On Vacation--Sort Of

So, last week I was counting the days until my vacation. I had to laugh out loud when I read Dr. Rob's vacation post. As usual, he's hit the ball out of the park with this one. I just wanted to add a few thoughts on the subject.

On paper, I get plenty of days off. For example, I'm at the beginning of ten days off right now. The problem is, being off isn't really being...off, at least not for me. Part of that is being a rural doctor, part of it is being who I am.

The story behind this vacation begins in January, when I attended a great spinning and weaving retreat at the conference center at the Point Bonita Lighthouse. Yes, I spin yarn and I make the occasional half-hearted attempt to take up weaving, but I'm much more of a knitter, or at least I used to be. In the good old early days of my blogging, when I was writing At the Still Point of the Turning World, I had a dial-up modem connection and I used to wait a good 30 seconds for an average web page to load. So I did a lot of knitting and spindle-spinning while waiting for pages to show up. These days, I have DSL and my computer is much faster, oh--and I work about 85 hours per week, so I don't do much in the way of fiber arts anymore. Not that I don't enjoy them, but blocks of time and energy are scarce. However, going to a workshop is a lot of fun and I had a great time in January, so I signed up for the Golden Gate Fiber Institute which is taking place this week.

Well, since January, I've been up to my earlobes in the entire hospitalist mess I wrote about a few weeks ago. My spinning wheels are caked in dust, and the half-woven project on my table loom looks like the beginnings of another relic. As I approached the GGFI week I began to ask myself if I was up to participating in the workshop. In the past, I would have sucked it up and gone, and probably had a rip-roaring good time, despite my fatigue. By I'm older now--forty this year--and the pace of being a more-than-full-time doctor is beginning to catch up with me.

You see, not only does taking time off a) cost me money and b) result in 2x the usual catch-up work when I get back, as Dr. Rob pointed out in his post, but ten days off doesn't really add up to ten days off. Here's why:

1. Total collapse: The first two days of vacation are usually dedicated to being in a state of collapse. I mean that literally. My first day off this week, I woke up at 9:30am, had a cup of coffee, and laid down for a nap at 11:30am. I woke up at 4:30pm, did some writing, did some reading, ate a light supper, and went to bed at 10pm. I was only awake for about 7 hours total that day, and the next day wasn't much better.
2. Deferred life management: My friend the Scanman often accuses me of being too organized. If he walked into my house, he'd know this is not true. Since moving in here three years ago, I still have a den full of boxes to be unpacked.  I have a garage full of boxes that need to be arranged and moved out of the way so I can turn the garage into a useful space.  As the years pile on, more day-to-day details are beginning to accumulate and their neglect is taking root.  At the time of writing, my garbage disposal is not working, the water filter in my refrigerator needs to be changed, and the toppling-over stacks of books and old mail on my coffee table have got to be straightened out.  I am getting a small start on the problem:  yesterday I vacuumed and shampooed the carpet in the front part of the house.  I went through the crispers of my refrigerator and eliminated all fungal science projects.  I have to do the same for the reusable plastic containers piled high at the back of the refrigerator, filled with a quarter cup of chickpeas or a half-cup of tomato sauce saved from a meal last November.
3. Fending off requests to help out: If I make the mistake of staying local when I have days off, people will forget I'm supposed to be off and call me up, asking to take part of Wednesday night or to hold the pager while they drive their kids to soccer camp 50 miles away. These requests are so easy to give in to, but invariably result in some catastrophe that needs my immediate attention at the hospital. I think it happens everywhere, but the problem is magnified up here in Rural, where there aren't enough providers to cover the schedule on a good day, and less than enough during vacation season.
4. Re-entry anxiety:  I know I'm not the only one to suffer from this:  the feeling of impending doom that strikes the heart of every doctor who has to Go Back To Work Tomorrow.  Sometimes the doom begins early, and the complaint becomes Oh-Geez-I-Have-To-Go-Back-To-Work-On-Tuesday.  Whenever the feeling begins, it erodes the joyful leisure of being on vacation.

The longer I'm in practice, the more the irony of vacation strikes me. I yearn for days off, but after I've had a few days rest, returning to work is AGONIZING. Even the smallest obligation seems extra-burdensome--"You want me to cover what??? Call on Tuesday morning until 10am??"--even if the work load is not that large. In contrast, when I'm in the middle of seventeen solid days of work, I can be woken up by a nurse's phone call at 2am, get dressed, drive to the hospital, assist a surgery or deliver a baby or whatever my task at hand happens to be, stay awake for the rest of the day making rounds, then go home knowing I have to do about the same the next day--all with a philosophical shrug of the shoulders and a terse "Life sucks and then you die" attitude.

The great deception of vacation is that you'll return feeling rested. I'm always exhausted after a vacation. Partly this is due to the four factors I listed above, but the majority of the problem arises from my determination to Have A Completely Non-Work Related Experience during my days off. I tend to over-schedule myself with activities, workshops, projects, etc. I get a lot done, but I get no rest.

So I decided not to attend the Golden Gate Fiber Institute, even though doing so forfeits my registration fee and means I won't see my friends there this year. Instead I'm going to sleep a lot, write a lot, tidy up the house a bit, and look aimlessly out the window at the cows in the next field. I'll visit my mother in San Francisco and eat myself into a stupor of really good Chinese meals. And maybe there's a small chance I'll feel ready to go back to work next week.

Comments

[BusinessOwner]

Welcome to the real world. Many of us that work in the non-medical world realized their is time off ever!!! Especially when operating one's own business, working twice as hard as other as others, and working for many more hours - 85 hours is part-time.

[CancerDoc]

Exactly. Unfortunately, I get "re-entry" stress from a simple weekend. It's all over at 7 pm on Sunday. :D