It seems like Hopkins is yet again on the cutting edge of medicine these days. According to the article, a former surgical resident, Dr. Oscar Serrano, with a seemingly impeccable record up until his dismissal had gotten the axe from his program after allegedly his superiors erroneously assumed he was behind a complaint that initiated an investigation of their surgery residency program. Furthermore, the article also states that, Dr. Julie Ann Freischlag, chief of surgery claims that this was not the case and that he was terminated because he was MENTALLY ILL! I am quite frankly nauseated to keep hearing about former residents who were just booted out of their program, have been put on probation, are afraid of pending probation, or dropped out altogether because of the hell they have been put through with their programs. In any other job if you get fired you can simply get back up on your feet and just work somewhere else. However, this is not the case with residency. It is like being dropped in the middle of Death Valley in the middle of July and left to fend for yourself without any food or water. Essentially, an MD without residency merely equates to that of a BA degree. In this case, MD stands for “Massive Debt”. Furthermore, you have all the years you already invested into medical school and the six figure debt that does not go away. This is why this is such a scary scenario and sadly it happens way more than it should. I hope this resident takes Hopkins to the cleaners and a precedent is set that an environment of bullying and intimidation with the threat of constant dismissal will no longer be tolerated.
From this weekends Washington Post, read about the sad pitiful tale of a well to do VP in the financial industry bringing down 150K a year who finds herself “struggling” in the current economy. How can this be?
“Steins takes a breath. Life in this $2.5 million house was built on the premise of two incomes, not the income of a divorced mother of three in a tanked economy. Her property taxes are $35,000 a year, the nanny is $40,000 and the gardener is $500 a month.”
When she pays a nanny nearly the same as an intern and lives in one of the most expensive counties in America is it no wonder? Why do I bring up this story? Because I believe it vividly portrays how one can find themselves in a heap of trouble if one insists on living beyond or even at their means. It also clearly shows how not having satisfaction in one’s life and quelling that emptiness with buying more things can entrap you. This is how you can find yourself mired in a job you hate with merciless hours robbing you of your valuable time and freedom. It appears that just to maintain this woman’s crazy lifestyle is running her 300K a year. So after salary and alimony, she is pulling 50K out of “savings” to stay afloat. This is a clear case of living BEYOND one’s means and is simply not sustainable in the long run. This woman can play pretend with all her peers and friends that she is a somebody, however she will never have true freedom. This is a life of confinement and stress that would choke me of my well being not further it. What is even scarier to me is what would happen if she loses her job? It appears that this is something this woman hasn’t even considered since it is apparent she doesn’t know how to apply the brakes with her reckless financial spending. In medicine, I hear so many stories of physicans making six figure salaries (who are in their 40’s and 50’s with loans long paid off) crying poverty who can’t retire or are stuck and miserable unleashing it on those around them. I sometimes wonder if they are living much like the woman portrayed in the article? I am sorry but I have no pity for such people. My advice for Laura Steins is simple. Sell the house, stop shopping at Saks, ditch the nanny and gardener, put your kids in public school, and learn to Live Below Your Means (LBYM) and start saving for unforeseen life events. Problem Solved. It makes me nauseous that I will be the one stuck flipping the bill to bailout irresponsible people like this. You make your bed and you sleep in it. End of Rant.
On SDN, bythesea asks, “Do you value the patient over everything else”. Having strong feelings on this very topic, I decided to also post my response here on my blog-
This is what makes the medicine field so taxing and draining. If the patient is not your priority, you better get out STAT. Otherwise, you can kill someone…literally. Medicine is not a career where you can just flip a switch when you walk out the door and forget about all your patient encounters. Your patients have a tendency to follow you out the door and creep their way into your consciousness at the dinner table, in your dreams, and on your golden weekends. You can find yourself on some beautiful beach 5000 miles away with 2 days left of your hard earned vacation and feel your stomach twist in knots at the thought of being on 24 hr call the Monday you get back. And when you get back into the full swing of things, you will be asking yourself when you come home at night if you made the right decision in treating Mr. Jones ailment? What happens if he gets worse? Should I have ordered test X? If not and Y happens will I be held liable? If it is not your patients then it is reading up on them that will keep you close and dear to medicine. Failure to constantly be reading and keeping up in your field will be detrimental to your medical duties as well and time not spent reading will emerge as guilt. I equate this to how a schizophrenic must feel with the voices that are always in the background singing their haunting chorus, except in our cases it is to read, read, read. And in my specialty at least, you always have to be thinking ahead of how you are going to tackle the next set of patients you will be seeing the next day. As I mentioned before, medicine is not “just” a 60-70 hr a week job. Add in the above and you can tack on another 20 hrs or so. Take all these hours in a year that medicine occupies your body and mind and divide them into your upcoming socialized govt annual gross income and you will really wonder if going through all this is really worth it anymore. Medicine will truly suck your soul. More than you can ever presently imagine.
When I reach “my number”, I am so out of medicine. I am completely burnt out after barely surviving through a residency and things are only getting worse. I feel like I am ready to retire and yet I am only in my early 30’s! I can’t fathom doing this another 30-40 years. In order to escape from the coming Obamacare, I plan to continue to subsist at the poverty line ($10830 US a year- and yes it is doable- I am proof) while living like a pauper in the ghetto as an attending. It is not suffering when you think of the prize of freedom on the other side. You will be amazed at how much you can save over time on even a resident’s salary if you are disciplined. I have come to the realization that I would rather be happy and live in some secluded cabin on the Big Island of Hawaii (http://honolulu.craigslist.org/big/reb/1305738266.html) or in the rainforests of Costa Rica than be chained to the hospital and get sh!t rained on just so I can live in some Barbie dreamhouse with a big a$$ mortgage and have my gas guzzling SUV parked in the cobble stoned driveway while trying to keep up with the the Jones’s or Dr. Nurse Smith that Coastie (over on SDN )has so vividly depicted. Heck with that! This philosophy of being that I speak of is called “voluntary simplicity”, you can google the term and learn more if you want. I concede it is very hard to get out of medicine but I am determined to succeed. I fully realize that you need a well executed plan in place or otherwise you risk committing financial suicide. Just dropping out of residency with no plan is akin to jumping out of a plane without a parachute.
I just wish I would’ve known all this ten years ago and spared myself a decade of grief. But ten years is enough, I refuse to allow more precious time to slip away. Just as Andy did in the Shawshank Redemption (one of my all time favorite movies which has more meaning to me now than ever before), I will continue to chip away at the walls of my prison until I am free again.