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“Where Does He Work?”

 

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I went to the doctor today. I’ve been battling an overuse injury in my right leg and finally relented to getting another opinion other than myself and my friends. This injury has really been hampering my training, and has been super annoying. First off, I am a bad patient like most doctors are. I go to hear their advice and opinion, but I do not always follow it. Even going into this visit I declined to do the routine x-rays until I saw the doctor and was examined. Sometimes when you are in the practice of medicine you have too much knowledge for your own good. I know I will push things past the limit I would recommend to my patients. I’m happy to report that I had no major injury- no stress fracture! I’m going to try my best to take it a little easier and not overdo it with my running this next month so that I can run my half marathon in May.
Anyway, I get there and I’m sitting getting checked in by the M.A. I had to come from work for the appointment, as I couldn’t get a time on my days off. This picture is from my visit today and what I was wearing.  The M.A. is going through my meds and history and reviewing my records and then comes to check my blood pressure. So I’m sitting there in my pink scrubs, which are embroidered with my name, “Dr. Hartsock”. I’m sitting there and she is taking my blood pressure and she says “I’ve heard that name before, where does he work?”
Boom. It seems even in scrubs embroidered in my own name, I still am not seen as a physician. Yes, I am young. Yes, I am a woman. Yes, I like the color pink. Yes, I am polite. Yes, I smile a lot. It is possible to be all those things and still be a bad ass doctor.
I hope as more and more women enter into medicine our implicit gender biases and gut reaction to assume every doctor must be a man can be overcome! We are women, and we are doctors, damnit!

Women in Medicine

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I was lucky to be raised in a place and time where I have not had any significant barrier in my way because I am a woman. I have been allowed to make my own choices, to pursue my own path in life, and my gender never deterred me from achieving what I set out to do. Can you imagine being a woman a hundred or two hundred years ago or more? Surely I would have been burned at the stake as a witch for believing in science and forgoing religion. Even today, in an alarming number of countries in the world I would be murdered in cold blood for being an independent woman who says what she wants, does what she wants, dresses how she wants. I can imagine nothing more terrifying in this day in age than still being expected to be subjugate to a man.
Does that mean my life as a female physician is without challenges? Unfortunately, no. Our older generation still holds on to long outdated ideals and many are blatantly sexist and racist. I long for the day when I glide into my patients’ rooms and every one of them puts down their phone and says “I’m sorry I’ll have to call you back the DOCTOR (not the social worker, the nurse, the PCT, the housekeeper) is here”. There still exists in medicine, as in many other fields, a double standard for women physicians. Yes we can have the big, high paying, important jobs in any specialty we want. We can lead our groups and practices and departments. We can invent new drugs and treatments and policies that change the face of medicine… but we are still expected to be married, have babies, and manage the entire household and family without missing a beat. I am in awe of my friends in medicine who have children. They work all day, 12 or more hours, and then go home and see their kids and have dinner ready for the whole family. They are expected to be just as excellent at work without any concessions to motherhood and raising a family. They work right up to their delivery and are back working full time shifts 6 weeks later. These women are a force to be reckoned with.
Not only is motherhood in medicine a contentious issue, but our behavior as women in medicine is judged differently. How many times in your training and practice have you encountered an arrogant male physician who says whatever he wants, does whatever he wants, and gets away with it? Male physicians can sexually harass female staff, throw tantrums in the OR, and talk to their patients as rudely as they wish. These behaviors are often overlooked as the doctor is seen to be too valuable an asset to address their behavioral issues. In the same vein, women physicians who act out are more easily reprimanded and even terminated for being “difficult”. Women in medicine who veer outside the traditional norms of a caring, maternal figure are labeled as too assertive, uncaring, cold, and bitchy rather than seen as confident, rational, decisive, and proficient. The implicit biases of gender stereotypes still confer women a disadvantage in a field once solely practiced by men.
Even with the challenges we face as women in medicine, there’s nothing I’d rather do. We are changing the practice and the face of medicine. We are strong and capable and we will continue to break boundaries and overcome any obstacles in our path. We are women in medicine. ❤️❤️❤️

 

Being a Hospitalist

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As a hospitalist my main weapons are not scalpels or catheters or ET tubes. I’m not pulling 13 hour days in the OR or performing back to back intubations in the ICU. My arsenal relies on my knowledge, my communication skills and my documentation skills.

Hospitalist medicine is still a rather new area of practice, having been around only for a few decades. It may be frustrating as a patient to know you won’t see your personal physician in the hospital, but that also frees up your doctor to devote more time to his or her office patients. Since we are all trained in general medicine in either Internal Medicine or Family Medicine, our job is to know a little bit of everything. I love being able to take a global view of my patients and their health, as opposed to specializing in any one arena. One of my favorite aspects of being a physician is sorting through a complex patient and trying to bring the entire picture into focus. There isn’t anything like the feeling you get when you clinch an elusive diagnosis and get the patient stated on the right path.

Documentation is the lifeblood of hospitalist medicine. We weave the stories of our patients lives and maladies into electronic records. Our words determine how sick someone is considered to be by the insurance company and if they will pay for and reimburse the hospital for our treatment. A simple turn of phrase and semantics can lead to a major reconfiguration of someone’s severity of illness. You learn very quickly the power of your words and how they can alter the shape of your patients’ lives.
Our profession as hospitalists really comes to life at the bedside. At the bedside I’m able to use my words to comfort, to heal, to reassure, to clarify and explain, to make the difficult to understand simple and accessible. In a few short minutes I can go from never having met a patient to gaining their trust, easing their anxiety, and providing them a clear course of action. It’s not always easy. Sometimes there is no answer for the patient’s complaints. Sometimes the tests come back with unexpected, life- changing results. Sometimes the answers we find are not what the patient wants to hear. In its these moments at the bedside that I always remember why I chose to become a physician. That connection you make with a patient, whether you’ve known them 5 minutes or 50 years, it transcends science and data and medicine. It simply goes back to human connection. That connection is the root of everything I do. I am so grateful for the opportunities this job provides me to do it again and again, day after day.

365 Days Of Exercise EVERYDAY!!!

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Ok party people, this one’s been a long time coming… 365 days in fact!!!
Every day. For 365 days. I exercised every day. It wasn’t easy, in fact it’s mostly been pretty damn hard. There were days I was sick or tired or had a migraine and all I wanted to do was sleep or veg out on the couch. It took everything I had those days to drag myself off my ass and do yoga or go walk the dogs for 20 minutes. Those days didn’t burn any significant calories, but they were so meaningful to me because I still did SOMETHING.

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It starts with doing one little thing. 14 months ago when I started to exercise the most I could do was walk my dogs or do the elliptical for 20 minutes. I remember the first time I took my dogs to my favorite local park, I got about a half mile and then had to stop and turn around. I was so short of breath and drenched in sweat. Families with small children and those little baby papooses strapped to their chest were practically blowing past me. I went home feeling defeated, but the next day I got up and I did it again. And again. And again. Just start small. What seems insurmountable at first will soon become habit. It doesn’t get easier, you will just get stronger and stronger.

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I have exercised through pain, sleepless nights, stressful days. I can touch my toes! I have climbed to the top of mountains! I have run 5ks and 10ks and 10 miles! I am organizing and planning a 5k/10k run for my hospital. I went skiing! I am training for my first half marathon! Above all, I have learned to believe in myself. To stop doubting myself and putting limits on what I can accomplish. It’s a whole new world out there, and I can’t wait to experience as much of it as I can!

#drjennygetsfit
Day 365

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Failing Forward

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There is a great # going on instagram right now called #failforwardcampaign. Reading about the obstacles other strong women have overcome really got me thinking about myself. What does it mean to fail forwards? To me, it means taking the worst moments, events, and mistakes in your life and using them as a catalyst to change for the better. We are not defined by our failures, but how we respond to them in the face of adversity. I culled through my own life and these are some of the moments that stood out to me.
1. Growing up, no one but my immediate family believed I would become a physician. I spent so much time believing them that I put limits on myself and never really gave anything 100%. I couldn’t shake the notion I might be what everyone thought I was- flighty, inconsequential, and average. I rarely even talked about wanting to be a doctor, even though I knew since I was 5 years old that’s what I wanted to me. I think that when we buy into other people’s negative perceptions of us, it has a scary ability to change the course of our own lives. It wasn’t until I was on my own in college I found my belief in myself and really came into my own. I believed that I was smart enough, strong enough, and that being a doctor was well within my grasp.

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2. Until getting to med school. Yikes. I nearly failed out of medical school. I hated med school so much. The first two years were torture. I was crippled by severe anxiety and rarely left my house. I would only go to school for tests, and was withdrawn and isolated from my classmates. I felt like I was letting down everyone who believed in me and fulfilling the predictions of all those who said all along that I could never do it. It was on of the lowest points in my life. I ended up taking an entire year off and then choosing to repeat my second year of school. It was only after I got away from medicine I realized how much I loved it and that it was the core of me.

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3. I let a physical injury set me back in all areas of my life. In residency I suffered a terrible knee injury that required multiple surgeries. I was despondent and gave up trying to ever get better. It would take me several years of chronic debilitating pain and my weight ballooning to 275 pounds for me to change. I stopped letting my injury and pain be the whole of who I was. I think it’s so easy when you have chronic pain to let that be the only thing that defines you, so that everything in your life revolves around the pain. I pushed through the pain and slowly got better with regular exercise and weight loss. I’ve lost so much of the weight that was physically a barrier to my health and happiness. I did not cure my pain, but I have found ways to minimize it and make it into an afterthought instead of the main event in my life.

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When I was living through each of the moment above, I was miserable. It is only now in hindsight that I can see how clearly those events shaped who I am today. Has it been a smooth easy ride? No! Would I be the same person I am now if it was? No! Going through these struggles has given me the fortitude to overcome the challenges life has will continue to throw at me.

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How Tracking my Food has Helped me Lose Weight and Stay on Track

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I first started tracking my food daily a year ago. It was a eye opening, life changing experience. I had tried it before but given up because it was so depressing. When I first tried it I was eating 2500-3000+ calories per day. Was it any wonder I weighed 275 pounds and was morbidly obese? When I finally got the motivation to try again, I made so many changes to my diet. From the obvious like getting rid of Taco Bell and Fazoli’s to much more subtle changes like how many grams of sodium I eat a day. I use My Fitness Pal to track, but there are all kinds of apps out there so find what works best for you.

Here’s what I learned:

I eat way too many carbs. I’ve been vegetarian since I was 16 and the entire basis of my diet was not in fact vegetables, but pasta. So much pasta. But not just pasta- bread and tortillas and chips. I had such a carb heavy diet I was not getting enough protein or fats. I also eat way too much salt. Especially if I eat out, salt finds its way into everything. I for sure wasn’t drinking enough water, either.

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So how has tracking helped me make changes that I can stick to?

Well first, I made small changes over time, I didnt just cut  anything out. I still got fast food but maybe only once a week. I still ate popcorn and candy and cookies, but much smaller serving sizes. I started to measure my food so I would know exactly what a serving looked like.  I started to cook meals intentionally knowing what the calorie count and macronutrient ratios would be.

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Today I made a meal which perfectly exemplifies my new way of eating. And yes, it’s a new way of eating, it’s not a “diet”, it’s a lifestyle change. I had been trying Purple Carrot out and one of the meals was Vegetarian Pad Thai. Their recipe used rice noodles and had 730 calories per serving with 108 grams of carbs, 27 grams fat, and 21 grams protein.  Well that didn’t sit well with me. I added baked tofu to the dish and subbed in daikon radish “noodles” for the rice noodles. New stats: 384 calories, 24 grams carbs, 20 grams fat, 27 grams protein. How much better is my version!!!

I always recommed my patients track their food for one week if they are trying to lose weight. Even if you just write it down on a piece of paper, keeping track helps you stay acccountable and will really open your eyes to what you need to change in your diet. Give it a try.

Trail Running In the Snow

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About a year ago, I was just starting to get serious about working out. My favorite early exercise to do was hike with my dogs. I had first tried hiking in my local park with them over the summer. I could only go about a half mile before I was drenched in sweat, out of breath, and exhausted and had to turn around. Winter is my favorite time to hike because the cold and snow keeps most people away. I love the serenity and peace that come with being alone in the woods (well not too much alone! I’m a chicken and and like knowing civilization isn’t too far away!).

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On this particular hike last year, I was coming down these stairs and I fell. I was basically inching down them holding on the to rail for dear life, and I still fell. Right on my ass. My muscles were so weak and atrophied they couldn’t even help me keep my balance and keep upright coming down some slippery stairs. It was humiliating (of course that was the time we saw the only two other people in the park that day), but also a turning point for me. I knew I would do whatever was needed to make sure I could protect myself against falls and injury.

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Being strong and healthy is the best way to prevent falling. So instead of feeling sorry for myself and beating myself up over a recent spurt of middle of the night binge-eating, I got myself up and went running in the gorgeous cold and snow. In one year I’ve come from falling on a simple stroll in the park to running 6.6 miles in the snow. What would you be like if you lived without fear and limits on yourself? Wouldn’t it be amazing to find out?

 

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