I’m not a commodity

(Remedy Drive – Commodity)

I have grown significantly in my ability to communicate this year…

…but that doesn’t mean communication is no longer a challenge for me.

I was realizing this weekend that like it or not, communication is a major barrier for me that continues to hold me back from really reaching my potential. A lot of times that comes in the form of not being able to demonstrate what I do and do not know and what I have and have not analyzed, leading people to assume that I don’t really know much or that I haven’t really actually analyzed what I needed to in order to come to an informed decision. Other times, that comes in the form of not being able to reach out for help at the times I most need that help.

That second one is probably my biggest frustration because I’m not in this for recognition. Sure, that first one is rather problematic in interviews which is why I have struggled so much to get where I am today. It is also problematic in being given the space I need to be able to actually do my job since people tend to hover when they think you aren’t going to do your job correctly and that hovering makes it incredibly difficult for me to do my job which sometimes starts to become a self-fulfilling prophesy – you think I can’t or won’t do it, so you hover. That hovering makes it so challenging for me that I start to actually be unable to do work that I otherwise could have successfully completed. You see that I didn’t do a stellar job and hover even closer – which makes it even more challenging – so I try even harder to earn my freedom yet ultimately many times just end up highly stressed but highly unable to succeed…

…but surprisingly enough, that is not what concerns me the most in my inability to communicate. It is that second one, not being as able to reach out for help when I really need it. When I kind of just want a little help but also could probably figure things out on my own I can ask questions…sometimes probably too many questions. Okay, by probably I mean definitely…sometimes those questions are things I already know because one way I avoid communication that is more difficult for me is by asking questions that will often lead me to no longer being in the situation where that communication is necessary whether that is by the other person doing the communicating for me, or just changing the situation enough that answers are provided without ever actually asking the question I was struggling with. I will admit that my incessant or unnecessary questions can be a little bothersome, but they get the job done…where I get stuck, however, it that when I am really drowning one of the first things I lose is my ability to communicate. I will lose my verbal skills first followed by my written communication skills. This can definitely lead to problems. There are a lot of selective mutism awareness sites that will explain this way better than I can, but basically, the problem is that if I am in danger I am unlikely to be able to access help. While big dangers are what concerns me the most, sometimes the littler dangers are the most frustrating. The sitting in front of a blank email for hours unable to put my question into words and therefore unable to access the help I need to be able to complete whatever I am working on.

But I have made so much progress that I know it is possible for me to get where I want to be someday…well, okay that might not be true, because it seems like every time I make progress I start to want to move my own goalposts just a little further away because for every new skill I gain I not only want more consistency, but I start to see other skills that I also want to gain…

About a week and a half ago for like very possibly the first time ever, I was in a group were I wasn’t even supposed to be in charge, and where everyone knew me at least a little so there was really no reason I would absolutely have to use my words. But not only did I participate, I didn’t wait until I was the last person who hadn’t said something. I didn’t wait for anyone to tell me it was my turn. I just did it. And I didn’t make my answer a single word or a short phrase…like my answer was multiple sentences long. And it was so incredible to be able to use my words like that. That kind of thing I can usually do at work, but like pretty much any social skill I’ve learned as an adult, I become able to do the skill at work first and am significantly more competent at work than at home for a very long time. The trickle from work into my personal life is incredibly slow…usually by the time I get home from work I’ve used up all my social for the day, plus the fact that a lot of things just eventually become not a choice at work means I have to figure things out there versus at home where if I don’t want to speak I really don’t have to.

Speaking of work versus home…today I took a day off of residency things. It felt super wrong (And was kinda stressful) because I have a ton of things I really need to get done and even my short list of things due in the next week is not really very short…but someone said something in a meeting last week that spurred me to take this time even though it was really hard to justify given the work that I am behind on…someone said to remember that after residency there is real life and it can be easy to be drawn up in all the things you need to get done, but taking time to think about your next steps is important…and I realized that was something I really needed to do. I’ve been trying so hard just to keep my head above water for this year that I hadn’t put any effort into next year…and while it was really stressing me out that I didn’t have that stuff done in August and September…eventually it turned into October…and then November…and now almost December…and I still hadn’t gotten it done…and so now it feels a lot like the year I decided I was applying for residencies when I only had like a week or two before the deadline…(and if I don’t hurry up I am not going to end up much better off- I pulled it off that time, but I am not interested in doing that again). Luckily I at least have probably 90% of my letters written as of right now since I spent the entire day (when I wasn’t writing blog posts…) writing letters of intent…Unluckily I still haven’t obtained reference letter writers, nor have I figured out the pre-application info session and interview things…or writing the essays and stuff some places want attached to your application…so yeah…tomorrow I really absolutely must get some residency work done, but I think probably I need to start making time for both residency things and application things or the decision on whether to obtain a residency is going to be made for me.

You’ve been you’ll be

(Cade Thompson – Every STep of the Way)

So I was thinking…the virtual midyear just isn’t very authentic. I mean, what is midyear without the crazy high stress of all the social issues involved in going to the airport? What is midyear without OCD acting up because airports and hotels are crazy germy but you like a psycho if you clean all the things so you have to make do with maybe one or two wipes and some hand sanitizer in the airport and just plan on not setting anything down anywhere but your lap and pray you get the flight attendants that let all your things sit on your lap or feet and not Mr. I’m going to touch your stuff and make sure it gets lots of awful disgusting airplane floor germs on it. What is midyear without packing all your meals for the week knowing you are probably going to be too stressed out to actually eat half of it anyway? (P.S. packaged items are a much wiser option than a banana – it will turn into banana mush enroute). What is midyear without somehow managing to rip a hole in at least one article of clothing and/or forgetting one key part of an outfit and trying to figure out how to fix that for the day? What is midyear without the crushing anxiety of being totally completely surrounded by a zillion people multiple times every day?

Okay, so yeah, there are a lot of the parts of midyear that I really struggle with that I get out of by not actually *going* to midyear…but…the problem is the parts of midyear that I really like are the parts that don’t work virtually. To me, the part of midyear I liked best as a student was none of it. Actually, that isn’t true. I was kinda crabby because everyone said midyear was super awesome and with different expectations it might have been good but it totally didn’t live up to my expectations. In reality, I did like *some* of the sessions because a lot of the ones I went to the real pharmacists were learning new things and I knew the things that were being talked about already so it felt good to feel competent. And I really liked the free candy. As a pharmacist, I feel like most of the sessions I run (often almost literally) from one to the next hoping to find something good but still find most of them really aren’t that valuable. What I absolutely love is mentoring students and younger pharmacists outside of the meeting itself. As in, if I could just go to the location of midyear but just wander the sidewalks, walk up and down the stairs, and maybe sit down in a cafeteria or something I would probably have an even more positive experience than actually attending the meeting. I mean, the free candy was still a very close second in my enjoyment, but people are my favorite thing ever. I love helping people be their best. Helping other people achieve makes me feel good, and plus it makes me feel like I have something worth sharing which is good because a lot of the times it is hard because my social skills tend to leave me at the bottom in most arenas, so being somewhere I am not on the bottom is so special. And the other valuable thing for midyear while I am still in a looking for a residency position is the showcase. Yes, I know there is technically a showcase at virtual midyear, but the part I need is the body language when I introduce myself that tells me whether there is any interest in me or not…and as a quieter person, I do better observing than asking questions, so the question-only format is not helpful for me because if I want to be seen I can’t just listen in on other people’s questions while looking to see if this is one of the programs that takes attendance…yep, I can get in, get what I need, and get out in usually less than half an hour per showcase session in a “normal” midyear…

And so now I wonder how far back my social skills will set me. Will I even have a chance at an interview and therefore a PGY-2 without the anonymity of an in-person event? Is it worth the effort and expense of trying? This is really all I’ve ever wanted, yet it seems like COVID has taken it away. Well, that and how far behind I am.

On the more positive side…yesterday I took the pharmacist resilience quiz again. This time I got a score above 71% of other pharmacists…so if we’re grading on a curve that means I am only just barely a C- so am still basically failing…so…I know that sounds negative…but…to me that was an incredible win…because…for one, the highest score I’ve ever gotten is above 81% of other pharmacists, so it is a tie for my second highest score. For two, just under two and a half weeks before that I scored above only 22% of other pharmacists…so I mean I scored more than three times higher this time…and if I’d taken that previous one a couple days earlier I would not be surprised if it was even lower. The day I took it was going to be my last day with a preceptor I didn’t get along with very well after 5 weeks of no evenings off and working way too many hours which had led to some major emotional issues. Hashtag burnout. All that to say, I was very pleased with my score.

But yeah, there was one preceptor I really struggled with. And after venting about one particular comment I was ready to move on…until…I got my final eval. So the preceptor I absolutely loved told me the eval would be a combination of both of their comments. The preceptor I loved discussed the eval section by section letting me know how she thought I was doing and what was going to be written in the eval. But then I got the eval. Most of the questions were left blank. The questions that were answered were barely answered. If I’d turned in an evaluation like that to any of my previous preceptors it would have been sent right back to me to re-do and probably a lot less nicely than the ones that have been sent back when it was obvious that I had tried even though I didn’t get the right answers. Okay, whatever…I did get the feedback on whether what I was doing was good or not verbally so who cares what is in the written eval, right? Well…umm…yeah, about that. There was almost no information in this evaluation except for a comment that I didn’t turn something in…and that is what really made me want to push for a conversation about that. I don’t just not do things, especially things that are basically school things. I felt frustrated, because it felt a lot like when one of my APPE preceptors told me on the last day that she had wanted me to say something about every patient every day…umm, okay, that would be a fair expectation if you’d told me that on day one, but not telling me until the end of the last day when I am about to go home is not setting up for success nor is it overly useful, because I can no longer change that. Same thing here; if you’d told me you wanted that I would have done it, but telling me a week after the end of the rotation is not useful for anyone…not to mention that maybe checking in on how I was doing on this project perhaps would have been a wise choice as well if you were expecting something from me…but I never heard a peep about this project until the evaluation…so I decided to as to talk. And she said yes. And then she said only with my program director present…and I was like sure whatever…and now I am kind of nervous, because I was planning on/expecting a 10-15 minute conversation where both our perspectives could be heard and then we could move on…but drawing my program director into the conversation makes it feel like she is planning on some big production…and I mean, having my program director there should help protect me from her really yelling at me, but at the same time, the more people that are there the harder it is for me to express myself and stand up for myself…and she knows how to use that to her advantage. She knows if she cuts me off and uses a tone really close to yelling that it intimidates me enough that I’ll shut down and won’t fight and will just accept whatever is thrown at me…and that is not going to put me in a place to have a productive conversation.

But the whole I don’t not do things thing…well…it has me very conflicted. I’ve told a couple people that I was going to go grocery shopping this weekend. I really did have plans to do that…and I haven’t really gone grocery shopping since July 2019 unless you count buying onions at Kwik Trip once in February when they were on sale, so I am starting to run low on meal options and would really like some more food in my life…so it is not that I am not motivated…but…I am really struggling with making that motivation into a reality. I don’t know what to buy. I put a lot of basic grocery items on my Christmas list, so I shouldn’t do a full stock-up…but I don’t know *what* I am going to get for Christmas and it might not be any food, so I might actually need pretty much everything. And I mean, I know I’ve heard multiple places that grocery shopping often becomes hard in grief…but…grocery shopping was hard for me before grief. I was finally getting to a point where it was not such a big deal anymore to buy groceries at target though the actual grocery store was sometimes more challenging, but grocery shopping has never been second nature to me. Inside a store it feels like all eyes are on me. I know that isn’t true, but that doesn’t change how it feels. And the vaulted ceilings in actual grocery stores make it feel like there are crowds of people everywhere even when the store is relatively empty, so that just multiplies the fear…and then grocery shopping where I live now is a lot harder than it was where I used to live because I can’t walk to really any store from my apartment. From work I can walk to Walmart or hyvee, but at this time of year it gets dark too soon for that to really be practical, because I wouldn’t just *feel* like everyone was staring at me if I was walking along the side of the road carrying a flashlight or something…and I also learned this summer that a lot of stores here do not have bike racks, which means that really my only choice is to drive to the store…which somehow also feels like a lot of pressure because if I am walking and I give up all I have to do is turn around and basically I just went on a walk, but if I am driving it feels like I *have* to complete the shopping trip. So yeah, I really want to go grocery shopping at this point really only because I said I would, because I know I can make it another week without grocery shopping, but I really don’t want to go grocery shopping, but I feel like not going isn’t a choice now that I’ve said I was going…but what do you buy at the grocery store when you haven’t gone in forever? The last of my beans are cooked, so I mean, that would be a good thing to buy, and I only have a few cups of gluten free flour so that would also be a good thing to buy and I’m also almost out of sugar. I have probably another month worth of fruit and vegetable products, but it would also be nice to have fresh fruit and frozen peas. And I’m out of rice. And I love noodles and I love yeast…but really for me, especially right now, if there are more than 2 or 3 things on my list I probably am going to get overwhelmed and leave the store empty-handed…so ideally my list gets narrowed down to one item or maybe two that I can bring to the register and then a week or two later I can buy something else until I have what I need or until I feel more confident in going shopping…so yeah, that is where I am at right now. Conflicted and overwhelmed over grocery shopping.

On a totally different note, I re-took the strengths quiz this week. I found out that there are two things I am not good at anymore and two new things I am good at. But apparently in the past 8-9 years my top strength now is something that wasn’t even in my top 5 before…and I haven’t decided yet if I think it is totally me or totally not me…So yeah, that happened…although I kinda wish I could take it like 10 times in a row to really figure out what I think my top 5 really are…although that might just leave me at the same place as taking multiple enneagram quizzes left me (although for that I took multiple *different* quizzes…) I have zero idea what my top enneagram is because ones that were towards the bottom on one quiz were on the top on others and vice versa…so basically I decided I was an almost all of them…

…also changing the subject again, I discovered today that I can’t make Christmas go away by working. I’ve been pretty open about the fact that I was basically trying to run away from Christmas because it was really hard last year. And it hit me today that Christmas is going to come and probably be hard whether I want it to or not. I can try to run but I can’t make it go away…and now I’m crying when I should be getting in bed…

…and I am frustrated because I had today off so I totally should have been able to make good progress on a lot of things, but I didn’t…mostly I wandered around trying to figure out which project to work on first…so now I have very little to show for my day…except that I figured out that I was converting time zones incorrectly and now have problems to fix on my schedule because one of the conference days I thought I could get away with a half day and, yeah no, I have not yet mastered the art of being in two places at once and when I converted the times in the correct direction it put my work responsibilities on top of the presentation I wanted to listen to…to be fair I did do a few tiny things, but not the most important things and not really things I couldn’t have done in a minute or two of downtime any day…but I hold on and remember God has a plan and sometimes even when things go objectively wrong God can use it for good…

…and now I for real need to brush my teeth and go to bed…’cause exhaustion is just going to make everything harder…

Don’t hold in your anger or leave things unspoken

(How you live – Point of Grace)

I have loved this song at least since high school. This morning it just really filled me. It started playing while I was getting ready this morning and I was like oh this song is really good and then moved on. Then a few minutes later it was playing again and I was like I really should pay attention because God is probably trying to tell me something.

Y’all, it is not about pretty red dresses. It is not about living like every day is worth celebrating. It is about that line in the title: don’t hold in your anger or leave things unspoken.

Today I feel so much better emotionally than I did last weekend. I’m still not ready to put words to just how I was feeling last weekend and throw it out there, but today, at least after I dragged my exhausted lazy bottom out of bed, I felt really good. Sure, I am still way behind on a lot of things and that is overwhelming, but I don’t feel crushed by it. I feel ready to tackle it and try to catch up one thing at a time.

And I think the difference is at least in part because I put into words to someone yesterday I am angry and this is why. It wasn’t like it physically changed anything, but after sending that email instead of being distracted by my frustration I was able to forget about it and move on. I still gave myself a few more breaks than I probably should have as an extra mental health precaution, but I really think it is the sharing of my thoughts instead of holding it in that really made the difference.

Completely unrelated…but…I also learned today to not be an idiot. So I desperately needed to get some energy out so I decided I was going to just skate for a couple minutes. First dumb thing I did: skating through some wet pavement. That is dumb because when the wheels get wet it gets a lot harder to control my direction of movement. Second dumb thing was that my hands were twisted up in my pocket. So I started losing control as my legs were going a different direction than my body and I couldn’t get my hands out of my pockets fast enough to catch my balance and they just barely were out in time to start breaking my fall…so now I have road rash on my hip…I’m thankful that was the biggest injury though, because without my arms to start controlling where my body was going just before impact it totally could have been my face hitting the pavement…and really as much as it hurts, my first thought was frustration that the perfect wrist guards that my daddy bought me for Christmas my last year of college were no longer perfect, because they got scraped up in the fall…also my helmet got scraped and I know as soon as you get into an accident you are supposed to get rid of your helmet so now I have to decide if I think I hit hard enough to need to get rid of that helmet or if it was more of an abrasion than a real impact on my head.

So to have your silver lining there must be clouds

(Every cloud has a silver lining – Thomas and Friends)

Sometimes life is really hard, but God is always there.

I’m not 100% sure how vulnerable I am ready to be in this post, and that makes it really hard to write, but I need a 10-minute break and I really need to spend some time writing something that isn’t going to be torn apart.

For about a week or so it was like something finally clicked and I was getting sleep every night – not necessarily enough sleep, but it was totally progress. I still felt exhausted, but it gave me hope. I should have known it was too good to be true.

Thursday night I actually fell asleep in a reasonable amount of time (yay!!) and then an ambulance decided that midnight was a great time to use its siren…usually at night they are pretty good about using just lights in residential areas but not that time…so I got to work on Friday mostly asleep but ready to get work done…and we’ll just say that very close to nothing got done…

And I feel like after finally having a meeting about one of my big presentations…the meeting I thought was going to fix everything…I felt even more lost about what I’m supposed to be doing with it before I finally sort of figured it out so it was really frustrating…and really even before that it felt like the whole day was just bad news after bad news…thank God for amazing coworkers who took over on some of the things that evening I just didn’t have the energy to deal with.

And of course then I went home, but like every time I got close to falling asleep I’d get another text from a resident…to be fair only one of them required I get out of bed and get into the medical record to help them, and the last one was just a thank you…which would usually be appreciated, but I don’t really want to be thanked in the middle of the night. I just want to rest.

And Saturday things also really weren’t going well most of the day and I was up most of the night writing emails…and, if you were wondering, it is totally true that it is physiologically impossible to consciously hold your breath long enough to actually fully lose consciousness. My awake mind knows that obviously because as soon as you weren’t fully conscious your brain will force a breath if you even are able to get that far, but my mostly asleep mind didn’t know that.

And this morning I didn’t eat breakfast, but at church someone had a donut and didn’t even know I hadn’t eaten and said he’d like me to have it…

…and I got home and there wasn’t really anything ready to eat, but I found a bag of popcorn and a cookie and now at almost dinner time I got a multivitamin mixed with this vegetable powder that is supposed to enhance resilience…so I might be missing the protein but between that stuff and the candy I’ve eaten I’m doing okay on calories, and I paid the bill that is due tomorrow, and my ten-minute break has already been fifteen minutes so it is time to stop.