The hardest transition

[migirl]

I also don't like to participate in these types of discussions because I feel like it's not helpful or supportive to share stories where things are good and shiny and happy. I'll just leave it at that.

But, for those of you still in the trenches, know that attending hood can be a happy ending and it's not all doom and gloom.

Sure, the transition was a little bumpy (they all were!), but it all worked out okay for us.

Hugs to those of you going through hard times.

[SuzySunshine]

I will say that I think the transition that was the hardest for us was residency to fellowship. We went from a great residency location with tons of support to a fellowship location with none, thousands of miles away from family.

Attendinghood transition was hard but not as hard and we are settled and happy now but in our specialty I think you set low expectations early on. Medicine will always have issues but as a whole it can be good after all is said and done,


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[MrsC]

The hardest transition for us was a kind of a unique situation, going from attendinghood back to fellowship. But it's followed closely by med school to residency.
The attending years have been good for us so far. The first private practice job was in a location we liked and the hours were good. This academic job is in a location we like better. The hours are longer but with an added specialty that's to be expected. Having said that, DH still gets home at 5 or 6 on a regular OR anesthesia day. ICU call is one week at a time, 24/7. He usually goes in for a full day until 5 or 6pm (many of his colleagues do not), takes calls through the night and occasionally has to go in, which is the plus side to an academic job. Certainly, his hours are nowhere near what I hear from some of you guys. Hugs!

[Pollyanna]

So is it the transition to attending hood that really sucks, or attendinghood? I think there is a difference.

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It's the transition. Attendinghood is life, some good some bad, but I would venture to say far more good than bad. I will note that had we stayed in AZ the transition wouldn't have been much of a big deal at all.

[Phoebe]

Frankly, every transition was hard in its own way. They all consisted of out-of-state moves and coexisted with marriage or birth of children and happened to people who don't deal well with change. My husband believed that every phase would be better for a host of reasons. It never turned out to meet his expectations. We are now in a location that I am not fond of which is 8 hours from the nearest relative. Someone asked me recently why I keep lowering my expectations. I explained that is what I've had to do being married to someone in medicine. My husband basically has three full-time jobs, not including being a husband and a father to our children.

[gem]

First year of med school was brutal for us. It was also our first year of marriage, and first year living together after being long distance for most of our relationship, so it was a huge transition and really ugly. Transitioning to residency was actually relatively easy and exciting. We bought our first house in a city we knew and loved, had our second child, and I think it felt really good to be able to put down roots after the years of the uncertainty of the Match hanging over our heads.

I'm not sure what to expect for the transition to attendinghood. I feel I have been sufficiently warned about the challenges by our colleagues a little ahead of us. To be honest the hardest part of residency has been coming to terms with the fact that there isn't a swimming pool of champagne a the finish line. I hold on to the hope that it may get slightly easier if DH has a little more control over his schedule, but honestly I don't expect it to be all that different. And in the thick of residency, that can be a hard pill to swallow.

[Ladybug]

The two hardest transitions I remember are into parenthood when DH was PGY4, and into attendinghood. The attendinghood transition was complicated by the birth of our second daughter and my continued struggle to adjust to staying at home full time. Each year got easier and the pay increased. Money was very tight the first year and there was the stress of building a practice and referral network to support the our guaranteed income which was only for 18 months. We rented for the first year which I'm glad we did. We didn't know the neighborhoods or where we would be happy. It took DH time to learn out to dictate efficiently and the first two years were all spent charting at home and in the middle of the night.

I'd say that we have chosen job over location. DH's boss has really taken him under his wing and moved him up through the academic ranks. He's supported his ideas and has given him a lot of creative input into restructuring the residency program here. DH has made it to both of DD's softball games this week and he took her by himself yesterday. We're playing golf on Saturday and Sunday. Last weekend DH said, "I love our lives." He did NOT feel that way for the first few years. He still dictates every weekend though. There's always work each day but it varies with family plans. He can shift around our plans. A few times a week he still gets up between 2 and 3 a.m. to work while the house is quiet. I think he goes back to sleep in the couch half the time. We're nine years out in academic medicine. It's truly been a process for us to steadily build the lives we envisioned. It's also nice to be out of the baby/toddler years. We are enjoying life more because our kids are easier and doing a lot of fun activities which gets us out and about. I also love the job that I landed here and I'm excited that our girls will have the opportunity to be educated here.

All that said we went through some very dark times and a serious depression. I think you can ignore so many things about yourself or your relationship because you chuck it all up to being situational in training, and it is a little. Attendinghood is when we finally dealt with some of our dysfunctional patterns. It's hard to tease out how much is just life and how much is post-training PTSD.

[scarlett09]

I'm going to tiptoe in and say that none of the transitions were hard. Parts of med school and residency were hard. Parts of attendinghood have been hard. Sometimes the hard parts were related to medicine (exams, Match, night float, scheduling holidays). Sometimes the hard parts were entirely unrelated to medicine, but happened to coincide with it (moving in together, wedding planning, grad school, difficult pregnancy). But the transitions weren't as terrible as I thought they would be. Is it because we are in peds? Maybe. Is it because we didn't move terribly far for medicine? Perhaps. Is it because of our personalities, past experiences, and relationship with one another? Absolutely. All of our transitions are but a microcosm of what has played out in other medical families all over the world. It would be incorrect to paint these transitions with a broad brushstroke. Instead, it is better for us to look at what has been shared as food for thought and things to look out for. And to expect the best, yet be prepared for (and aware of) the worst.


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[PrincessFiona]

I also don't like to participate in these types of discussions because I feel like it's not helpful or supportive to share stories where things are good and shiny and happy. I'll just leave it at that.

But, for those of you still in the trenches, know that attending hood can be a happy ending and it's not all doom and gloom.

Sure, the transition was a little bumpy (they all were!), but it all worked out okay for us.

Hugs to those of you going through hard times.

Another happy ending here!

I think each transition was a little tough for different reasons (time, young children, finances, lack of social support). Attendinghood was tough for me at first because we had a lot of debt, no social support and chose to live on the frozen tundra. There was some misery ... I won't lie. But I'm happy now. I'm really happy. It all worked out. There are happy endings.

Kris

[houseelf]

I'm going to give mixed reviews, so take heart those of you who are fearful from this thread. I have some good AND bad things to say about transitions.

Med school was a complete cake walk. Seriously. I studied far harder than him. He watched ME study. He cooked dinner for ME. I'm still mildly jealous at how easy school is for him.

Before I continue with this analysis, disclosure requires me to state that our 7 year residency program was about as hard core as they come. This situation accounts for a small minority of people, so don't freak out after reading my experience. Before residency, we were obnoxioulsy smug and felt our love was *special*. We thought that we were special little snow flakes with a clearly superior relationship and higher skills in coping, intellect endeavors, work ethic that would SURELY overcome the problems of all those whiners out there. I mean, really, how hard could academic general surgery be? LOL.

Yes, we really were that blissfully naive once. Naiveté is such a beautiful gift that should never be crushed. Life has a way of beating that down. Fortunately, the gift of wisdom replaces it. Residency sucked. I could throw in 20 swear words, but really. It was bad. Trust me on this.

Fellowship was super hardcore for him. It was much better for me because I wasn't working and had a sense of community. I'll never forget my husband coming home the first day stating, "Remember all that stuff I learned in GS? That doesn't mean anything here. It's like a whole new specialty." Nonetheless, his harder time was better because of factors that had nothing to do with medicine for me. He also earned a living wage for the first time, so that was nice.

Then, the first year out of fellowship were AMAZING. Seriously, when you go from working 100 hours a week for a decade to 55, it's like the Rose Bowl parade every. single. day. There was enough money to pay our bills, pay down debt, and save! We had some control over our vacation and time off! He got 6 weeks vacation a year! I mean, our first year into attending hood was amazing. It was like a movie scene montage with dollar bills covering the bed with the hero and heroine are giddy in love.

A few years out of attending hood, things have sort of unraveled. We are definitely beset with a sense of, "Holy shit, THIS is what a decade of our life went for? Really?" As others have stated, this realization is intimately intertwined with the whole 40 thing. I know other forty year olds who feel like they pissed their youth away and have strangely similar regrets for paths that couldn't be more divergent from ours. My husband feels like he worked his life, our young married life, and our young family life away. It is a horrible realization. Also, there is the realization that there is a lot of narcissistic, sociopathic a**holes in this profession that he once revered for its commitment to service and selflessness. Hospitals are just corporate america redux.

In reading through this thread, I really thought this was an amazing point and one I will try to work into conversation with my kids if I can do so in a positive way:

Other interesting note: my mom always used to say that people hit their late thirties or early forties and say, "is this all there is", and then that is when affairs happen (regardless of profession). She is big on prepping her kids for the future and explained that everyone feels like this from time to time and it's okay. So I guess I expect that feeling from time to time and don't get too worked up about it.

As someone who sees this all around me, it really should be addressed. "Hey, one day life is going to get hard. I mean, really, really hard and you are going to want to chuck the whole thing, maybe run away. That's part of the process where you get to start digging out and recreating a better, richer, more authentic life It is going to hurt like nothing you've ever felt before, but the journey will take you to a better place." I think that this is a conversation that we need to have more often.

I truly believe that most of us live our first 40 years trying to impress others or live by external rules. 40 is when you realize that this is your life and assumptions get questioned. Sometimes this is for the better, sometimes this is as painful as hell. At a minimum, let's just say that this has some profound ramifications.


I also felt like this was very applicable:

All that said we went through some very dark times and a serious depression. I think you can ignore so many things about yourself or your relationship because you chuck it all up to being situational in training, and it is a little. Attendinghood is when we finally dealt with some of our dysfunctional patterns. It's hard to tease out how much is just life and how much is post-training PTSD.

Yes!!!

We put a lot on back burner for a decade. (Gross understatement!!!) Issues never got resolved, communication patterns withered, resentment grew. Honestly, my biggest mistake is I just quit fighting. Whatever. I promise you this is a worse place to be than fighting.

Over time, you forget to live together as a team because survival is the theme of the day. Some selfish behavior gets reinforced. Some survival mechanisms, although maladaptive, get reinforced and dysfunctional patterns merge into synaptic responses. It is a recipe for marital discord. I am NOT blaming medicine, but it isn't exactly a great situation to grow together and slowly work through things through the years.

We're fighters and we're digging our way out. I believe in the process.

I can't tell you that any stage was all good or bad, medicine always unfolds against the backdrop of life. They are intimately intertwined. She can be one bitch of a mistress though. I know that this is the journey we were supposed to take and we weren't supposed to know things until we were supposed to know them.

To any would be readers, just don't get ahead of yourself. Take the long view, do the hard work and keep your chin up. It's sounds like a cheap platitude, but it really does account for so much of success and happiness. Control what you can because a lot of it just isn't up to you.

[SoonerTexan]

That was lovely


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[TulipsAndSunscreen]

Thanks K! A great read.

[Vishenka69]

Hands down internship to residency. He was in a very malignant program and I was literally talking him off the quitting ledge on daily basis. In comparison any kind of attending job afterwards would seem a piece of cake.

I think reviews of attending lifestyle are very specialty specific. DH doesn't round or dictate, so when he walks out of thr hospital, he's DONE. There are still (very annoying ) phone calls with his partners bitching about something stupid bug those don't usually take too much of his time and he can still watch the kids while talking.

I would strongly encourage to have multiple discussions prior to choosing a specialty. There's not that much to gain from super specializing yourself into one corner of the country.

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[ladymoreta]

I think the transition from undergrad to medical school was the hardest, but that was probably exacerbated by my job that I hated. Residency was a relief because DH didn't like a lot of the required medical school rotations, and he really liked anesthesia. He was also in a very autonomous intern year at a great hospital.

Attendinghood transition is... complicated. Like others have said, it was such a relief to have better hours, way more money than we'd ever had, and the possibility of being settled. However, the transition was also very stressful. The bleeding money we didn't have for about 6 months was rough, and moving to a new town with two very young children was more isolating than our previous moves.

[houseelf]

The bleeding money we didn't have for about 6 months was rough, and moving to a new town with two very young children was more isolating than our previous moves.

This is one of those dirty little secrets no one prepares you for. Congratulations! You have finished eleventy billion years of school and residency. You now need to pay for boards, a move, a new house, possibly selling an old house, etc, ad infinitum AND you aren't going to be paid for a few months! You're a fighter! You can do it.

The way that medical careers are set up are moronic.