In Which Our so-called Heroine is Confused. And also invites the input/mentoring of anyone in general medicine or infectious diseases.

Very confused.

I am about to be 50% done with my residency.  I don't know how time passed so quickly and so slowly.  I also don't know what I want to do after I finish.  That, dear readers, is the challenge.  I love general medicine.  It intimidates me a bit in that one must know everything.  But I like everything, and I l like the variability.  At the same time I am a meticulous, inefficient physician who fails ridiculously at multitasking.

My mentor/internist suggests I make lists of pros/cons for each option and talk to people in the different fields I am considering.  As usual, she is right.  IF YOU ARE OUT THERE AND YOU ARE A GENERAL INTERNIST OR AN INFECTIOUS DISEASE SPECIALIST, YOUR INPUT IS GREATLY APPRECIATED!!!

And then there is the other issue -- that I highly doubt I will ever be a mother, but if I were, I'd want to work part time.  Yet what point is there in crafting a career that allows me to work part-time when there is almost no chance of needing it?

I'm not even sure how to proceed with Operation Infutility.  Husband is not showing signs of wanting to move forward.  I, on the other hand, am not ready to give up.  I need children!  My dearest, best friend is still offering her ova and she is now married long enough that they should let her.  On the other hand, she doesn't have proven fertility.  But I think it's worth a try.  I could always find an anonymous donor at the same time.  It's just that Husband isn't currently interested in trying.  I don't understand.  I know there are lots of people out there who have meaningful, complete, happy lives without children.  But I am not one of them.  I dreamed about having babies from the time I was not much more than a baby myself.  I am happiest when I have a little one in my arms, when I get to nurture.  I am not ready to give up yet.  Because personally, if I can't have children I would rather overdose on all the potassium in my medicine cabinet, and all the antihypertensives, and all the NSAIDS.  Dramatic?  Yes.  But true.  I do not want to live a childless life.

Oh, one other little tidbit.  I got to care for a young woman with Turner's Syndrome the other day!  I am not alone, and I can make a positive impact on her.  I hope she choses to follow up in my clinic.

Have a good night, everyone, and Chag Chanukkah Sameach!

In Which IVF Fails. Again.

I've had quite the streak of luck.

1. Had to work a month at my least favorite hospital, with a bad attending, and a bad intern.

2. Was on call on my birthday.

3. As a birthday present, found out we were out of embryos.

4. Our fourth IVF cycle failed.  We did a two-embryo FET using an 8-cell and a 5-cell transfer.  I got the call today during a lecture on STEMIs (ie heart attacks).

At this point we have tried two different surrogates and two different ovum donors.  I don't know what our next step will be.  I wonder if it makes sense to continue.  Maybe I should just hope Husband will reconsider adoption?  My family keeps pushing us to continue IVF but my mentor/internist suggests cutting our losses and I think perhaps she's right.   But I don't want to make any decisions while I'm still emotional.

And emotional I am.  I feel angry and hurt and sad and hopeless and jealous.  I don't think I'll ever become a mother.  I don't believe anymore.  I want to be a mother more than anything in the entire world and I would give anything to make that happen.  But I wonder if I must accept the unacceptable.

I will eventually regroup.  For now, though, let the pity party continue: samosas and palak paneer for dinner, washed down with mango lassi.  A book-buying binge.  And a donation to charity.

Happy Thanksgiving...sort of.

In Which Our Heroine Emerges from two VERY LONG months

...only to be headed toward another busy one: cardiac care unit.  But at least I have done my two months as a senior resident leading a team and for the rest of the year only need to supervise myself.  Leading a team is challenging, especially when you constantly function with half a team because of peoples' days off and clinics.  It's disjointed and I wish there was a better system.  But nobody wants to read about how the ACGME mandated duty hours actually harm my education and patient care, so I will step down from my soapbox.

I don't have much of an update right now on operation In Futility.  I can tell you that this next cycle may be a major reflective point.  If it fails, we are again out of embryos.  I don't know what the next move should be.  Do we find a third egg donor and transfer to a different clinic?  Northwestern clearly hasn't brought us great success and I know there are some excellent clinics in Surrogate's state.  But is there a point?  Why do the same thing over and expect different results?

Except I don't know what other option I have.  Husband is still absolutely unwilling to adopt.  And I am unwilling to live without children.  My mentor/internist/person who tolerates my self-centered ridiculousness says that Husband will reconsider with time and that I should learn patience.  I know she's right that I need to learn patience.  But I'm not patient.  I have never been patient.  I wish I could be but I don't even know how to learn patience.

Dear readers: How does one learn patience?  Can it even be taught?  Personality traits are so difficult to change.

In Which Our Heroine Requests Advice or, When the White Coat get Heavy

Dear all,

I could use some advice.  Being a senior resident is TOUGH!  How does one manage the team?  And teach?  And supervise the interns while giving them autonomy?  And teach the medical students and make them think Internal Medicine is the BEST field EVER (because it IS!!!)  And not break down crying because of outside stressors?  And -- for the really ambitious -- get sufficient sleep?

I suppose that last can be answered by not blogging late at night.  So I will go to sleep now.

Goodnight all.  Moadim l'simcha for those celebrating Sukkoth.

Briefly, more updated

Another Yom Kippur has come and gone.  Another embryo transfer has come and failed.  I expected it to fail but still hoped it might be my rainbow baby.  After all, what could be more auspicious than a fresh transfer on Erev Rosh Hashanah?

Apparently, lots.  Surrogate's beta-hCG was 2.

We will transfer two frozen embryos in November.  At least, I hope we will have two.  There are currently four so I hope at least two survive the thaw.  If (or when?) we exhaust all the frozen embryos, we will consider switching fertility clinics.

It was a difficult day.  I don’t use my phone on Yom Kippur (Day of Atonement), but Surrogate texted me so it popped up on screen.  I forced myself to shul for the last 3.5 hours of prayer but struggled.  Less than twenty-four hours earlier I was dressed all in white, singing joyously to melodies we use only on the holiest day of the Jewish year.  But that night my eyes just ran over the prayers blankly and I could barely focus.  I was so sad and angry.  I believe without question in God, which only made it worse because I wanted to show myself that if you really believe you pray and you praise God no matter what.

Since then I am back at work, although I can't focus at all.  I just want to obsess and cry even though it changes nothing.  But knowing that intellectually doesn't stop the emotional me from wanting to scream, "STOP, world!  I am upset and I wish you would take notice."  Patients don't stop getting sick because I am upset.  Interns and med students don't stop requiring supervision and teaching.  So I guess I just have to pull myself up by my bootstraps.  My internist/mentor says just to plan for each day.  It makes sense.

One infertile day at a time.

:o(

Found out tonight that our transfer didn't take.  (Sorry I didn't mention we were even transferring -- didn't want to jinx it.)

I suppose on the bright side, no miscarriage this time.

We will try again, but I have stopped believing.

Shanah Tovah u'metukah! A good and sweet New Year!

Hello Dear Readers,

I promise to update you fully once I finish my ICU rotation.  In the meanwhile, I wish you all a happy and healthy (and fertile) 5773.

Take care,

Mim