Should I keep my second job? Advice please!

[Sha]

There are pros and cons each way, it just depends on you. What is your gut telling you to do?

 

[jstarfireb]

I would quit...sounds like it's not worth it.

But I have to ask: how on earth do you get the time off from residency to do this when you get called?

 

[rockzilla]

Reading your story, I think of: all the people around the world who work harrowing, difficult, stress- and anxiety-inducing jobs where they are miserable because they have to. Because they need the job to feed their family, because its the only job available, because they don't have the education/class/life situations to do anything else.

If you, a highly-educated, successful, talented and in-demand doctor, with a supportive husband and an enviable financial situation, can't make the choice to not take a job that literally makes you sick to your stomach with dread, who can?

Yes, there is always the money. It will always be more "responsible" to do the most lucrative thing, to reach financial goals sooner, but really, this is a very "American" way of thinking [yes, I know you are Canadian, but a lot of the values around hard work are similar]. We value a work ethic, being fiscally responsible...but ask yourself, what is it for? Do we all put in the years of effort, strenuous schooling, challenging ourselves, for the sake of ending up with the biggest bank account? Do we work ourselves to the bone because there is somehow something more noble in work than enjoying life?

You are in a unique position to be able to choose not to do something for the money. Think about that...you are in a position of power, even if it doesn't feel like it when you are up in the turbulent air. Think of the sense of mortality you feel when you are up there, and what your critically ill patients feel when they are in your care: If this was the last year of your life, is this how you'd want to be spending it?

 

[allycat0303]

As Wildcat03, eloqently explained, the assumption that a physician can't properly care for a patient because he is stressed or panicked is false. When there is a disaster in the OR, the surgeon is both stressed and panicked. In a similar manner, an emergency physician is both stressed and panicked when a young patient codes without warning because at that very moment you realize that you have the potential to save someone if you are quick enough or smart enough. In addition, had I not been 100% comfortable with my ability to care for the patient, I would not even consider this. Originally, the company offered a substantial bonus to accompany pediatric patients. I'm about 90% comfortable with pediatrics, and declined (vehemently). My first though is, "if this was my father....". I would not endanger a patient's life for money, that calls into question my integrity and respect for the sanctity of life. I have said many times, to my attending, "If I don't grow up to be a good surgeon, then I'm going to stop because it's not worth the guilt." I have enough insight to realize when I'm not good at something.

Most medical mistakes are NOT made because a physician is *stressed*. When physician's are most vulnerable is when they are tired,they are overconfident about their abilities, or just plain negligent. For example, the nurse calls the resident because the patient is breathing badly, and the resident never passes by to evaluate the patient (because you're too tired and you forget, or you just don't care). Or a staff that declines a suggestion because he doesn't like who the suggestion is coming from even if it is in the BEST intrest of the patient. Or a resident that thinks he can insert a chest tube without supervision because he's done it 1 before successfully, and it goes through the heart and the patient dies. All of these things have happened in the last year.

I only made it back from Amsterdam for my call, before I was sent out again to Germany I found that the anxiety was mostly before the flight and not during. Part of it was because I was picking up a patient based on inadequate information. Before actually laying eyes on the patient, I was quite anxious, it appeared to be a combination of unknown patient status, mixed in with flying, unknown destination, adequate supplies stocked onboard.

Upon returning to skyservice base, there was a team leaving for Japan, and a nurse on the flight was having an anxiety attack over the upcoming flight. She's been flying for 13.5 years with the team, but she told me it never gets better! He explained a) it's a small plane b) they land on small airfields in newfoundland and iceland with LOTS of windy, adverse conditions. c) Although the planes are well maintained, it's not a secret that sometimes they make emergency landings, or need to turn back because of mechanical problems. Last month, one of the jet's landing gear failed to deploy and they were preparing for an emergency landing (on the belly of the plane) when the landing gear miraculously kicked in. He said that among the 50+ nurses, RT and physicians that work for them, 1/3 have a some degree of discomfort during flight. If it's not about flying, it's the clautrophobia (which thankfully I don't have). I posted a picture of the inside of an airambulance plane, so people can get an idea of the size of it. Needless to say, 18 hours in this enclosed space can be difficult.

As to whether or not I'm going to continue...I'm not sure. I'm home now, got some rested and feel like it wasn't *that bad* in retrospect. I'll see how I feel in the days to come.

jstarfireb: Part of the cardiac surgery program in Canada is 1 year mandatory research year. I can only fly with skyservice during this year. In July, this will be over, and I return to normal residency as a PGY4. However, some surgery residents will take an extra 6 months off if they want to make more money.

 

[movie zombie]

you are doing a great service....and you've been able to assess what the trigger issues are for you.....and you've found out you're not alone with your stress flying issues.... i think you're original post was in panic mode. i think you've now found a centered place. i think you can do it for the time period allocated......and i hope you do. as i said, you are doing a great service and getting a chance to network with people you might never have met otherwise....who knows how that will benefit you in the future? congrats on completing the trip and keeping an open mind. having seen the interior of that plane i can now more appreciate the working conditions. again, thank you for what you are doing. who knows when anyone of us will need such assistance?

 

[kelpie]

I don't feel like I can suggest either way what the right choice is but I wanted to add that I hate flying too. I fly A LOT and I am still thinking "Oh my God, it's about the get a whole lot worse" with every bump. So sticking with it may not resolve your fear. I also had a really draining job before my current one and what helped was that I knew I was moving in a year so there was an end in sight and the money was good.

 

[rosetta]

God knows I've worked under a huge amount of stress, no sleep etc etc.

I never felt 100% happy doing it though.

I'm sure you can still look after your patient (I'm sure I couldn't as I'd be far too stressed) but is it really worth the fear you feel?

Those planes really do look small

 

[allycat0303]

MZ,

Your words were very kind. You are right that I was more frightened in Amsterdam. I was exhausted, lack of sleep, no food and homesick. I lost 3 pounds on the 3 day trip. It was awful.

When skyservice asked me to fly again after I got home from Amsterdam, I initially said no. I really couldn't handle the thought of another second in that plane. They told me the patient from Germany was a young man that had a heart attack (39 years old), and they had put in a LVAD (a ventricular assist device, it's like a mechanical heart). There were about 20 companies that either refused or were unable to get a team together to bring him home. Skyservice agreed but only if they could find a physician, but all of the other residents that work for my company said no. I deal with VAD's all the time, and I was comfortable bringing him home. They did have to pressure me, there was perhaps a little guilt tossed in because the patient has been in Germany for 6 weeks, stable, but without a way to come home.

When we first boarded the plane, he said to me, "I don't like flying." And I told him, "I really hate it too." And he looked me straight in the eye, and said, "Thank you agreeing to bring me home anyways." Upon landing in Houston, the US customs agent came to the plane and they said to the patient, "Welcome home." He cried with such overwhelming relief. When he saw his wife, it was the most intensely emotional moment I have ever witnessed in my entire life. I can't imagine what it has been like for her. She has been in the US for the past 1 month+ with their 3 children, while her husband was in Germany. I know he still has a long way to go, but I would be lying if I didn't say it didn't feel like I had made a difference in his life. It made me reconsider my decision to quit. Honestly, VAD's are rare, they only bring about 1-2 a year home, but for the people we are bringing home, they might not always express it, but I imagine it must be a tremendous relief for them, and their loved ones to be home. I don't know about the future, but I'm still glad I had the experience. And I'm sure that my next commercial flight will be less anxiety provoking!

Rosetta: I don't think the money is worth the fear I feel. But bringing the patient home from Germany, seeing the happiness on his face, that was unforgettable.

 

[missy]

Ally, that is such a heartwarming story! Thank you so much for sharing it with us. I could definitely see how the desire to do good here could outweigh your fear of flying. And I can see how this could be a very satisfying job if you can deal with the stress of flying and being away from your dh. Big hugs for what I know is a very tough decision.

 

[Fly Girl]

When our daughter went to England for her semester abroad during college, we purchased medical evacuation insurance. If she was to become seriously ill or injured while abroad, it was wonderful to know that we could have her at a local hospital within a matter of days. The issues of having to deal with a seriously ill family member in a foreign country are huge. Medical evacuation insurance was reasonably priced, and well worth my peace of mind.

Whether you decide to continue or not, Ally, thank you for what you have done so far in providing this valuable service.

BTW, my husband is a nervous flier. But after I got my private pilot's license, he was my first passenger. He held on to the little strap over the door (meant to help you in and out of the plane) with a death grip. Rather silly of him. Anyhow, after flying with me in little planes a lot, riding on a commercial plane during turbulance doesn't bother him any more. He got used to it. And, yes, smaller planes do bounce around more. I tell people that it is the difference between taking a ship on Lake Superior versus a canoe. They seem to get that.

 

[movie zombie]

When we first boarded the plane, he said to me, "I don't like flying." And I told him, "I really hate it too." And he looked me straight in the eye, and said, "Thank you agreeing to bring me home anyways." Upon landing in Houston, the US customs agent came to the plane and they said to the patient, "Welcome home." He cried with such overwhelming relief. When he saw his wife, it was the most intensely emotional moment I have ever witnessed in my entire life. I can't imagine what it has been like for her. She has been in the US for the past 1 month+ with their 3 children, while her husband was in Germany. I know he still has a long way to go, but I would be lying if I didn't say it didn't feel like I had made a difference in his life. It made me reconsider my decision to quit. Honestly, VAD's are rare, they only bring about 1-2 a year home, but for the people we are bringing home, they might not always express it, but I imagine it must be a tremendous relief for them, and their loved ones to be home. I don't know about the future, but I'm still glad I had the experience. And I'm sure that my next commercial flight will be less anxiety provoking!

this says it all, ally: you were his angel. you made a very big difference in their life and i'm guessing you will make a very big difference in the life of others whether or not you do another flight. i'm hoping you do continue because it must be pure hell to have a medical condition that requires this type of flight in the first place and not be able to get home. your holiday gift to that couple was to reunite their family and have him home for the holidays.

i'm glad you are home and getting some rest.

 

[diamondseeker2006]

MZ,

Your words were very kind. You are right that I was more frightened in Amsterdam. I was exhausted, lack of sleep, no food and homesick. I lost 3 pounds on the 3 day trip. It was awful.

When skyservice asked me to fly again after I got home from Amsterdam, I initially said no. I really couldn't handle the thought of another second in that plane. They told me the patient from Germany was a young man that had a heart attack (39 years old), and they had put in a LVAD (a ventricular assist device, it's like a mechanical heart). There were about 20 companies that either refused or were unable to get a team together to bring him home. Skyservice agreed but only if they could find a physician, but all of the other residents that work for my company said no. I deal with VAD's all the time, and I was comfortable bringing him home. They did have to pressure me, there was perhaps a little guilt tossed in because the patient has been in Germany for 6 weeks, stable, but without a way to come home.

When we first boarded the plane, he said to me, "I don't like flying." And I told him, "I really hate it too." And he looked me straight in the eye, and said, "Thank you agreeing to bring me home anyways." Upon landing in Houston, the US customs agent came to the plane and they said to the patient, "Welcome home." He cried with such overwhelming relief. When he saw his wife, it was the most intensely emotional moment I have ever witnessed in my entire life. I can't imagine what it has been like for her. She has been in the US for the past 1 month+ with their 3 children, while her husband was in Germany. I know he still has a long way to go, but I would be lying if I didn't say it didn't feel like I had made a difference in his life. It made me reconsider my decision to quit. Honestly, VAD's are rare, they only bring about 1-2 a year home, but for the people we are bringing home, they might not always express it, but I imagine it must be a tremendous relief for them, and their loved ones to be home. I don't know about the future, but I'm still glad I had the experience. And I'm sure that my next commercial flight will be less anxiety provoking!

Rosetta: I don't think the money is worth the fear I feel. But bringing the patient home from Germany, seeing the happiness on his face, that was unforgettable.

Beautiful, Ally!!!!!

 

[wildcat03]

Oh man, Ally! What a great story! What an amazing gift you were able to give that man, his wife, and his children! Who knows if he would have made it home in time for the holidays if you hadn't been available. What a great fit, too! A CT surgeon and a VAD patient. In our hospital, the VAD patients can only be one of two places - CTICU or cardiothoracic stepdown! Great job facing your fears.

 

[Mara]

Ally! What a great story, it made me teary. I hope that you continue, because I think you'll be able to look back upon this and feel you have prevailed. Life is short, but 6mo in the scheme of things is not very long at all for what it sounds like this could bring you...in more ways than one. Hope you are well!

 

[tuffyluvr]

Honestly, only you know what's right for you, but facing your fears will force you to overcome them. Its no where near the scale of what you're doing, but I was terrified of needles--like, had a full-blown panic attack every time I had to get blood drawn. I forced myself to give blood until I got over it. Now I'm an aphresis donor and sit with a needle in my arm for hours at a time, once or twice a month! It was quite empowering.

And I think your homesickness will get much better after you have done a few trips and get used to it. I used to get really homesick when I had to travel for work. It can be lonely, but you also get used to it and it really makes you appreciate home.

I think it sounds like an absolutely amazing opportunity, and I think you should give it a chance, but if you truly hate it even after several trips, don't force yourself to do it just for the money.

 

[jstarfireb]

jstarfireb: Part of the cardiac surgery program in Canada is 1 year mandatory research year. I can only fly with skyservice during this year. In July, this will be over, and I return to normal residency as a PGY4. However, some surgery residents will take an extra 6 months off if they want to make more money.

Ah, I see! I keep forgetting about research years since I'm not doing one.

Ditto what you said about stress not contributing to medical errors. Certainly fatigue is a major factor, but not so much stress. In fact, I think we sometimes do slightly better under stressful conditions.