Denise 0:07
Myth, Magic, Medicine, and everything in between, two doctors talking... Hello, and welcome to Myth, Magic, Medicine. I'm your host Denise-Billen, a retired doctor now consulting hypnotist. And this podcast is just two doctors talking. My guest today is a doctor who runs a nonprofit physician mastermind and podcast to help others find ways to create lives that straddle the messy tension between personal and professional goals.
Hi Melissa, so lovely for you to join me today. This is Melissa Welker an MD, who is an anesthesiologist full time and mother to two small children. Little boys, I believe, right?
Melissa 0:48
Yeah, yeah, it's not too early for my day. Tara. Oh, two and four. Yeah. Yeah.
Denise 0:53
Oh, fun. I love the conversations for that age group. That's just fabulous. Yeah, they're really cute. Yeah. And this is really early in the morning. So they still fast asleep. You're hoping
Melissa 1:03
I hope so. I am actually hiding in the basement so that they don't hear me I have a really old house so that you can hear everything. So I hide in the basement often.
Denise 1:11
Yeah. Okay. So then we'll come on exploration a little bit, so we should get the show on the road. Okay. Melissa, what are you going to be talking to me about today? I am really intrigued by your blog, CordeliaCrossing I like that.
Melissa 1:28
Yeah, I thought and now we we've been chatting a little bit, I thought it'd be interesting to talk about just how to how to balance everything, how to balance what you want, personally, and how you want what you want about professional and how to find that. That I think some people now right now call it that rainbow unicorn or golden unicorn where you both thrive as a person and as a clinician.
Denise 1:53
Oh, I forgot to ask you partner, is he also a medicine?
Melissa 1:57
He's not actually he did, he did some consulting before and then when COVID hit and we had our second kid he now stays home with the kiddos
Denise 2:06
on that slice. Yeah, she have that flexibility.
Melissa 2:08
Yeah. Yeah, that's really really nice.
Denise 2:11
Yeah. So when when you were you were an athlete, you said what was your, you're a runner?
Melissa 2:21
Ah, so I've done many things. And I think the most most of time I do I'm mostly a cyclist now. With little kids. It's mostly aspirational, most, you know, my my athletic endeavors are aspirational. But I did triathlons for a while like in med school. I did triathlons, I got an Ironman for a year when I did my MPH. Just fun. I swam for a long time and so most things, swimming, running and cycling are the biggest things for me but anything outdoors
Denise 2:57
Oregon's great. Yeah. So your your kids do you think it's it's the practice of medicine that slowed you down athletically or having children because they take up so much of your time while you're not being a doctor?
Melissa 3:12
You know, I think it'd be so interesting if I tried to put the timing together I think the medicine slowed me down honestly first so just doing you know our in house calls so often I think was a big issue and then having kids just as a whole other you know, they Yeah, here at speaking up kids I might actually slip my
Denise 3:40
Oh one's found you?
Melissa 3:42
Well No no, I think my dog child is requesting letting out so let me go back otherwise you'll hear her whine for a while
Denise 3:50
No problem I can clip things out
Melissa 3:52
I'm so sorry for that.
Denise 3:54
That's perfectly okay. I should have done quite a few of these with people who have children and the children come and join them on their laps. It's fine.
Melissa 4:00
I know I know so that may happen Yeah, we have I have two dogs there we got them in residency and actually so now they're geriatric, they're geriatric dogs and so I've geriatric dogs and toddlers and they both need a lot of potting and I've been told people can tell I have little kids because I say things like potty you What would you like to go to the potty?
Denise 4:27
Yeah, so that's a great does go away after a while. As their language changes so will yours. So you're you're an anesthesiologist, you work full time. Yes. Full time mean Monday to Friday. Are you on call and you have full standard schedule or what's what is full time to you?
Melissa 4:49
You know, that's a question so many people want answered. So, I think I whenever I talk to people, this is actually something I tell them to define what is full time when someone says they have a full time job, what does that mean? So, ironically, my job could be construed as slightly less than full time or slightly more than full time. So what that means is, I do non-clinical work on Monday. So I am our OB medical director as well. OB anesthesia Medical Director, so I have non clinical days on Mondays, and then I work Tuesday through Friday definitely and then call plus call as well. So one weekend a month. That's usually about 72 hours. full weekend, and then, you know, I take call probably one to two times a week.
Denise 5:47
That sounds more than 40 hours.
Unknown Speaker 5:49
I think it's usually about 60 ish, hours a week. That's why I said it depends. So it's funny. According to some calculations, I am less than full time and other calculations. I'm like, 1.2 times and then. Yeah, so that if you add admin time, which we don't set, that's why I technically I'm not technically full time. But after you add admin time, it would make me Yeah, so
Denise 6:20
you get Monday off. I said, we won't put you on call on Monday. But there's a lot of stuff you have to finish on
Melissa 6:27
. Correct. Yeah.
Denise 6:29
Do you specialize in a particular kind of anesthesia? You're in the OB section. So do you do a lot of OB?
Melissa 6:36
Yeah, OB. I do a lot of OB and that was, ironically, I would love to say that, it's because I had this a lot of experience, and I was the best person for the job. Ironically, I think I was I wanted to get involved in leadership. And then I also when I took the job, I just was thinking of having another kid. And I just wanted to make the department better. So I thought, you know, if I'm gonna have a kid and I'm gonna have it here, I'm gonna work on making this a better place for not just me, but other people too. But it was a little bit selfish because I knew that I was gonna have another kid. So so that's what I took that that job otherwise, you know, I think I have too many interests, maybe? It was probably my fault, my problem but I do general anesthesia. And, we, the hospital I work at so my group, we cover a bunch of different hospitals with the hospital I work at that I really like that type of work. We do is we are a Tertiary Cancer Center. So we do a lot of big cancer cases like colorectal cases.
Denise 7:49
Are you involved in pain as well or is that a different section?
Melissa 7:54
That's definitely in a different section. So we I do pain but not not as much chronic pain will get consulted, but just as medicine, like works out, it's hard to actually integrate that with acute, acute like perioperative care. So I do mostly the perioperative side, not so much the chronic side.
Denise 8:17
Okay. Yeah. Okay, so you've got that nice, full time and a bit job. And you've got two kids that you're taking care of. And your husband is able to stay home, which is fabulous.
Melissa 8:28
Yeah. Yeah. Highly recommended. Yeah.
Denise 8:31
Highly recommended.But but not always a possibility. Right, if he could do it. And he's continuing to work, I assume, but but around the kids schedule. And so what, why have you started this other little thing that you're doing? Let's see. Yeah, talking about improving the world, for anesthesiologists at least?
Melissa 8:59
Yeah, that's a great question. And the funny thing is that I have another one of my friends is an anesthesiologist, she's my current candidate, accountability partner. And it's interesting because she asked me recently that really kind of hit to hit to my core, she says, 'It sounds like you keep trying to find an ideal job for everyone else. But you still have found the ideal job for yourself'. And I think that, you know, we I think as people and as clinicians and who else how whatever title you want to put before you as life moves, we move and evolve too and I think that I realized that that might be a continuous search. Just a continuous evolution, and I think I'm trying to embrace that. And so my, what I did is during COVID...so everyone's been hit by COVID I feel like during COVID, that whole phrase could probably be put on so many podcasts in the search. But so everything shut down for a while we were just doing emergency cases. And so there was a lot of there was this big push pulled me, right. So there was people going, not doing cases when COVID was not bad here, and they weren't really working here. And then people were flying to Louisiana or New York, and you know, you got guys got hit pretty bad. And so there was this supply demand mismatch, right? And also, I think a lot of people who had never taken a breath,
Denise 10:47
were forced to.
Melissa 10:48
Were forced to yeah, and I mean, not everyone had that some people just kind of kept going on. But there was this big shift. And I think that what I realized, I think a lot of people realized is that if things don't change, we're not going to have a whole lot of physicians. And we don't do a very good job of using our resources, you know, using our people in effective ways, and figuring out ways to get them places, right? So even the credentialing became easier. State licensing became easier, because it was like a pandemic. But there are so many groups that needed people, or people just couldn't, you know, they're not working, so they're not making any money. And so they're having that that issue too. And I realized, we just don't do a very good job of, of finding that balance, finding those people that want that want or need work, or more work. And then what about those people that you know, their parents are sick and dying, or they have little kids or, you know, they have health reasons and finding that and addressing that. And I think I think medicine has to change. And that really became apparent to me that if we want to continue addressing, if we can want to keep physicians, and I'm talking about myself, this is like, very personal for me, too, if we want to keep physicians and I think we do have to find more creative ways of really finding,um.
Denise 12:23
I think, I think medicine is medicine is changing. How much of the change has been driven by people actually doing that work? And how much it was being changed by bean counters. That sounds vicious, that sounds you know, bitter. But how much of it is being driven by by analysts and systems people who've never actually been in the trenches? Yeah. So, so do you see your work is trying to make a little bit of a change in that? Are you trying to get more, ore conversation going with physicians?
Melissa 13:00
Yeah, Yeah, I think I think if, if I go really far back, yeah, honestly, a lot of it's just trying to figure out what actually makes a difference, you know, what changes make a difference. And I, I'm hoping that, you know, right now I'm building a platform that, hopefully, we'll help people exchange that information a little bit better. So they can say, you know, that I, I am a, you know, the whole spectrum, like, I am a person with a ton of debt, and I just want to work, I mean, you know, if you if that's the person, you want to make the most money, you want to work, pay it off, become financially independent, you don't have kids, you know, whatever your thing is, or you know, you want to work part time and take care of your kids and parents or, or you just want to travel, you know, all the in between, find a way that so you can say, this is the kind this is the kind of life I'd like to lead and have an say, Okay, this is the, this is the place where I can do that, like that makes sense. So that we can keep people in medicine. And I do think I do think medicine is like you said, I do think it's changing. But I think like anything in medicine, I realized it's changing, but we, if we either change with it, and influence a change, or it changes it takes us with it. And it's so interesting for like at the towards the end of the so where we are now, right? I shouldn't say the end of the pandemic, who knows,
Denise 14:39
There'll just be another one.
Melissa 14:41
Where we are now right? So there's this huge physician shortage. There's this huge especially for anesthesiologists but it's true was
Denise 14:48
We knew that we were going to be down numbers anyway - just because of people retiring and the lack of , the increasing population but staying static in the number of physicians available was going to lead to a shortage,
Yeah! I mean, we Yes, I mean, we've known I think we had, in one of my health systems classes in my, during my MPH they that someone gave an analogy or this might have been a lecture of medicine being a raft that we were all, we're all like paddling on, right? We're all like paddling, trying to stay upstream of this huge waterfall, we're trying to not go over the edge and crash, we're all gonna paddle really, really hard. But we're not going to make it like, it's gonna go over the edge until we either, you know, find an engine or get off or something like that. But somehow we think if we just paddle harder, we're going to make it right. And so I feel like, I mean, that was, you know, 15 years ago, someone gave that analogy. And so I think that we're, we're kind of there now I like it feels like we're, we're here where this, this time is going to something big, feels like that's gonna happen, at least for me. And what I realized is, if this were a normal job, right, we should be able to, we should have the leverage, we should have the ability to make good changes for physicians, right? There's not enough physicians, there's this huge need, everywhere needs people probably in every specialty, I might be wrong, but every specialty, most specialties. And yet, instead of things conditions getting better, most of my friends during COVID, took pay cuts are working more than they want to are working more short staffed with less resources, taking more call than they want to. And they're not necessarily and I don't think money fixes hardly anything. I just think it's a band aid a lot of times, but it is, you know, it's it's a necessary, maybe, I think that that's not even, that's not even necessarily going up, for some people it is, but it's not really being addressed either. And so I just feel like if we have all these things that are pushing, and we should have this ability to change and make the system better, because people are leaving, you know, there's not enough of us already. And, and physicians really need or not physicians really need but also patients really need like, good care, like there's so much need. And it still doesn't feel like it's going the right way. I feel like if all of these, quote market forces, so I love economics, too. But if all these market forces can't push it to be better, what is, what's going to push us to be better? I think we have to, you know, yeah, and I keep looking around. I don't know, if you've had this experience, I keep looking around. My mom had many joints replaced in the last two years. And one of the orthopedic surgeons said, you know, I hope you don't get her joints because you're going to get joint replacements do and I think probably true. Yeah, exactly. And I look around and I say you have who's gonna replace my joints, you know, who's gonna take care of me, because all of us will be the same age as me, you know, like, we're all...
I'm in the already people getting replaced. So I'm older than you. We see it and it's terrifying. I had to change. I had to I had to go to a funeral. And and so I had to change a doctor's appointment that was made six months ago, that but that was a standard was a six month check. So I called the office so I'm really sorry. The next appointment out for my primary doctor was seven months. So basically, sorry, you don't keep this fun. You don't have it. Here in Delaware we're desperate for primary care. Yeah. And a lot of nurse practitioners being filled up into spots and I'm a snob and I want to see what I will for routine stuff. But if I have a question, I want a doctor to be answering the question. And it's, it is kind of scary. And it must be even scarier for people who were younger looking at you know, 20-30 years from now how things are gonna look
Melissa 19:26
Ya know, as I say it is scary is definitely a word I could I could use with relative impunity. I feel like I tried to think of it as being interesting, maybe?
Denise 19:41
Chinese interesting -interesting times? Yeah,
Melissa 19:43
Yeah, maybe I'm in the sense that I mean, I hope that I hope that it's just the the darkness before we reform we can say great for her patients. Similarly for me when I was pregnant, it was is so funny whenever COVID was both good and bad, right? So they cut down the amount of OB appointments, we had to go to or that were recommended. And because of my age, I'm high risk, or I was high risk, I should say. And so the amount of appointments was less than when I went low risk.
Denise 20:26
But if the requirement is, presumably because they want to make sure that things are fine, is that a good idea? How things were they have missed? I mean, I've had the death was caused by a friend dying suddenly the funeral was a friend who died of cancer, she didn't see her doctor for ages. And all the sudden it was too late. And yeah, yes, there was a lot she didn't like, doctor, she was very nice to me. She didn't like drugs, you know, there's a lot of trust issues there too, that led to that. But really, the the lack of the ease of having routine appointments really impacted an awful lot of people's health in other ways.
Melissa 21:04
Yeah, I mean, that's, I that's what I think, too, is that if you or me or even my husband had to go in for something recently, have a hard time getting in. And a hard time navigating the system. I think that clearly, other people will too, you know, and I think if you're set up with all the resources, I similarly, you know, I've had this with my, with my kids, and nothing, nothing big for them or anything, but just getting in the appointments is hard. And I think that the the hard part about medicine is I think we get the system that we put in, right. So if we put in these people that and we tell them that, you know, their life doesn't really matter, like their outside life, we don't care that you have kids, you don't care that your parents or friend, there's dying or anything, you need to work you need to do your RVs, you need to get all these other things. Then, of course, when they see the patients, and the patients have the same issues. Ideally, they would say, Oh, yes, I'm a person too. I get it. Like, you know, it's hard to remember to take your meds on time, it's hard. These are things like life is hard, right? Instead of that, I think that because, you know, it's not really an excuse so much. It's just I think that's, that's what would naturally occur is that then, yeah, when you can't, when you have to cancel your appointment, they would say, Well, I mean, tough. Like that's, this is just like, what this is what I get told when I have to go to my funeral or whatever I have to choose between this and this. Um, I and I just think those two things have to change, you know, I mean, they don't have to change. But I would like a system where, where people are treated with compassion and generosity and understanding and kindness, regardless of if you're a physician or a patient. And I think if you treat, it has to go on both sides. You know, I don't think that people talk about that analogy, can't pour from an empty cup and all that other stuff. But I think that I think it goes on both ends. And for me you know, I hit we we talked a little bit about the finances so I one of my big goals, kind of driving goals that I didn't realize kind of kept me in medicine, not thinking about things, was paying off my debt. And once that was gone.I looked around,
Denise 23:37
May ask how long did it take you?
Melissa 23:39
Um, two and a half years?
Denise 23:42
Very good!
Melissa 23:45
I'm not sure if I am. It's so funny now that when I talk to people, I'm not sure if I'm proud of that. Because as part of me, then, you know, a couple years later COVID hit and I thought, oh, when we weren't doing all these things we could have been. So there's a balance. But yeah, we paid off our debt really quick. We just we did we just live like a resident. Yeah. Time. And so I love it. You said that. I think I made $35,000 a year as a resident, I think I might have gone up $40k at the end knows. Big, big. But yeah, so we paid off really quick. And I remember thinking okay, now the shackles are off, like now my debt is gone. And then...
Denise 24:28
But now you have too little dependents are taking all the money anyway.
Melissa 24:31
This is true. But you know, you look around and you think when your life doesn't work or you know, when you can't get home to see your kids or there's other things I think that sometimes you start questioning like is this really what I want my life to be like, like, Is this really what I want? And I think if I'm questioning that, I think a lot of people are I don't think that that's a unique thing to do. Because I think people want, they want I think people want Trinsic Lee they want progress they want meaning. Yeah, they also want, you know,
Denise 25:06
You want to know that your work mattered to somebody?
Melissa 25:09
Yeah. Um, and I think that
Denise 25:14
Actually I suppose, honestly, just perhaps you don't get some of that feedback, you know, how often does the patient wake up from anesthesia and thank the anesthesiologist, how much how much interaction you actually get with, with the patient?
Melissa 25:30
That's true. That's true. People usually do not remember me, that's what I always tell them. Like, you will remember anything after you wake up by the time you get out. But I'm good. I mean, I will say that selfishly, that's a little bit why I like OB anesthesia is because when you get to see babies being born just like this, more, someone says having kids is like one of the most optimistic things you can do. Because not only are you saying, right now, you know, I have the ability or whatever, to take care of a new life. But that new life also has a potential lifespan of 80 years. So you're saying for 80 years,
Denise 26:09
the planet's still gonna be here.
Melissa 26:12
I definitely had that thought before. We haven't kids. But um, and so I think that's just it's such a, such a cool place, like such a very reverent place to be able to experience so that's really nice. And also, I think that women have been, especially women's pain has been kind of discarded for a long time.
Denise 26:36
It says in the Bible, we're supposed to be in pain. Clearly written by a man
Melissa 26:42
This is your punishment. It's that's so funny. I think it's your punishment for
Denise 26:48
eating the apple. Yeah, kicked out of Paradise.
Melissa 26:51
And labor pains, which I think sometimes when you go back through history, this is a whole other topic, the history of medicine, you think, Oh, this makes sense why we do it this way. It's still messed up. But it makes sense because you have all this, but I think the ability to have that transition period without feeling like your body is ripping in half is really nice, you know, so I'll go on and put epidurals in. And people go from like screaming to like, "oh, this is okay, like, I can do this, this fine." And I think you're right, that feedback. When it's on one of my partners said, it's like getting your cookies at work like that's like, your it's like a, it's like a really nice treat, like you did a really good like job. And you don't always get that. But with that a lot of time
Denise 27:42
And most of the time everybody in the room is happy. Obviously, there are some awful things that happen. But most births are joyful experiences. Yeah.
Melissa 27:51
Yeah. Well, I think it's interesting too, because, like as a, I don't know, how you feel probably similar in the emergency department to a lot of times I see people at a really bad day, like their day is not great. They have can't like, you know, they have cancer. They're coming because they broke some bone in their body. They found out they had something that needs to come out. Maybe they're worried they have cancer. Maybe they're, you know, they're having a brain tumor, aneurysm, they're worried about dying or maybe, you know, big heart surgery. Yeah, they're,
Denise 28:32
they're very, very few entirely voluntary visits to a doctor that aren't somehow painful at some level. Yeah, giving birth whilst uncomfortable is for most people a wonderful thing and everyubody in the room is happy.
Melissa 28:47
happy. Yeah, yeah, exactly. And, and that's what I tell people that that's, that is the really nice part about that, that part of my job. I mean, the other part when people wake up and say, okay, and they were really worried that we're gonna die. That part is good, too. But sometimes they wake up and you say, like, well, good. The cancer is out. Now to chemotherapy, you know, it's not,not quite as satisfied. Yeah. It's just life. It's just live. But yeah, I It's interesting in talking to hearing you talk about your experience a while ago, too, and it's so the corollaries are still pretty strong. I feel like with this, I mean, I think in life, our experiences are more similar than different. But it's interesting that you're right in in a span of time medicine hasn't changed
Denise 29:44
In the half century almost since I started, I am amazed at how old I am. Stunning! Anyway, let's, let's go back a little bit. I may rearrange this a bit. But but so you, you've started a foundation. How did you How do you describe the work that you're doing your consulting work?
Melissa 30:03
Yeah, um, it's I would say it's, it's a journey right now, a lot of that I'm trying to define for myself. So my getting into, I call it like non clinical staff, is I realized that there was this big part missing, you know, that I, that created that kind of more global vision part that I had always thought like I got, I went into medical school and I got an MPH thinking I was going to work at like to Bill Gates, Bill & Melinda Gates Foundation, do a lot of Public Health work. And that's why I was gonna go into Emergency Medicine, develop all this stuff. And then I found out I did, it just wasn't for me. And so I remember, I started looking at how, and I'm still looking at kind of how I really want my life to look. And so one of the things that is I'm very passionate about, like we've talked about is trying to tell people that are find ways where people can find that, that that I don't know if I call it balance, but that tension, that a push and pull that feels right to them between all the different aspects of who they are, and to embrace that person as a whole person. And so, a lot of the consulting I do is problem solving, like how do we? How do you figure out how to, to staff and say, It's okay, that you can go on a sabbatical and like travel with your kids in Europe. And that actually might be a good step. It's not easy, you know, figure out how to replace that person or do this other things. But that person will probably come back.
Denise 31:58
Are you working with administration? Or you do do one on one with physicians who are looking for balance, for lack of a better word?
Melissa 32:06
Yeah. So far I've done mostly with physicians themselves. And I've just started reaching out into bigger organizations too. And so that's kind of that's that part. I'm trying to redefine a little bit more. But that's, that's kind of what I worked with. So people that are looking to leave medicine, see if there's a way to, to ask for what they want to be creative and create, like creating their jobs. So I think a lot of people,
Denise 32:38
Presumably, do they know what they want? If you've never seen it, how do you know it's there?
Well, that's, I mean, I think that's the biggest problem, right? or I shouldn't say the huge problem. I like to think of it as a challenge. But yeah, you're right. I think that that's similar with women in medicine or other minorities. I think that it's hard to, it's hard to see things you haven't seen before. And so I think that's actually part of the reason why a lot of physicians are just quitting. Yeah. Because they haven't seen a way that it works better. You know. And it's so interesting, because there's, when you feel like start giving people or telling people like, well, if you're just going to quit, your job will probably there's, there's so many people, there's so much need, if you just tell them, I'm not, I'm not going to quit, if you let me go halftime, or you let me go thre quarter time, or you let me go quarter time, because of quarter time a halftime or whatever is more of you than they're gonna get if you click. So if you go into it, and you asked, and you say, hey, like, right now. So one of the one of my colleagues I worked with recently, I won't name names or anything, but their dad died. And they just couldn't do it, like they just didn't. They weren't in the space, they need some time they needed to take a break. You know, and I think the one there's so many I think, in the US culture, unfortunately, we don't have very good. We don't address grief very well, there's not a system. I don't know if the system is right for everyone, but there's just not a, we ignore
We don't respect and honor it the way it needs to be. Yeah, here have a pill, let's get rid of it.
Exactly. And so I said, Of course you feel like you need some time. Like that makes sense. Like whatever you need, whatever. I think everyone's different, but whatever you need makes sense. And he felt like he just couldn't ask, you know, for that. And he just didn't see and I think just giving people options saying like, Okay, why don't you, you know, why don't you just ask, like, even just something so simple as saying, you know, if you ask the worst they can do or say no. But if you don't ask, then you've already given that you've already put a no, you've already given yourself the No, you've already you were already going to get the worst thing. You just don't want to actually feel it.
Do you think people at some level think they will be penalized for asking?
Melissa 35:32
Yes,
Denise 35:33
Because you're weak or some other strange thing? You're not a real doctor, if you don't want to work 115 hours a week?
Melissa 35:40
Yeah, no, I think I think they are afraid. And unfortunately, I don't think that fear is invalid. Like, I think that there's still there still is that culture, you know?
Denise 35:54
We do in general in the US, and in much of western hemisphere, at least. We put a strange sort of badge of honor in overworking. Yes, yeah. I haven't had any sleep. And this is not a good thing. Why aren't you taking care of you? How can you take? We don't let long distance lorry drivers or people fly planes without sleep? Why on earth would you want a physician without sleep?
Melissa 36:23
Yes, I think it's so interesting, because, you know, obviously, there are things that I wish were not the case. And sometimes, you know, someone does, someone does have to work at night, right? Working at night, as you've mentioned, is not good for anyone. But someone does have to do it. So there is that. And I totally recognize that. But I agree with you that it's it's too bad that not only is that a badge of honor, but asking for help, or saying like I am too tired is still not okay. And I would say that's still the case. Like I don't think that I don't think that that has changed that much. I think it is hopefully changing with the culture is changing. But I would say it's interesting that whenever people talk about residency work-hour restrictions and stuff, a lot of times I hear people say, Well, what are they going to do when they graduate? And they don't have any workhour restrictions, like how are they going, they're not going to know how to work 72 straight hours. And I said, Well, no one knows how to work 72 straight hours, we just have convinced ourselves that we can do it. And can you really do it? I mean, I can like yes, I technically have to take 72 hours straight of call. Most the time. Like we were working on breaking that up more. And you know, I have neurosurgery colleagues that are even working worse, they take a week straight of call, which is just insane.
Denise 37:49
And they're operating on people's brains that's even crazier. Not that there's any part of my body. That really is not. No, not good.
Melissa 37:58
But yeah, I mean, that's just like physiologically, I don't care. You know, I don't know if you've ever seen the Dr. Glaucomflecken, so he is actually he works at one of the hospitals that I work at.
Denise 38:12
I didn't realize where he was in the US. Yeah, he's in
Melissa 38:15
because in Oregon, and so funny, he has this thing with about neurosurgeons and they talk about like how their biggest goal is to overcome the their physiologic need for sleep, like rest and sleep or food and sleep or something. And then like, what's their biggest strength,their ability to overcome their physiological need for sleep and food and rest? And I think that's how medicine is right. Like, that's a parody, we think that's funny, because we feel that and I think I don't know how to address those, like, how to address the fact that that we still need people at night. Well, we still need people to take call, and we don't have enough people. But we can't do it this way. But I think we still even though I don't have answers, right? We should look at solutions. And not just pretend it's normal.
Denise 39:06
Yeah, we're not. You know, again, million years ago, my eldest child is almost 37. But when I was pregnant with him, the males in my cohort were, some of them were very supportive, but several of them were angry with me because it was going to be more work for them and they didn't get paternity leave. I didn't we didn't get maternity leave, I had to take vacation time for my for my pregnancy time. And I booked I said the first childwent back at 27 days, then when I was in fellowship, I had to go back 20 days. Yeah. And and it was, you know, you being out you falling out of the system, even if you just had a really bad cold. Or conjunctivitis, my God in pediatrics can't work conjunctivitis anywhere. It puts a strain on the other people because there just is no give in the system. There's no There's no additional people to pull in.
Melissa 40:07
When you learn that so earlier right, I think right, right, right. Of
Denise 40:11
course, you can't have locum tenens residents No, at least in the in the attending level, you can, if you pay enough, you can get people to come and work.
Melissa 40:22
Well, it's funny. So my intern year, we did everything right. So ironically, on my pediatrics rotation, I did nights, I was on nights for wards for pediatrics. And I am, I did not get tested, I will say, so I'm not 100% sure this is what I had. But for the whole three, four weeks of nights, I pretty sure I had RSV, or at least for a good chunk of it. And I remember walking around the hospital at night, you know, at two or three o'clock in the morning, with a mask the whole time. I mean, this is really COVID. So wearing a mask would have been really funny. And having the nurses come up to me and say, like, you know, that patient doesn't have RSV you don't have to wear the mask. And I said, this is not for the day, that way. Because I'm sick, and they said, Why are you working? And I was like, No, I can't. I mean, there's no one else to work. And so I remember working with 103 fever at night for weeks. And I just
Denise 41:30
I remember saying so that was one of my earlier attending level jobs. And I say, Well, what do you think your strengths are? What do you ? I remember telling somebody, I'll work to 102. And I won't work past that. That my brain doesn't work past 102. But withTylenol or content. But, but what kind of message about looking after yourself is this? What kind of public health messages this? Go around spread your disease amongst your patients who are immuno- compromised.
Melissa 42:04
Oh, that's the funny thing about that is that's so bad for patients, right. And the funny the funniest thing is, we had, there was one week, I think, where I switched two days, for some reason. And there was a resident retreat or something, but just for the pediatrics residents. So I'm the only non pediatric resident on there. And they needed someone to cover that day, the night switch. And so they said, Hey, how about you just continue working? Like from nights and you just continue and go in the day? And I remember thinking, I am literally sick. Yeah. And you want me to keep working. Because there's no other person.
Denise 42:50
And it's also harder to go from Nights into days than to go into nights? Because everything's you know, it is extra people around. And I liked one of the aspects I liked about nights was also Oh, fewer politics, and all the other stuff. Yeah, ask somebody should do something and they didn't do it, I realized they hadn't done it and I got it done.
Melissa 43:13
Yeah, there is something I will say there is something calming about walking around a hospital or something at night, when you have a moment of peace, like that just feels it does feel more peaceful because everyone's asleep. There's not a whole or probably not that many people are asleep. But you know, ideally, and you're walking around I do actually I do think if it matched my physiology all the other stuff that I wouldn't I don't actually mind the work. I like to work at night sometimes because you know, it needs to be done. In your right. There's less politics, there's less drama. Usually not all the time. But yeah, so that part I don't mind.
Denise 43:56
It's been lovely talking to you, you must find something else we want to talk about to talk again. But I would like you just to give a little bit. I know that some of your website is still being built out. Yeah. But how for those people who are listening to Melissa, and wondering "What is the answer? I want to talk to somebody about the answer" How can they continue work only with anesthesia people or do you work with with the rest of us lowly beings?
Melissa 44:22
No, I'm I work with whoever I honestly right now. I'm trying to kind of hone down my niche. So I work with all physicians, I think all physicians, it's much more interesting to me to talk to non-anesthesiologists because we're kind of weird. So you can go to my website www.CordeliasCrossing.com And then hopefully soon, the platform I'm building will be a position home that's a physician home all of the same word.
Denise 44:51
Let me know when that's live and I'll put it in the show notes retroactively. I don't want people to go there and not be able to get to something. But yeah, but I will put it in later and and Cordelias Crossing is there and you've got some articles there and people would be able to find you
Melissa 45:06
that yeah, I'm also on I have a love hate relationship with a social media. So I'm trying to embrace it a little bit more, but also Facebook, Instagram and LinkedIn as well. And yeah, yeah,
Denise 45:20
Good. What do you think is next for you? Are you? Are you going to take a vacation with the kids soon? Did you? Did you manage to get some time out of this? Time and a half? Yeah. 1.2 full time hours or whatever it is?
Melissa 45:35
Um, yeah, that's good. We actually just, we just got back from kind of a staycation, Oregon. So we're really nice in the summer. So we just stuck around and went to the coast and took a little time off and tried to get a little caught up on on my non-clinical work. And yeah, so we're going to do that. And then hopefully plan or planning our first big post- COVID trip in December, so we'll see. We'll see. Yeah,
Denise 46:08
And you've got you've got all the school coming up too for your kids. Got a four year old you're gonna get another year probably before they'll...
Melissa 46:16
Yeah, yeah. Right. Now we're, after we get off the you know, this today, they're going through swimming school. So we are swimming, reading basic stuff. Not biting people school, that kind of stuff. Yeah. Yeah, being sociable. They're pretty good, though. They're actually pretty good. But yes, they're there. So I tell people, they're so close together, that they, they get along really well. And they also fight really well. But mostly they get along. They're pretty cute. There. I tell people that I think if the you don't want to put a ton on your kids. So I don't want to say that this is definitely all them. But it's too much pressure for them. But I think that they are a huge part of the reason that I realized that I should take better care of myself because I wanted to show them a better way I wanted to be around and I also you know, they watch you. They watch everything you do. And I said, you know we can I can tell them all you can do it whatever you want. And, you know, you're, you're intrinsically worthy, and all this other stuff. But if I don't show them that they feel the same way. So now I have to do it, which is really good. That they'll say Mom, you said you were gonna do and then they'll say X, Y or Z and then they're just the best accountability partners.
Denise 47:48
Mm hmm. It's really great. Thank you so much for joining me. Yeah. Thank you.
Melissa 47:56
Thank you for having me bye
Denise 48:00
Thank you for joining us at myth magic medicine. If you have found this episode useful, you can apply for free CME credits for the link provided in the transcript. If you're not a medical professional, please remember, while we're physicians, we're not your physicians, so please consult with your own healthcare professional if you think something you have heard might apply to you or a loved one. Until next time, bye bye
Transcribed by https://otter.ai
