Maintaining Balance Through Medical School and Beyond

Category: Residency Life

The “How are You?” Dilemma: Freedom in Honesty

I must admit, February of Intern year isn’t the best. The high of being a resident has worn off to the everyday stress and anxiety that comes with the job. I spent January on a block of nights and clinic. At our program, we will do a week of nights (Sunday through Saturday 6pm-6am) followed by a week of clinic (Monday through Friday 8:00-5:00). Transitioning to nights isn’t that hard for me. I’ll take a nap Sunday afternoon, drink my latte (thank you Jacob!), and walk to keep myself awake in the hospital. Switching back to days is a completely different story. Trying to get my internal clock to straighten out seems to take days, but the clock keeps ticking and we keep moving forward.

Living in Northern Indiana brings weird weather, comfort food, and kind people. It is common, and almost law, to say “hello”, “good morning”, or “how are you?” when you walk past someone, honestly anyone. When you give pleasantries out like candy, are they actually said in a sincere and inquisitive manner? After our “hellos” and the inevitable “how are you,” I found myself internally asking “do you really want to know?” And one day, I truly asked.

On my second week of nights solo, I came into our work room like a whirlwind. There wasn’t any specific event that caused my stress and anxiety to be elevated, it just was. My lunch was thrown in the fridge and my computer got up and running. The list of patients was completely new to me and longer than I had anticipated. My fellow intern was working in the emergency room and came in to finish her notes. The conversation started like normal: “Hey Aleena”… “Hi”… “How are you?” I looked up from the computer and studied her for one second, and then two. My mind felt like a dumpster fire. On one hand, I could make this conversation stop quickly. I could say “doing all right” or “okay” and it would be over. Or I could be honest. Wasn’t that a scary thought? I knew I wasn’t “all right”, I wasn’t “okay”.  I knew this intern was a safe person. I wouldn’t be ridiculed, I wouldn’t be dismissed. How lucky was I to have a friend and coworker that I knew would pause with me. So, I said… “honestly?” Her retort was quick and so much like her I wanted to laugh. “Obviously,” she chuckled. “I’m surviving.” Pause. She turned to look at me then too. She knew, she understood. Even if we didn’t talk about it, if we weren’t honest, interns all knew that feeling of surviving. I’m sure it continues through residency, but getting through this day, this week was all I could focus on. “Yeah,” she said. Her voice was softer and held a hint of sadness too. Our conversation wasn’t long. The job needed to get done, but in that moment I offered myself the freedom to be honest in the “how are you?” dilemma. I cried later that shift, around 3am, when putting my emotions aside no longer became an option and it poured out of me in tears. It wasn’t any specific trigger. Instead it was all of the small things I was carrying for too long: not seeing my husband and daughter, not sleeping well, feelings of isolation, my own imposter syndrome and feeling inadequate, feeling lost and a drift, ruminating on my tough cases, the patients I lost, and those I had to tell terrible news. All the small boxes had grown taller than me and too heavy to hold, it was inevitable that I would trip.

I’ve spoken and written many times about my own mental health, the highs and lows. I’ve talked about my struggles and worked to be honest and open about those things in the last few years. I’m here to tell you it’s still hard. It’s hard to be honest, be vulnerable, and open. It’s difficult to let people see all of you, including the dark and twisty parts of you. I hope moving forward I can be honest in those moments, and I hope I’m given the space and grace to allow that.

I want to encourage all those who read this to be intentional with the words you say, even to strangers. Be ready for the response when you ask a question. Allow your fellow humans to be vulnerable and offer a safe space. If time does not allow for a conversation, wish them well as you walk by. You’re allowed to break tradition with the “How are yous”. If the question is thrown your way, at least be honest with yourself. Take a moment out of your morning to assess your own well-being, and if you find yourself just surviving or just holding on, reach out and get help. You deserve more out of like than just surviving.

My days, and nights, are busier than they used to be, but I am always ready to talk with friends over coffee.

A Year of Excellence

For me and my family, 2022 was definitely a year to remember. We had lots of adventures and were fortunate to have most things work out in our favor.

We began the year taking home a newborn baby from the hospital. Our daughter Charlotte was born premature, but is a fighter. She managed to avoid the NICU and grow as God intended. We spent quite a bit of time in the hospital at the end of 2021 due to complications with my wife and were gifted our daughter December 31, 2021. Our lives were very blessed getting to spend the entirety of 2022 with a healthy child in our home.

In the early summer my wife graduated from Medical School and we found out we were heading to Mishawaka, IN for her to continue her education. Packing up all our things from Toledo, OH and heading back Indiana was stressful. It put some strain on us with scheduling, timing and arrangements. My wife’s parents were nice enough to allow us to live with them for a few weeks until our permanent living arrangements could fall into place. It was a huge help for us to have that opportunity. Due to having to move into my in-laws until our housing became available, we ended up having to move twice. We moved from Ohio to storage units, then from storage units into our home. Having the opportunity and ability to make such a move (though not far in distance) was a true blessing. Our families helped out more than they probably needed to and we are grateful.

We bought a van to make traveling easier for our family. Unfortunately, about one month after the purchase the transmission went out. It seemed to have an issue prior to going out, but it went from functional to broken fairly quickly. Having to spend the money to make the repair was a burden, but was necessary. I’m sure a lot of people have been there before, spending money to fix something that was just purchased. Though we had this issue that took a toll on our finances, we have very much enjoyed driving it. Who would have though it would be so fun to be able to ride together comfortably and have space for more people or things.

Charlotte grew from a 4lb 4oz premie into a crawling baby and now into a walking toddler. She has been developing so well in everything from speech to motor skills. She definitely has her finger pincher skilled mastered for picking up peas. Her repetitious use of the word “mama” and her desire to investigate everything has shown me that she will grow to become an intelligent child of God. I have been blessed and amazed to watch her grow.

Though everything wasn’t perfect, I feel that 2022 was a great year. There was lots of good that happened and we learned more than we thought we would about life. The hardships made the good times sweeter, helping us become more disciplined along the way. I think 2023 has a lot in store for us and I am excited for what lies ahead.

2022 – A Year of Changes

From Aleena:

It’s been a while since I spent time writing. Major events and important milestones are kept in my bullet journal but writing in length about my thoughts on those events is something else entirely. I feel as though this year changed every part of my life. I received new titles, started a new job, moved states. I experienced many highs and lows over the year. Some days I was so tired, I barely made it through the door before falling asleep. Some days I never wanted to end even as the clock continued to tick towards midnight. We didn’t send a Christmas card this year, so we thought a post on our year would have to suffice.

January 1st was spent on postpartum after the early delivery of our daughter on 12/31/21. Charlotte came into the world at 4lbs 7 oz. She was a fighter. Even though she was 5 weeks early she was strong. Her blood sugar never dropped. Her temperature was well controlled. She drank well from a bottle. She was as feisty and stubborn as her namesake. If I am honest, I started the year in a very confusing position. I was overjoyed that my daughter was with me, but I was sick and felt defeated. Mentally and emotionally, I felt low. This tiny, too tiny, child was relying on me, and I wasn’t sure if I was going to be okay again. My pregnancy had been wonderful, but my labor and delivery were nothing how I imagined it would be. In many ways, I felt as though my body failed me and I wasn’t sure how to move forward. Thankfully, the clock keeps ticking. My tiny child healed my heart and my body slowly healed. Those first weeks went by quickly, and I’m sure there are many women like me who feel like that time lives behind a veil. Everything seems slightly fuzzy. I’m thankful for the pictures I took to remember those days, even the hard days are worth remembering. January came and went. I’m thankful to my mom and mother-in-law who spent weeks with me, helping me learn to take care of my daughter and giving me time to heal, grieve, and move forward.

February: Adjusting a family continued as Charlotte started to grow. We celebrated 11 years together on the 12th of February. I am amazed as how far we have come and all the things we’ve done in 11 years. The things we talked about at 15 years old were coming true. All our hard work was paying off.

March: The first half of March we waited (im)patiently for Match Day to come. I am a firm believer that God always has a plan for us even if we don’t see it. Sometimes we believe our lives are going down one path and he will send us through a different door. March 18th, we sat in a large conference room counting down to noon. I had made my list over a month prior. I was sure I knew where we were going. God had other plans. BETTER PLANS! I opened that envelope to see I had matched at St. Joseph Regional Medical Center in Mishawaka, IN. We were going home. I expected bigger emotions that day. I heard others shouting with joy, happy tears going down their faces. I felt relief that this whole thing was over. I was happy, but I was ready to put the circus of residency match behind me. I wanted certainty of my next steps. I wanted to know we had a plan and a home. Finding our next city was step 1.

April: Beginning of April brought the end of medical school. Jacob took me out for an ice cream date to celebrate.

May: I celebrated my first Mother’s Day and 26th birthday the first week in May. We spent time with our families and continued watching Charlotte grow and learn. Packing was in full swing. We were able to find a home to rent in Mishawaka. We would be able to move in on July 1st. Until then we would live with my parents in South Bend. There are days I miss our home in Toledo. We had so many memories there including bringing Charlotte home. We did many renovations to make that home ours. It was difficult to know I was leaving a home that felt like mine to live in a house that would never quite feel right. However, being near our families is far more valuable. On May 20th our families gathered as I walked across the stage to be hooded. This was my third favorite title I received with “wife” and “mama” coming in first and second. It was so nice to look up in the crowd and see my husband, daughter, and both sets of parents waving at me. I am proud of myself for accomplishing this goal! It definitely wasn’t easy but will definitely be worth it. May 28th was our last day in Toledo. Our families helped us pack up our home and move us back to Indiana and to my parents’ home in South Bend. Our belongings were moved into storage and our suitcases came with us. This wasn’t the first time we lived with a set of parents during our transitions. I’m thankful for such good relationships that allow us to live as a multigenerational household, even for a short while.

June: Jacob and I celebrated our 6th wedding anniversary. We spent as much time together as a family during this month before I started working on July 1st. We took a short trip to St. Joseph, Michigan and enjoyed time outside and wandering around the town. Orientation began in the middle of the month. The first time I met my fellow interns, I knew I was in the right place. These were my kind of people!

July: I was on call July 1st. What a strange feeling that was. I started the year on inpatient medicine. While I was on call, Jacob and his family moved us into our house in Mishawaka. I felt like I had dived headfirst into the deep end, and in all reality, I think I did. It was a strange thing to announce myself as Dr. Brown when I walked into a room. Even now, hearing someone call me “Dr. Brown” has my inner child giggling. Thankfully, most people still call me Aleena (or Mama).

I think the clock sped up because August, September, and October came and went. Work continued as I learned how to navigate the hospital, the EMR (electronic medical record), and learn from those around me. Charlotte grew and grew and suddenly my tiny, tiny baby was crawling, laughing, and evening whistling. She was eating real food and dancing to music. Some days I had more time with my family than others. We had family dinners when we could, date nights when we could, and little adventures here and there. Jacob and I had some big conversations about our future. For most of 2022, Jacob and I thought Charlotte may be our only child. We walked out of that hospital on January 2nd with our daughter, but both of us had to heal from our experience. We spent a few weekends sitting on his parents’ back porch talking about our family and our goals and visions for the future. One Sunday in September, we were walking out of church. Charlotte was on Jacob’s shoulders, and I had this longing feeling in my chest that someone was missing and should be holding my hand as we walked out. I knew then we were meant to have another child. My hope and prayer is this next year will bring us the joy of having another child. For those who may have been like us, it is okay to change your mind about children. Whether you thought you were only meant to have one or thought you wanted more. It’s okay to change your mind and make the best decision for the family that you have. Children are truly a blessing, but they are HARD work. My feisty 35-weeker turned into a feisty 1 year old. She has taught me so many things about being a mom and about life in general, but raising a human being is tough, especially with no manual. But as the clock keeps ticking, I find myself wishing for just one more minute of newborn snuggles, of nursing, of crawling, of nighttime rocking, of afternoon naps. I look forward to the day she comes running into my arms after work and tells me about her days, afternoons spent doing arts and crafts, family ice cream nights, movies and snuggling. One of my favorite book quotes says, “don’t let the hard days win” and I do my best to remember that on my on-call days, night floats, and tough times with family. By the end of October, I found myself with a 10-month-old and finishing 4 months of residency. I had done all the core rotations and felt much more comfortable at work.

November and December brought us the holiday season. I enjoyed decorating our home and convinced Jacob to put lights on the exterior of the house. Charlotte even had her own little Christmas tree. She is obviously too young to understand Christmas but knowing this was her first, and maybe only one as our only child, I wanted to make it special. She spent time with Grandma Sharon making Christmas cookies for my work and for our families. We spent time in the snow and cuddled up at night. She had many Christmases, one with just us, one with my family and one with Jacob’s. As the only granddaughter on both sides, she was definitely spoiled. The love our families have for Charlotte is unmeasurable. I’ve enjoyed watching her build relationships with her family all year. I was able to take time off between Christmas and New Year’s. I’m extremely thankful for a program that prioritizes their residents and families. They do their best to allow us to spend important dates with our families, just another reason why I am glad God’s plans are bigger than mine. Charlotte turns 1 on 12/31. We will be celebrating with both sides of the family. There will be balloons, cake, cupcakes, and so much yummy food. The days were long, but this year flew by. I don’t know how my preemie turned into this amazing 1 year old, but I am beyond excited to see what this next year has in store for Charlotte. There may be more changes for us this next year as a family but having some constant in this world is needed. Walking into 2023 I feel like a completely different version of myself in a lot of good ways. There has been growth and healing this year that was needed in order to move forward.

Looking Ahead: I’ve already thought of some goals for myself in 2023:

  1. Read 12 books (or more)
  2. Write 1 blog post per month (or more)
  3. Spend 10 minutes journaling per day in both my Bullet Journal and “Better Every Day” Journal
  4. 1 Date night per week with Jacob
  5. 1 Family Activity per week with Jacob and Charlotte
  6. 2 Weekend trips this year
  7. Spend a couple days a month taking photos for our families and others

I want to spend more time documenting and enjoying the phase of life I am in presently. Residency and parenting are both hard yet rewarding. I want to remember these months, especially if we hope to add another member to our family this year. This year I’m choosing to enjoy the ordinary aspects of life and finding peace amongst the chaos and tiredness.

If you’ve somehow read until the end of my monologue, I hope your 2022 was filled with moments of joy and that the times of sorrow were few. I pray 2023 is full of answered prayers and new experiences for you. And if you ever want coffee, I am always excited to sit with a friend over an iced latte.