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Cali ChicaParticipant
Dear Anita,
yes NYC. Known to be the greatest city in the world. Not in the middle of nowhere. The land of opportunity and the city that never sleeps – with beauty and energy in its own right.
yes, how easy to under appreciate this when looking for something different.
my husband feels that I may resent us staying in nyc. I have always wanted to live out there. The weather the culture. The focus on outdoors – the ability to spend your time doing these nature oriented activities. Ever since I first visited there I knew I wanted to. I guess I caught the California bug. After my husband and I met San Diego became a special place for us. he too felt he could see himself out there many times in his life – and especially after meeting me.
but hey- we are in Central Park, with abundant beauty around us at least half the week. The proximity to doing things is like no other. I mean you know – you used to live here downtown I recall.
I feel sad deep down inside today. Or confused. Or maybe not sad – stressed. It is hard to differentiate sometimes since I’m so used to feeling distressed. I think you know what I mean. I feel in a way I am mourning the concept of a fresh start or moving somewhere new – somewhere I do love. Maybe – not sure. My innate feelings I don’t always trust, distress is much more complicated for those of us who have been through so much. It isn’t just happy sad mad. It’s deep complicated and tangled.
Cali ChicaParticipantDear Anita,
Yes ice accidents are a concern – be very very careful and take it easy!
I am not worried about Dr. T lying, its more of – what are you doing? Are you in or out?
Sure, his dad may have had the stroke – but Dr. T what is your long term plan?
Regardless that overhead is high, been high – we see the numbers – but Dr. T has been able to make a decent living we have seen all the financials. Issue is the time now is different perhaps for a new guy like my husband. And as the doctor yesterday said, it is a cut throat environment.
I think my husband in many ways feels like he is “grieving” the concept of not moving to CA. He knows deep in his heart it is not the best decision. But the allure is there, the lifestyle is there, and getting out of the northeast does have an appeal.
Cali ChicaParticipantDear Anita,
Good morning. Freezing cold morning over here! I hope you enjoyed your walk yesterday, and beware of the ice! I don’t want you having any falls like last year!!!
To your last point yesterday evening, the changes do seem abrupt – of course. Here my husband is worried about this SD job, and all of a sudden seeing his current job in a new light. It is a combination of fear for the other option, as well as perspective.
There is the concept of medicine being difficult everywhere at this moment (Your husband stated it perfectly months ago – when you spoke to him, he mentioned many points – medicine is ruled by administrators and insurance companies that just care about the bottom line, money — therefore doctors are treated like metric items to be pushed around often). So knowing this, and learning to accept it is key. Yes, it isn’t ideal – but it is the state of affairs at present. 10-20 years ago was different. This is the case in all of the US, east coast or west coast.
The only difference being that many things in the east coast can be more grueling simply because of the “hustle” and the aggressive nature, and often a difficult patient population.
That isn’t to say the West is any better. As you mentioned if he is in sunny SD in a nice building with great colleagues – what if he has 1 patient that day – the stress of that far supercedes a clinic full of inner city patients in nyc!
So there we have that.
My husband is pleased with his chairman’s response to him, and his openness. He has noticed recently that things are changing, and that he will have to be much more patient in this sort of setting (as in, IF I am going to work here I just have to know change happens slowly – and with that, know that at the end of the day it is a predictable/stable job that you come to daily).
So here’s something more, interesting timing. Yesterday I had a phone call with a physician in SD. I connected with him through our network somehow (long story) he works at one of the local hospitals and is pretty entrenched in the community. He was one of the leaders at this hospital over the last year.
Anyway, he mentioned how the SD orthopedic community is “cut-throat” as in there is the perfect storm of “too many great physicians, and too little volume” which makes it difficult for many.
He also mentioned that he knows the group that my husband would be joining, and the other surgeon. (the one I mentioned that may be approaching retiring/going on his own). Let’s call him Dr. T.
Well, he stated that he knows Dr. T quite well, and he is a great honest person. He feels that Dr. T was thinking the over head (costs you have to pay when you’re in the private “eat what you kill” model) were getting too high. And so he may be branching out on his own (he is in his 50s and already has experience out there for years by now).
So we spoke about this, and why would my husband want to join a practice, where the current surgeon in his specialty is trying to phase out, perhaps because high costs! Moreover, if the climate is that cut-throat and perhaps difficult to get patients – well that says something.
He recommended we speak to Dr. T again and be more direct. And say to him, “will you be leaving” and what his thoughts were on the overhead. Be direct.
I agree this is a great idea. Dr. T mentioned that his dad had a stroke recently and he is not doing well, so he is going to spend more time away from the practice, and that my husband could have the volume of patients he would be unable to see. But what is the real story..
It isn’t a good idea to join a practice without knowing the full story of course. My husband will be talking to Dr. T this week.
All in all, more and more fingers are pointing to NYC – aren’t they…
- This reply was modified 4 years, 11 months ago by Cali Chica.
Cali ChicaParticipantDear Anita,]
You are absolutely correct about the calculated risk part. I also agree about the fear aspect and seeing this current job in a different light. But here’s the thing, that perhaps I did not mention. His department (subspecialty) is currently in the growth phase. Some older surgeons retired and they have hired new ones (such as my husband and one 2 years prior who is his colleague and now friend – nice person and i’ve met his wife a few months back). They are re-building it many ways, which takes a lot of time esp when it comes to large nyc hospitals (as you can imagine). In the past few months, they have hired a new physician’s assistant, and other staff members. These changes have already started to help my husband somewhat. When he spoke to th chairman to give his notice, he did mention certain aspects of the job that were difficult such as the need for more staff such as PA, and the rigorous call schedule. The chairman noted that they would be hiring more PAs and hopefully another surgeon in the next year, to reduce the burden on my husband and his colleague.
That being said, these things do not change the: patient population, and the overall daily struggles that go with an inner city setting type hospital. Yet, he believes that once he gets things like his own PA, a new secretary, etc – some of the daily nitty gritty annoyances will be reduced.
I can see that.
BUT (huge but) the overall demographic remains the same. I will say though, sometimes with the right set up (staff, and subspecialty organization) even the most difficult hospital positions can be become okay since there is a reliable daily/regular flow. it takes away th need to “hustle” per say.
It all depends on the person, and what they are looking for.
you are right, will he/can he survive the move.
I think in so many ways – why throw such a huge stressor (and yes it is a stressor) onto him at this point in our lives. What he craves is more peace…what we crave is more peace. But I see the calculated risk, and the long term potential for more peace perhaps in SD…
Oh my!
Cali ChicaParticipantDear Anita,
I agree with all of your post. And here’s the thing, why sign up for IFS. At this point in our life, after all we have been through – why sign up for them. It is a good question, isn’t it?
There is the concept of a different type of lifestyle in SD – but that works only if you are financially not worried, and not worried about steady work flow – it is not like we are going there for entertainment or retirement.
But, there are other potential benefits of the scenario – and IF my husband can get busy quite quickly that “worry” won’t be there. Lots to consider…
Cali ChicaParticipantDear Anita,
I agree entirely, entirely.
Especially the aspects of family.
The concept of San Diego is as follows. My husband will be salaried for the first year. If he “meets his overhead costs” he gets a percentage of the profits after that. After that year it is the private model of eat what you kill as we discussed. This can be anxiety provoking and leads to the idea of having to make sure you are busy enough of course. Whereas in this NY job, he has a steady flow of patients coming in, and will always have the base salary. He too here can make a bonus each year if he goes above a certain overhead as well. Slightly similar in the productivity bonus aspect.
Another part of SD is that the other person who does exactly what my husband does – is now backing off a little from practice. Not retirement but approaching that. He stated he is going to lessen his hours, and give my husband the overflow of patients he has, as he has a long waiting time already. That would be beneficial for my husband as it seems he wouldn’t have trouble being busy day 1. But of course you never know – and that is the whole point of moving somewhere new – you are starting fresh!
So that goes along with the emotional aspect of things – going somewhere new and starting from scratch — versus continuing what is known and stable.
Next point, we have decided that if and when we have kids, I will work part time. This would be possible in both environments, and my job opportunities are slightly better in nyc (more because it is a bigger city and more hospitals of course, and just more of everything). So therefore we would be relying more on his income. So the question comes in to play – would it be better in that sense to stay in a place where there is that stable guaranteed salary long term. Or on the flip side, it doesn’t seem like SD would be that difficult to get busy anyway – but of course more of an unknown. That is the other point that we discuss often.
Cali ChicaParticipantDear Anita,
A few key points I would like to re-highlight for myself:
1) any deep is too deep. yes
2) her relationships with others will remain problematic for a long time. yes
AND it is not my job or duty to fix them, nor is it POSSIBLE. attempting to do so is a lose-lose scenario
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I am open to hearing your input, would love to hear it, about the move. I will let you begin (knowing what you know so far about the 2 options) and I will add and continue the convo 🙂
Cali ChicaParticipantDear Anita,
Good day!
I read your last post and it reads perfectly to me. I sum it up in this:
have fun, but don’t get too deep
It is best for her and I both, win-win. Looking back when I got too deep, with her feelings about friends or this or that – I would take on this extra stress which is unnecessary and unhealthy – and lose-lose. I will no longer do that.
Enjoy time with the puppy, know it may bite – but know that when you are doing playing with the puppy, it is okay to walk away and say see ya later!
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Back to the move aspect of things. So now we don’t have as much pressure of “we already told his job here we are moving so that’s that”
We will spend the next week or 2 (given holidays are here there’s a lot of other things going on) to really let it all sink in. It will truly be a difficult decision to make, and there are a lot of pros to each side.
I wonder how we will come to a conclusion!! I truly do!
Cali ChicaParticipantDear Anita,
Have no ambitions to create a better, honest communication between the two of you. Let it go, let go of any such hopes, intentions and hopes.
This is my biggest take home here. Thank you for wording it this way, and directly. I understand completely. I also understand the later point about how, when you no longer have this expectation, the bites become more like nibbles.
Makes perfect perfect sense. I will let that sink in…
I will head home in 2 hours and rest my head, hot tea, and maybe this weekend a massage! Let’s continue some more tomorrow – stay warm in the dreary weather. I have good thoughts about 2020 ahead!
Cali ChicaParticipantDear Anita,
How exciting! Yes, indeed. This break will be very much a breath of fresh (cold!) air! I am not getting to worried about my plan for after January!
Yes, I wonder what that new is for you – maybe 2020 will bring some insight about it…
Continue the conversation I shall, head does hurt – but I will type what I can.
So, the conversation with his parents went very well as expected. They were very unbiased and supportive, and fantastic listeners (as always). The thesis of the weekend was that there needs to be time. Time is essential – and give it time so you can assess. Often you never know the answer, but it is always worth giving yourself more space to analyze as much as you can – in a career oriented situation.
So that is what we did, we got some more time. I am very appreciative of his chairman’s response to my husband – very reassuring.
So what’s more…
I thought a lot about the conversations about my sister over the weekend. I know I can’t “blame” her for my behavior when I am around her – but I do know that I have to accept the fact of: we were raised in a household of sickness, our interaction is based on sickness. There is resentment and anger within each one of us.
I also learned, from our conversations – that her manner of communication is a lot more hidden than mine. This elucidated the reason why I would end up feeling so uneasy and uncomfortable many times. Like being bit, but then instantly being told that the puppy is a sweet dog from the shelter, don’t get angry at it.
So then not only do you feel guilty for being upset/angry – you invalidate your own feelings of unease. Double whammy –> double distress.
I know she can not be apart of my inner circle. I know my distance will create alarm in her. I also know it will create alarm in me.
You made a note about the concept of “primal love.” And how it originates from primitive, preverbal, infant. I think about what you said – how often this sort of thing can be an obstacle.
I think about the “love” and attachment I had for my mother – instant of course as a newborn, and evolving as I grew with her. It wasn’t like I ever woke up one day and asked myself: “do I love my mother?” No! I would have said of course!!
Similarly, I didn’t give my relationship with my sister much of an “option” from my own end, as you know.
I do hope to establish a good balance of “closeness with boundaries” — but I do know it will go through some growing pains prior of gaps, space, and change.
I think I have in my life, communicated a lot, likely over-communicated many times — not to the right source. As in, am I explaining things to someone that has the capacity to understand? I think it is important going into 2020 as an adult (not child) to know that staying strong by your goals (no not career and growth – but health and peace) means truly not worrying what the other person thinks. Some of the strongest most “stable” people in my life do a good job of just simply saying “no!” and nothing more…
- This reply was modified 4 years, 11 months ago by Cali Chica.
Cali ChicaParticipantDear Anita,
No, I will not be employed on Jan 1 2020!!
Yes, I have a deep down good feeling for 2020 – the number feels innately beautiful to me, and yes 2’s – a new start, team work for 2’s.
My husband already has given notice and his last day is Jan 31. If he decides to stay – then he shall continue.
We will continue the conversations in the meantime!
How are you Anita? What is new?
Cali ChicaParticipantDear Anita,
Good morning. Bad headache today – combination of the stress plus the longer hours at work – but you know what?! My last day is Dec. 31! Hurray!
Regardless of what we do – I will be done with this draining job, at least I can celebrate that!
Here are some updates:
My husband was feeling uneasy, as you know, and did feel in a way that we “jumped the gun” in giving notice to his job. They have been extremely supportive of the decision (his boss the chairman) and sad to see him go. He felt last week a palpable discomfort. We decided with my in laws this weekend that the best thing to do is give some time. This is not the sort of decision to make in a hasty state when you don’t feel entirely prepared. You know, it may take an extra day or week – whatever it is, but time is time.
Anyway, today my husband went to his chairman and was completely honest about his hesitations about moving, and perhaps interest to stay, etc. He was happy to hear this (the chairman and said a few things). He can take his time to make his choice, and if he decides SD and is not happy there – he can come back anytime, he will be welcomed back and has a job waiting for him.
The great thing about his position here in nyc is that this chairman has always been great, sure the intricacies of the job are not all dependent on him…
I am glad for this update – and it will put my husband at ease too
Cali ChicaParticipantDear Anita,
I hope you are having a good day. I wanted to write to update you that we had a good weekend and discussions with my in laws. I’ll write more later in the week when I have some more time and mental space. I’ll be thinking of our conversations – and thanks for your support. Speak soon my friend!
Cali ChicaParticipantDear Anita,
I read the first 2 lines of your post – yes! I did go back and re-read and sink in.
Today is a busy, no almost inhuman day.
There! I said it! Admitting things out loud without feeling guilty, or needing it to be validated!
Yes, 20 cases, hardly time to use the bathroom, literally running between patients. Head kiling me, back hurting me.
Oh how glad I am that there are only a few more weeks of this – something I learned is that – it will be impossible for myself to feel calm, healed, and un-frenzied in my life if half my days are like this. Not possible.
I could not read any further as I am not very focused today. But I will loop back around to the above post on Monday.
I will be here at work until very late, and then tomorrow morning we are heading to my in laws to have many discussions as you know. Wish us luck!
I will write to you first thing Monday and comment on above post and fill you in on the important weekend. Be well Anita, and rest well this weekend and have fun. Thanks as always for your support!
Cali ChicaParticipantDear Anita,
Good morning to you! I went back to our threads from the last 2 days and re-read them. It seems like we covered a lot of ground in just 48 hours.
As far as going back to 1-4 above and adding what it means in context with future interactions with my sister, I will say this:
I do, by all means, have a deep primal love for my sister. The type that is difficult to explain.
I also know that she is that delightful puppy that tends to unpredictably bite.
I also know that my communication tends to be direct – although can be blunt. And hers is indirect – which can leave me feeling confused, uneasy, and feeling invalidated in my annoyance/anger/hurt.
I know that I do not do well with indirect or passive aggressive communication. I thought back to many times in my life where this is apparent. And I know this for sure now after our communication. It is not always possible to avoid this, obviously – but with my sister I know what I am working with now.
My approach with her should be the following:
I don’t want to lose contact with her, but I have to accept, even if it feels sad, that I am going to inevitably lose that “closeness” I feel.
The issue with that over closeness is the following: I will tend to over-extend myself, causing annoyances in her often – and I will allow many loop holes to be a victim of her biting – it is a lose-lose situation for all.
Instead, I will maintain my main energy on my inner circle – and ask my self each time I communicate with her and/or make a plan with her: does this serve me RIGHT NOW, does it serve my husband. And lastly, is this a good time.
I notice I don’t do this. I jump to interact with her if she reaches out to me immediately knee jerk. Just as I did with my mother. Innate, instant, knee jerk. That left me feeling angry, resentful, torn, and bitter. Nothing good.
Now my mother is gone, so I have yet another person to relate this to – and it is crystal clear in front of me.
I must ask myself FIRST. I notice I never felt I had this “luxury” – but look how much I suffered due to that. Look how much my marriage suffered too. I must ask myself FIRST, I am entitled to – it is imperative that I do.
ROAR!
Happy Friday to you – cheers to our strong coffees!
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