can't blame my OB/GYN because I haven't seen her in two years. But every month that I picked up those pills and for the decades before that, no one mentioned the need to take a vitamin.

I went through a vitamin phase. Before getting pregnant, and while pregnant, I took those prenatal pills, and afterwards until the bottle of pills ran out. Then I relied on my "healthy" eating to do the rest. I am still a big proponent of using food to get your vitamins - it seems to be the right way. But obviously something is wrong in my diet, my lifestyle, my whatever.

I left the pharmacy with a bottle of multivitamins. When I got home my husband said we already had some in the cabinet. Go figure.

What annoys me is that the correlation between me and fatigue has always been written off as "you have four kids", "you have a lot on your plate", "what do you expect with your lifestyle". All excuses. What if the real problem is the birth control pills themselves?

And that started a whole different train of thought. I am tired of messing with my body! Yes, the pills are working and doing their job - but maybe I am TIRED of the side-effects. I am tired of being tired, the migraines at that special time, maybe that's why those last 10 lbs aren't going any where, what else am I doing to my body that is causing harm that could be taken care of another way. There must be another way.

And that is how you find yourself up all night reading articles online about birth control, hormones, natural family planning, and alternatives forms of contraceptives.

What would it feel like to not be filling my body with chemicals to change the chemicals that are already there to prevent my body from doing what it was meant to do? What would it feel like to be drug free?

Medical Mondays Kicks off Fall!

So, it's October. Once again I marvel at how that happens, the days are just flying! Fall is my favorite time of the year, and of course this day is my favorite Monday of every month. I hope you feel the same.

Are you confused if you qualify for the party?


If you have a pager interrupting your life... you DEFINITELY qualify!
Do you work in healthcare?

Doctor? Nurse? EMT? Chiropractor? Vet? Dentist? Therapist?

MA? NA? PA? DA?

Are you the spouse or SO of a healthcare worker/student?

Are you a nursing student? Medical student?

Intern? Resident? Fellow?

You get the picture, right? Come on, now... don't be shy! Let's keep growing and meeting new bloggers, so we can build a community of support and friendship, learn from one another, and share our stories.

LINK UP YOUR POST!

Here are the rules:

1. Follow your co-hosts via Bloglovin, GFC (if you are Blogger), FB, email or Twitter.
2. Link up you medical/med life blog. If your blog name does not clearly state how you fit in to the med/med life world, please write a little intro or link up a specific post which clearly demonstrates your connection.
3. Visit at least 3 other link ups, comment, introduce yourself, and tell the your stopping by or following from MM!
4. Help spread the word by using our button on your post or sidebar, tweet about Medical Monday, or spread the word on Facebook! The more the merrier for all of us.

Complete step one by following your co-hosts:

• Emma at Your Doctor's Wife
• Jane at From A Doctor's Wife
• Lisa at Life of the Ray Doc's Wife

Want to be awesome?
Post our button on you post or sidebar and help spread the word:

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Now, link up below and have fun! The link up is open through Friday, so be sure to come back during the week to check some great reads!

Have You Seen...

Here is a little known fact about me: I am a Jane Austen fan.

I used to be a purist and would only accept works that were authentic Ms. Austen. I scoffed at books attempting to tell a story from another characters point of view. I snubbed my nose at the modernization of her stories. I preferred the authors words, the time period, and everything to be just as she intended. No liberties taken.

While I still prefer the BBC version of Pride and Prejudice, especially on a cold and dreary day, the updated movie with Keira Knightley is well done and enjoyed when I don't have all day to sit and watch but still need a fix.

I allowed myself to indulge a little in the movie Becoming Jane, that explores the making of Jane Austen. The rules had been broken.

Then a few years ago during a book club we read An Assembly Such As This: A Novel by Fitzwilliam Darcy, Gentleman by Pamela Aidan. And I was hooked and immediately read the other two books in that series. So much for being true and loyal.

I couldn't get enough.

And then one of my favorite authors, Shannon Hale, wrote a book called Austenland. Loved it. And then another called Midnight in Austenland. Loved it, too.

And then they made a movie: Austenland! You can watch the trailer here.

At first it was released in limited theaters across the country. I live in a large city and it was only showing in one theater in the whole state. It had been out a week or two and I talked my husband into seeing it with me, but it was sold out. The following week I decided to just see it myself. Matinee showing on Labor Day and I bought my tickets early. Good thing because it was a full house. Now I understand it has been released all over, so there is a sporting chance it is at a theater near you.

Nearly three weeks later and I still find myself laughing hysterically at something, or some song! Maybe you know what I am talking about:-) Maybe you want to find out for yourself.

If you are a Jane Austen fan, or love to make fun of Jane Austen fans, or like a light-hearted film, this is a movie for you. I can't wait to see it again, and then buy it and watch compulsively.

There, I have confessed yet another guilty pleasure that has absolutely nothing to do with the original intent of this blog!

On another note, Medical Mondays is coming up on October 7th! Don't miss it! That is unless you are watching this movie:-)

Can a Doctor and a Lawyer be Friends?

More specifically can a surgeon and a personal injury lawyer be friends?

I think I mentioned much earlier that we have recently moved back to the same city we lived during medical school. During that time we made friends with a couple who had just completed law school and were getting ready to start practice. They were great friends. I even hosted her baby shower - 8 years ago.

When I say great, they weren't the kind of friends we did much with. We never went out for dinner, never swapped recipes, or babysitting, never talked about the future or complain about what was happening in the moment. We saw them on Sunday's at church, or at other activities our congregation held. They were on our Christmas card list. But, we never called to chat and didn't really keep in touch much. They were solid, good people we knew we could depend on to do anything. We shared similar values and principles.

Fast forward and now we are living back in the same city, and they are still here! We were so happy to see them and had them over for dinner this weekend. It was nice to get caught up somewhat and to get our kids acquainted with theirs. And I think we have found a babysitter in one of their daughters. Bonus!

They hadn't change at all. And they said the same about us. It was like we had never left. In fact, we were all living in the same places we were then. The only thing that changed was the age and number of our children.

But as dinner concluded the guys were discussing work and the question of whether or not they could be good friends crossed my mind.

Before they were just "learning" their trade. So green and untainted, full of hope and dreams.  Now they are both practicing their craft and often they are disgruntled with members in each others profession. It's not like he is a strictly a malpractice attorney - that would be awkward. But my husband is being deposed this week and isn't very happy with attorneys. There were a few moments during the conversation where I could tell my husband was trying to change the subject. They agreed that there are bad lawyers and bad doctors.

The issue of health care, and the bureaucracy, and insurance companies are not good dinner conversations, especially when both of the participants are protecting their own interests. It didn't get out of hand, but it was interesting to see that my husbands views have been affected by his involvement on one side and our friends views have been affected by his on the other.

My husband has only been practicing for a couple of months and already his partner has been drilling into him the need to cover his tail. This profession may be one of a very few that requires absolute perfection 100% of the time. If you make a mistake and someone chooses to exploit it you can be ruined.

In the meantime, we really like this couple and hopefully we can maintain our friendship with the same degree of effort it has taken in the past: easy breezy. In the future I'll have to steer the conversations away from work and towards a subject that is less wrought with conflict.

I may have to pass a new rule in our home. Maybe even have it printed in large vinyl and posted for everyone to see:

We will gladly talk about sex and religion - just please don't talk about health care!

I wonder how that would go over?

Tears for Strangers

Sometimes I forget that my husband actually works on people who don't intend to cause themselves harm that day. How frustrating it must be to clean up messes that never should have been made in the first place. (Sounds like motherhood.)

Most of the time I hear about the circumstances that bring people to his operating room, some of them don't even make it to the OR, and I shake my head. How many people try to kill themselves and fail? How many people drive drunk and are in motor vehicle accidents? How many motorcyclists refuse to wear helmets? How many different types of risky behaviors are there? Lots! These are the people my husband usually sees day in and day out. It's a big trauma center, and they get the worst of the worst.

And then there are days when someone comes into his OR who shouldn't be there. They didn't do anything wrong. In fact, they did a bunch of stuff right. But, it still didn't change the fact that they aren't going to make it. While the guy who shot himself in the head will make a complete recovery. Some things don't make sense.

Like the barely teenager who is in a motor vehicle accident with his older brother and friend on their way to a church activity after having spent the morning at a community service project. A young kid who idolized his older brother and wanted to be just like him. Who was a good kid in school and had many friends, and a loving family. Parents who are about the same age as we are, who never imagined when they sent him out into the world to do a good deed in the morning, that he would be taken from them before dinner. Parents who will be burying their son. How does anyone recover from something like that?

I typically don't shed any tears for my husbands patients. Their situations are sad, but self-inflicted, and I don't think about them. However, this one had us both crying tears for complete strangers and I don't think we will ever forget.

It's Like the Lottery, Only Different

From the moment you our your spouse/boyfriend/sister/brother contemplated joining the medical profession family and friends gently urged them on with sentiments along the lines of "one day it will be worth it". What they mean by worth it is "one day you will have enough money and all your problems will be solved".  How naive they are. How naive we are.

I think this type of thinking (money is the answer to all of life's problems) is more common than we acknowledge. If you read my last post it is has been scientifically measured that the happy number for income is $75,000. So why would well-meaning friends and family want anyone to marry or obtain an income above that figure if it won't have any measurable effect on their happiness? Hmmm, maybe they are hoping that we will attempt to increase our happiness by spending money on them or buying experiences that we share with them. Or maybe they don't really like us as much as we thought.

I do not doubt their motives, really. I think they believe that having a higher income somehow means some of life's difficulties will pass us by. And there maybe some truth to it, but what if is was as equally untrue? What if it didn't matter how much money you had? What if the honest truth was that regardless of your income bracket you would be faced with challenges, hardships, heartaches and tragedies on par with others who have significantly less than you? Would you believe it? I have a feeling this might be closer to the truth than we are willing to admit.

Happiness has been on my mind lately because what I thought would make me happier (because I believed the lie) hasn't made a difference. I was happy before, don't get me wrong - but I think I was expecting elation, ecstasy and carefree to be a more permanent sensation. And now even I am laughing at myself. Go ahead, you can laugh with me. Instead it has just stirred up a whole new set of feelings I wasn't prepared for.

So what is the verdict? Will more money make you happier? It's a trick question and there is a lot of fine print and exclusions. You don't believe me. I can tell. Why? Because we all want the opportunity to try out the theory for ourselves. We will be the exceptions!

I won't attempt to deceive you. The first paycheck was like winning the lottery!  But, that feeling lasts for just a moment. Why so short lived? Because you quickly realize that having a high income doesn't mean you actually have money. Quite the opposite. Now that you have money everybody wants it.

Call it sticker shock, call it post-traumatic stress syndrome - the first time you see the income taxes portion of your payroll you may need to call 911. That is if you are able to get to the phone. Just like winning the lottery, most of your income is gone, never to be seen again and there isn't anything you can do about it! Taxes are now our single largest expense several times over. A cool 39.61% of our gross income. Sure we knew we were going to be in a different tax bracket, but I never considered that we would pay more in taxes in one month than we did in the last three years combined. It's the truth, I checked our filings because I am curious like that. I know what a great problem to have, but it's still a problem.

We need to lower our tax burden in a hurry! That would sure help pay down our debt in a big way. But what is there that we qualify for at this point? More kids? The ones we have now won't help anymore. Student loan interest? No.  Don't you find it ironic that once you are finally able to start paying your loans back you don't get to take a deduction for the interest you do pay because you make too much? This is going to be a topic of discussion for our financial planner. I am sure it won't be the first time they will have a new doctor in their office claiming that something must be wrong and asking to have some of those loopholes they have heard about in the news. Where can I get a loophole? Is there a dispenser somewhere?

I hear the naysayers now "why are you complaining about taxes, you have plenty of money"? You'd think, but....

From the moment you start medical school you begin digging the hole we call debt. You ignore it while it is happening because there is no alternative. In residency it slowly starts to remind you that it is alive and growing and waiting for you. You start cringing when the statements come in the mail. By the time you get your first paycheck, often decades later, it shows up on your doorstep with suitcases and a long term lease agreement that must be honored.  That little hole you starting digging years ago has become a tunnel to China.

You'd like to make your student loan situation a distant memory in a hurry, but you also need to start saving for retirement. NOW.  Remember that pitch from the HR department about contributing to a 401(k) and that if you started saving only $100 a month starting at age 20 by the time you retired you would have 1 Million dollars? That might not be the exact number, but the principle was that money invested over time grows exponentially. Guess what this doctor doesn't have? Time!  Instead of having a working career that spans 45 years - we will have 25, unless he wants to work into his seventies! And we might just have to do that. Time is not on our side and we are digging ourselves out of a hole. A house size hole. A house nicer than any house we have ever lived in hole with a matching mortgage payment.

But it's not just the student loans. It's the realization that being a doctor is a very expensive career decision. Because you have invested so much money that didn't belong to you pursuing an expensive career, you now have to take precautions to protect that career so you can afford to pay your debts. What a sick relationship. Outside of medical malpractice insurance, your family has to guard themselves from people that will never be patients! To say my husbands hands are insured isn't much of an exaggeration. We have insurance in case he can't work as a surgeon. Insurance in case he can only work in a limited capacity. We have insurance in case he expires prematurely. We have insurance to protect our home, cars, property, and assets we hope to accumulate. We have liability insurance should someone sue us from an accident in our car, home, driveway, sidewalk, tree, or from looking at them wrong, etc.

So when I look at our new income I see money that has already been spoken for and lots of hands coming to get what is theirs and not as much left as I would like. Not because I am ready for a shopping spree, but because I sincerely want to be done with debt as quickly as possible so we can move on to other things. The reality is that if want to pay off our debt aggressively, save for a meaningful retirement at a normal age, and buy a family house while our children are still living with us, we'd be smart to live like we always have. Right now it is the only way to mathematically make it work in the short time we have. Or we just throw caution to the wind and enjoy today and let tomorrow take care of itself. I am on the fence most days.

There are some things I have dreamed about and anticipated for years that would make everything worth it. (If you've been down this road, you know the "everything" I am talking about. If you haven't, I can't begin to describe it in one post and if I tried you wouldn't believe me anyway.) One was having a home in a safe neighborhood with a yard where our children could run and play outside. The other was taking family and couple vacations, something we never did during school or residency. I think both of these things are in keeping with the proven methods of increasing happiness: spending money on others and experiences. These are two things I am not willing to let go of now.

So for now, don't expect any debt-free announcements this decade.