Hard 3 months

I have been wanting to write in here over the past 2 months but have been refraining. I've been keeping a big secret (which I am not good at) and also suffering at the same time so it has been especially difficult. Because I like people to know when I am suffering so I can get sympathy! I am pregnant, 12 weeks today. I want to end that sentence with an exclamation mark but I can't. I am so miserable and am having a hard time being excited about my pregnancy. Sounds terrible right? What kind of mother says that right? Well, I will fill in the details. I wake in the morning and have to drink apple juice or crackers immediately to prevent vomiting, and this works only half of the time. So I have a little morning sickness--no big deal. Well whoever termed it morning sickness must have had a big laugh. It is all day long miserable sickness. I literally feel nauseated from the moment I wake up until the moment I go to bed. I have even woken up in the middle of the night to puke. So to mitigate the vomiting, I use zofran daily--multiple times a day (I sure hope they are right that it is OK for the fetus!), olus every other home remedy people have written about on line. I am continually grazing because if I eat all the time then I guess I can trick my body into not puking. Work is the worst, I would be surprised if people at work didn't realize how shitty I feel all the time--and how I can barely keep up. I have found the most private and clean bathrooms in the hospital that I can sneak off to and vomit throughout my shift--3rd floor near surgery clinic is the best. In fact, sometimes I prefer to throw up because then it gives me about an hour of reprieve from the nausea. Throw in some extreme fatigue and I would say that I am the most miserable I have ever been. No exagerration.
I get SO JEALOUS when I talk to NEARLY EVERY ON OF MY FRIENDS WHO HAVE HAD A KID and they say things like: "I never got sick" "I couldn't even tell I was pregnant." "I think I was nauseated one time." "I ran until I was 7 months pregnant." Blah. If I work out, I have to stop to puke so I barely manage a walk or bike ride. So you would think that since I throw up all the time that I would be losing weight, but all my grazing has resulted in unexpected weight GAIN! More than expected for first trimester. So that's great.
I am hoping and praying that this will truly end by week 14 which is what people have said. My fear is that I will be one of the lucky ones that it persists throught the pregnancy. I had 2 days in a row last week that I didn't throw up so thought it may be at the end, but it came back with a vengeance so that was false hope.
So how do I feel about being pregnant? It sucks. How do I feel about becoming a mom? I don't know, I can't think past my misery. I'm selfish like that. I don't know if it is a boy or girl. Gary and I are going to wait to find out the sex. Sounds like a cliche, but I truly just want a healthy baby.
Well I am going to go puke. I have a new strategy, when I know I am going to vomit soon anyway I eat something bad for me because I just throw it up anyway. I just downed a TWIX bar!

I left my heart in Wyoming

Wow, I have not written in here for over two months. It is amazing how time flies by. Gary and I just spent an amazing month in Nepal. I went there as part of a team of physicians teaching ultrasound to nurses and nurse-midwives there in a remote village called Phaplu. The ultrasound course went really well. We also traveled around Nepal going to a National Park seeing wild rhinos and croccodiles, also we did a trek in the Himalayas which was an amazing experience. Besides our wedding trip to Thailand, it was our best international trip to date. We saw such a wide variety of places in Nepal including staying at a house there with a family while we were doing the ultrasound course. It really helped me decide on a direction that I want to take in life. I get so much satisfaction by traveling that I feel like I need to incorporate it into what I do. I realized that I likely cannot stay and work permanently abroad, but if I can get a niche, like ultrasound, I could easily keep doing like I just did. Put on training courses there for providers--it is so rewarding and so much fun and really is quite useful. So now I just need to decide if I am going to do a fellowship in ultrasound. I really don't want to do one. I am ready to start working...I have to decide if it is worth it.

I've also realized something that I already knew. I love the mountains; I feel at peace in the mountains. It is where I need to be. I have a nostalgia for Wyoming, it is my happy place. It is what I think of when I think of home. I think I need to go back. As much as I love living in San Diego, it isn't home to me. I need to wake up with nature right out my door step. I need to have horses and go riding, have property where my dog can run free. I need a big fireplace, and an old log cabin. I need a small community that I can feel a part of, participating in fairs/art shows and local road races. So that is who I am. I may likely be a rural emergency physician, perhaps get involved with search and rescue, and go on a couple international trips during the year to keep things interesting. Well anyway, that is what I am thinking today. .. you never know with me!

An Examined Life

I wish I would have kept writing in here more often. I think it is good for me to get my thoughts out on in writing. It helps me clarify my thinking.
I have about a year left before I will need to decide where I am going to work. This causes me a lot of anxiety rather than excitement. I am excited that I will be done with residency and will finally be "beginning" my life. Yet I still don't know what I want to do with it--this causes me anxiety.
I chose emergency medicine because I really wanted to do something great but also have the flexibility to do something crazy/nontraditional.

Here is what I am seeing: Residents graduate, they get a job and they are now making a good salary. They buy a better car, a better house, and work the grind--waiting for their days off. They have kids, and their biggest stressor is whether to send their Kindergartener to a private $15,000 a year school or send him to public school. In the community practice, it isn't even about the interesting medicine anymore as it is during training, it is "moving the meat" and trying to get out of your shift on time--making sure your notes are complete for maximum billing.
It seems so UNFULFILLING.

Alternately, I went to a speaker on campus sponsored by the global health initiative which highlighted a physician who has been working in Ethiopia for the past 2o years with a catholic NGO. This man had done something incredible with his life. Picture after picture was of the children he had saved, or had improved their life significantly. Some he had adopted, others he worked to cure their cancer, get them a surgery, or provide just basic care. When he spoke he seemed truly happy, truly fulfilled. He was not rich, but lived a nice life. At the end of his career he could look back and think: "Wow, look at what I did with my life."

Then I think about me. Am I selfless enough to give up the salary/lifestyle here to do something so altruistic? Although is it true altruism--when I would likely get as much out of it as my patients? I have worked so hard to be able to make enough money to have a nice lifestyle where I can travel, have a house and a cabin, drive a nice car. Do I want to give that up? Am I that kind of person?

So what about what I am doing in the emergency department every day? Aren't I helping people? Yes, I suppose I am, but it doesn't feel that way. If I wasn't there, someone else would be. The system is in place. I dont NEED to be there. Being a physician in the US is almost automated...pt comes in with a chief complaint, I order tests, pt admitted. Normally very simple. If the patient didn't see me, they would see someone else. It is a rare day when I feel like I truly helped someone. But maybe I am just wanting more to life than there is.

Why am I always unsatisfied? Why do I always want more?
I didn't want a traditional marriage, I don't want to buy a house, I don't want to be tied down to one place, I am struggling with even having children. What am I afraid of? Normalcy, I guess.
Why do I want to travel--I want to go everywhere, I don't want to feel like I have missed out on something.
I don't want to look back with regrets. I only want to look forward with excitement. Is that too much to ask?