I’m peaking in my career

Supposedly, I’m peaking. And this isn’t about egg yolk and marenge pie. I’m 43 years old, have been in medical practice for fourteen years, and am looking at a canyon in 360-degrees from where I stand. That’s what the data says. I wonder if I am going to do the electric slide or how I’ll boogie through the next years of medical practice. I try to think, “This is the best moment of my life, right now,” any time self stigma and fear of mortality creeps in. (That’s not saying, “This is as good as it’s going to get!” Ha!) I want to cherish the gift of practicing medicine, for however long I am blessed with it. 

It’s a popular discussion amongst my colleagues these days, about how long a physician should practice. There’s a newer’ish respected program called, PACE, that evaluates physician competency to practice as they get old.  This is a huge shift in the culture of medicine. It’s meant to respectfully assist rather than discriminate with ageism. I try to imagine what it might feel like if I were approached and asked to take the test. 

So what does a psychiatrist rocking her best jeans have to show for herself anyway, you may ask. Well, (tapping the mike), “I’d like to first say thank you to my sponsors….” Wink.  I mean my patients! Thank you. 

…Hey! This peak is crowded! Give me some room!

Ahem. But at my “peak,” at the best of my career, I thought it would be fun to play around with, “Why?” What’s in my doctor’s bag that is so special?

  • Ask, “Why do you want to be alive?”
  • Start all work-ups with a medical work-up. 
  • Give full informed consent with the 5-Treatment Paradigms of Psychiatry
  1. chemical (medication), 
  2. psychotherapy, 
  3. hospitalization (inpatient and outpatient), 
  4. alternatives (such as acupuncture, massage, sleep hygiene, lifestyle change, etc.), 
  5. stimulation therapies (such as ECT or TMS).  There’s nothing else (that I know of 🙂 ) that anyone is going to offer you in psychiatry, no matter who’s clinic you go to. 
    • Push to full treatment response. 
    • Work toward quality of life, not cure, not perfect.  Ask again, “What makes like worth living for?” Design treatment toward those goals. 
    • Routinely and deliberately consider the flow of patient’s treatment agendas with physician treatment agendas. 
    • Mood journal. Nobody believes they were “that bad” after they feel better. Everyone wants to stop treatment when they feel better. (This is why there are so many repeat pregnancies, for example!). We all need our own voice (mood journal) to look back on and speak the truth. 
    • Fight for oxygen. If your patient has sleep apnea, don’t stop working toward treatment compliance. There are no medications that can take the place or make up for oxygen to the brain. 
    • Community. More community. 
    • The third eye – a therapist. None of us can be a mirror into ourselves. We all need someone outside of the “triangle” to speak.

    I’ll be thinking of more as I try to go to sleep tonight, but it’s bed time. I’m off! Sleep hygiene! Arg!

    Self-care Tip: Evaluate your position in your lifeline, and treasure where and who you are with deliberation. Keep on!

    Questions: Where are you in your lifeline? Are you struggling with ageism? What gives you value? Please speak! I, and the rest of us, really need your voice. 

    10 thoughts on “I’m peaking in my career

    1. Some very interesting thoughts passing through your brain. I believe that when the beginning of early peri-menopause up and through completion of menopause, we as women, much like teenagers & adolescents, may go through a phase similar to what I refer to as a lobotomy. It happens unexpectedly for unknown reasons and sometimes, now that we are older and wiser, we are able to put and keep it in perspective.  The blessing is our brain is still functioning, it is just a question of in what capacity…fully, partially, or sometimes just on auto pilot?All are good, all are functioning, all will move forward and we will see the miracles and blessings that come during this time. Then… we have even more gratitude than we ever had.Each day is a gift and we, (women) are very simply amazing, so Embrace & Enjoy!🌷

      Sent from my Verizon Wireless 4G LTE smartphone

        • Just ride the wave called life, one way or another, eventually you will end up on the shore. When you need a rest, relax, float on your back and catch your breath.
          Then, when you are ready, swim, surf, play & keep moving.
          The wet sand provides a comfortable landing. It’s all good. Enjoy the ride.

    2. After radiation two years ago and Lupron shots urologist said cured of my prostate cancer. Good place to be. Daughter, 32, on a suicide mission with crack, lost job, house, abandoned 2 kids, not a good place to be.

      • Yes it is.
        No it’s not.
        The irony is everywhere, isn’t it? May God’s Spirit be with your daughter, Carl, grandkids, and the gap between you and those you love. You are very important to us. Keep on.

    3. I remember in the 40s feeling that I needed to be more cautious with driving. It was as though the luck could run out and now I needed to be more deliberate and carefull.

      If I hurt a body part it stayed hurt longer.

      Time accelerated and the fight between body and mind gets harder so I push back even more.

      Goal setting, keeping a schedule (sort of, I retired), dreaming of and executing big adventures plus love of family keep me rolling.

      It is interesting to watch you youngsters go through this.

      • Yes there is that fear, that weaves like a DNA helix with the Time Paradigm. You pushing back is pretty awesome. Pushing is good, because the Time Paradigm is just one paradigm. It’s inevitability is built on the constructs of our own perceptions. Keep pushing Richard. Let us know about your experience.

    4. Dr. Sana, My life just lost my world – Sweet Maple my 9 yo golden retriever passed peacefully on April 7 from kidney disease. Mapley was my lifeline and I am grasping at air as I reach for her leash for joy and habit to a walk where there are none anymore. System shock
      – disorientation my mind always has and always will be singing and talking expecting her at my side. It all happened so fast – 3 days from her last test. I am traveling now because I could not bare to be at home without her; home is her.

      • Oh Sheeze KELLY !
        I’m so sorry. You must b hurting. It stinks and more! I am afraid of this kind of grief. I think many of us are. Thank you for telling us. Please tell us how you are along your way. Keep on Kelly.

    5. Strange question to ask today. Am feeling sad for my brother who lost his wife on the seventh. I also lost a SIL from my late husband on Monday. My husband had a hospital proceedure on Tue into Wed. today I wish I could talk with my long dead mother, my fantasy mother. Not the one who would say “stop feeling sorry for yourself” mother.

      I live to finish my memoir and see it published. But I can’t work on it right now. Can’t focus. So..

      I live to love my husband and siblings. I live to LOVE.

      Take Care, young Sana! Go for it. 🙂

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