Sleepers, Awake!

Once during my 4rd year in residency, I worked for 12 weeks without one day--one 24 hour period--off. I don't remember much about those 12 weeks. I just know I that I did it. I remember the dread of the day before and the relief of the day after. For all the days in between, I must've been in a trance. I guess that's the thing to do--check out, go on auto-pilot--during those times. When I ask patients who have been in the ICU, on mechanical ventilation, one foot in the grave, if they remember any of that experience just about 100% can't recall a thing. Looking back on my years as a resident, it seems that it was one big blur where I remember some random moments (usually brought on by watching "Scrubs"). It was so easy to come out of residency and continue on that 90-100 hour work week. Turbo surgeon on auto-pilot. The amount and stress of work and endless hours of being available for work continued to validate my ego and define me as a surgeon.

Then I woke up. I wish I could tell some heart-warming Hallmark channel story about some sweet patient who changed a hardened surgeon or a Doctor, Heal thyself! tale. Not today. The stars aligned in such a way that I left my busy and successful practice in Seattle and found myself back in Upstate NY working part-time in a significantly less busy practice. I missed my wonderful life in Seattle: a rewarding practice with great colleagues and lots of elective surgery, an utterly gorgeous city with a friendly and active multisport community, a place where I felt that I finally belonged. While I completely HATED my new work and living situation at first, it did give me alot of time to get back into triathlon and figure out what was really important to me.
The price and process of self-awareness is that all those emotions, thoughts, behaviors hard-wired bubble to the surface. Each can bring about incredible joy, pain, both, and a more thorough understanding of oneself. Sounds very Dalai Lama and zen-like, huh? Well, let's just say it takes up alot of time and energy to process all of it. Time and energy that used to be dedicated to work. Well, for the last 10 days work has increased its volume and intensity to the point where I went back into auto-pilot---or at least I tried. It's Friday. I'm off call. The pager is turned off and I'm psychologically spent. I guess I was more awake for all that work than I thought. It's not the hours or unpredictability of the hours of work that are exhausting. It's worrying about people--sick, whiny, demanding people with unrealistic expectations, who take out their frustrations by being rude to you. I worry about them because that's what I do, it's my job, and I'm awake.
I hope that over time I'll be less exhausted, build up endurance and fitness in this arena the way I do with training. I remember when I couldn't run longer than 30 minutes without a walkman. I needed the distraction to just get through the workout. Now I can't stand to run with any music because I find it distracting. I want to completely tune into my cadence, pace, and how I'm feeling whether it's fresh and fast or hoping someone will jump out of the bushes, attack me, and end this misery (one of my thoughts around mile 14 of IMLP 07). Self-awareness sounds great for triathlon, but it seeped into other aspects of my life too. I have a finite amount of mental energy to expend and for the last 2 weeks the tank has been close to empty. Something's gotta go and I'm hoping that by this fall it's going to be work. Just in time for IMLP 2009 training!