What I just wrote through ...

Never since my first book was published in 2013 have I ever missed a publisher's deadline.

Despite things like: travel, solo call coverage of an entire practice for years, leading a rural  hospital during the biggest wave of the COVID pandemic in 2020-2021, giving writing talks, moving a few times, book signings, drafting more books -- I still somehow managed to meet deadline and stayed calm doing it. From 2013 through the present.

Until this month.

There's got to be a limit to what a human being can endure, and no, I don't think I've reached the limit yet. But holy cow I came closer than I've come, and there have been moments where the exhaustion is so profound that I'm completely numb.

Here's what the last 45 days entailed:

1) First and foremost: My younger brother was admitted to hospice 2 weeks ago. He's a special needs kind of guy who has been medically fragile his whole life. Mom and Dad and I have known this day was coming -- frankly, we thought it would have gotten here before now. We've prepared. Hell, Mom has completed my brother's funeral service months ago so that my folks wouldn't have to deal with it whenever my brother passed. That's smart. And heartbreaking. Despite all the preparations, getting that phone call from Mom on a random Monday morning was about as shitty of a conversation as you can imagine. Here's me not going to pieces because Mom needs me to talk with the doctor to go over "medical stuff" and make sure everyone's on the same page. I'm good at compartmentalizing, but not this good. My head and my heart hurt. All that said, the joke in the family is that my brother is like a cat with 9 lives, and probably as one big joke on us, he'll plunk along for way longer than anyone predicts. Out of spite and a good sense of humor. Oh, my heart.

2) My colleague who splits most of the practice with, officially resigned. Who has two thumbs and has to take 20+ days of Ob and c-section call each month? This gal.

3) A smidge of writing stress. I'm finishing up one big project that's been years in the making while waiting to hear back on an entirely different big project, and basically my brain is too locked up to do much creating these days, which then creates a whole new set of worries. Add in the fact that I should be doing marketing and publicity, which frankly I suck at because #DayJob, and whammo -- self-doubt/vapor lock/stress, here we are.

4) Sheer exhaustion from work: Never did I imagine that I'd be starting an entire medical practice from scratch including an outpatient clinic, an inpatient hospitalist service line, and an Ob line. Then, just for giggles, I'd turn around and start an entire other outpatient clinic from scratch. And hey, just found out we are opening yet another clinic. None of this would be an issue, except that I'm only paid to do administration work for 0.2 FTE yet my hours correspond to 0.5 FTE admin. And my clinical time should be 0.8 FTE but based on hours of clinic and call, it's well over 1.0 FTE. Nothing like 20+ days of call in a row to make me doubt my life choices. Like, I dream about work, I'm so buried in it. That's not great.

5) Speaking of life choices and bad admin FTE allocation, the MotherShip wants me to take on yet another bigger administrative job, and as a reward will give me a bit more admin time. Talk about an existential crisis. I'm like, let me get this straight. You people want me to do the current admin job 0.5 FTE which is only allotted 0.2 and then add in a second admin job at 0.3, for a grand total 0.4 admin FTE. Look, I'm no calculus genius, but those numbers do not math correctly. I swear to god, my boss looked me dead-ass in the eye and said, "It's not that much extra work. And it's not really an extra job." To which I said: "Is it a separate job for anyone else? If so, then yuh huh it's another entire job." After some gut-wrenching talks with mentors and colleagues as sounding boards, I decided to professionally tell the MotherShip to kick rocks. That was something they're not used to hearing, and hoo boy was that a fun chat.

6) Lord have mercy, we have been constructing a house for nearly a year. It was promised to be done in 12/22. That's over 6 months overdue. And we finally moved in last weekend, because of course we did. Know what's fun about a flaky contractor? Discovering what items weren't exactly completed as promised. My favorite story in this brand new house is when Hubs went to hang some clothes in his closet and the hanging rack fell down from the wall, as if no stud whatsoever had been involved in the hanging of said rack.

7) Given the DayJob situation and a complete lack of alignment with my values of sleep and writing and not being burned out, I'm looking at some other job opportunities versus completely retiring from medicine. Hello, existential crisis!

I will say this: I'm in such a better headspace than a few weeks ago, and so much of all that's going on has sunk in. I've also made a few life decisions that have taken all the pressure off. Basically, I invested in myself and called my own number, and that's made a massive difference. And as for the writing and editing? Somehow I returned a 350 page manuscript while staring into the abyss. It's done. 2 weeks over but it's done.

Still, hoo boy. I'm reminded of a hospital chaplain who hears the regrets of dying patients every day. He says: "Live deeply. Do not waste time on everyone else’s vision for you." And he's right. It's scary to state to people: here's what I want out of life, but that's what is needed. And hopefully, there won't be any missed deadlines in the future. And there will be plenty of time for what's important and for letting my brain just think and enjoying these trips around the sun!