I hit the breaking point I didn't know I had. As is typical with breaking points and rock bottoms, hard to predict their location unless you're right at it. It had nothing to do with me of course, but rather my ability to do my job. I'm talking about coffee, specifically referring to the caffeine contained within coffee and its addictive properties.
For whatever reason, I am very sensitive to caffeine, both for good and bad, and known this since medical school. Good, caffeine has the desired effect of waking me up and helping me focus through that 3am surgery. Bad, if I don't have the usual daily dose I get pretty sick. The last time I can remember not having morning coffee was before residency, when I had on purpose weaned myself off the drug in preparation for the rest of my life. But since then I've enjoyed coffee every morning, knowing full well the physical dependency my body was developing. It fueled the strings of 16 hr work days broken up with 4hr nightly naps that came with the responsibilities of surgical residency. Helped me study that extra hour, and helped me restart my life after crashing post call. Then a few weekends ago I had one of those calls that required I hit the floor running. By the time I could come to a pause it was late evening and I hadn't had the time to drink any coffee, and at that hour I needed to be able to rest. So I took the risk and did not take any late evening caffeine in order to sleep. I tried to compensate the next day, but it was too little too late, and I had to ultimately go home and let my PA finish what was needed on my patients. Not being able to fulfill my responsibility to my patients was my breaking point. This physical dependency my body has, for better or worse, is not worth not being able to do my job.
Cold turkey was obviously not an option, as it would render me useless and unable to fulfill my responsibilities. So its been a painful slow wean, meaning a daily headache, but just the right amount of headache that I can still work and find relief with ibuprofen. In summary, it's not fun, and ultimately has provided me with perhaps an appreciation and understanding not previously held for those in similar situation, given whatever their personal drug of choice (alcohol, nicotine, opioid, etc). I mean, can I ever just meet a friend for coffee again? I'd like to say yes, but let me survive the rest/worst of this withdrawal first, before I fully answer. Eventually I want to confidently know I can do my job either with or withOUT caffeine, and then stay that way.
I don't want to give a lopsided view about my calls. They can be rough, as previously described. But on the other hand, I had a call the other night and the pager didn't go off a single time all night. Granted that is rare, but not every call has me running like crazy. Unfortunately it tends to lean one way or the other, rather than an even distribution of the work steady throughout all calls. Its more like a pendulum with huge heavy swings one way or the other. It's hard to predict which way the pendulum swings; weather can lend a prognosis, but it doesn't always hold true. Over time you somehow pick up a feeling, almost a foreboding of which way the oscillation is pointing for the day, but up until the alarm goes off to start the day, nothing.
Much Love.
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