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Nicholas Genes, MD, PhD

Medscape Med Students.  2007; ©2007 Medscape

Posted 02/06/2007

"Dr. Couz" always wanted to become a doctor, but she also was determined to be a balanced, well-rounded person, too. Now a resident in emergency medicine, she continues to resist her profession's attempts to run her life. She writes anonymously about her work at the hospital and about her life outside it on her blog, Tales From the Emergency Room and Beyond.

Dr. Genes: Is it really possible to be well-rounded during residency, or are you planning to make up for lost time when you're in practice?

Dr. Couz: In the struggle to remain well-rounded, I think I'm winning. I have to admit, though, that I'm luckier than most residents. I have a really supportive husband who believes that since he has more free time than I do, that the bulk of the household chores should be done by him. This allows me luxuries like having 2 dogs and working out regularly. My husband and I are out in the woods hiking with the dogs daily. I also run and do yoga. I'm actually training for my first half-marathon in the spring.

I absolutely do not believe in "making up for lost time" once residency is over. I suppose that a certain amount of that is necessary during your R1 (internship) year, but in most specialties, life doesn't get all that much better after residency training is over. The demands on your time are different, but no less in number.

It's far too easy to give up everything in your life that isn't medicine with the justification that it's a temporary sacrifice. So you put off your relationship, your hobbies, taking care of yourself, and everything else that was once a part of your life, only to find yourself at the end of residency alone, out of shape, and unable to talk about anything other than medicine. A sad state of affairs.

I'd be lying if I said that the lifestyle of emergency medicine wasn't appealing to me. Shift work rocks, for those who can tolerate an erratic sleep schedule. Emergency medicine seems to attract a very defined personality type that goes beyond the typical "short attention span" stereotype. For starters, I've never come across a soft-spoken emerg doc. Second, they don't tend to be the kind of people who view having a life outside of medicine as a liability. They are triathletes, windsurfers, skiers, and paddlers who just happen to practice emergency medicine. I love that.

Dr. Couz at Tales From the Emergency Room and Beyond hosts Grand Rounds February 6, 2007

Dr. Genes: What are some posts you've written that resonated with readers?

Dr. Couz: The first post that really made an impact was back when I still thought that no one read my blog but my mom. One day, I wrote a diatribe against home birthing. I was in the middle of an obstetrics rotation and was strongly influenced by a couple of cases I had seen that month. A few days later, a friend emailed me, livid. She had been planning a home birth and was infuriated by my suggestion that her choice was risky and irresponsible. I apologized for hurting her, but unfortunately, it ended our friendship. I think that was the last time I wrote a post without considering its impact on the people who might read it. The funny thing is, I don't even feel that way anymore. My stance has softened as my experiences have changed.

Even after this short period of time blogging, I enjoy looking back at what I now consider some of the defining moments of my intern year. My first night on call, the first time I pronounced a death, the first time I stuck up for myself in a disagreement with an attending... I remember exactly how those moments felt at the time. And that's why I blog.

Dr. Genes: What inspired you to start blogging?

Dr. Couz: It took me a long time to get into medical school. I applied 3 times before I got interviews. Thankfully, once I got interviews, I was able to let my personality do what my transcripts hadn't, and I got in. Thank God. I honestly don't remember ever wanting to be anything else.

During my many failed attempts at realizing my dream of being a doctor, I kept myself motivated by reading books by medical students and residents describing their experiences. Not just House of God (which would be enough to turn anyone off medicine), but also White Coat: Becoming a Doctor at Harvard Medical School by Ellen Lerner Rothman, A Not Entirely Benign Procedure by Perri Klass, and the books by Robert Marion, The Intern Blues and Rotations. Reading these books somehow helped me "keep my eyes on the prize" when my motivation was lagging.

I've always enjoyed writing, and I guess I had a daydream of someday writing my own book like they did. I never really got in the habit of recording the things that happened to me as I went through medical school, but by the time I started residency, blogging had started to go mainstream. Initially I meant it as an online diary to record my experiences, but little by little, people started to discover me and leave comments. Sometimes I'm not sure whether I'm still writing this blog for me or whether it's with the audience in mind.

Dr. Genes: Next week, Dr. Couz becomes the focus of the medical blogging community when Tales From the Emergency Room and Beyond plays host to Grand Rounds. Each week, a different blogger compiles the best of online medical writing for Grand Rounds. In keeping with her ambition to remain well-rounded, Dr. Couz has chosen a theme of "Medical Professionals as People"; she'll be highlighting entries about balancing work with family, hobbies, and other niceties.

Around the Blogosphere

Being in emergency medicine myself, I'm a little partial to blogs from EM physicians and nurses. And I'm lucky that there are so many to choose from. Maybe it's because of the interesting patient encounters, the odd hours, or the personalities that the specialty attracts, but there seem to be more blogs from emergency room staffers than from any other field. Among those who've hosted Grand Rounds are GruntDoc, Emergiblog, Doc Around the Clock, Protect the Airway, and Mr. Hassle's Long Underpants. Most EM bloggers have a fairly humorous undertone to their posts, with a healthy amount of frustration and venting. Check them out to learn more about this new and excellent specialty.

Nicholas Genes, MD, PhD, second-year resident in emergency medicine, Mount Sinai Hospital, New York, NY

Disclosure: Nicholas Genes, MD, PhD, has disclosed no relevant financial relationships.