I was halfway through my clinic on Thursday afternoon before I realized the significance of the day. It was September 1st. It was my one year work anniversary, or my workiversary, as I had coined weeks before in anticipation of the date.
And yet, it was a Thursday like many Thursdays before it. I slid into clinic just minutes before my first patient was roomed and ready, hurriedly eating my lunch in front of my computer while responding to tasks. I wiped my mouth with the back of my hand before seeing my patients and dousing with Purell. Although my Thursdays are only a half day, they tend to be the day all of my patients are most likely to show up and end up being some of the more harried days for me and M, my MA.
"So-in-so is 40 minutes late, so I'll see Such-and-such first, and then So-in-so...and now we're 30 minutes behind," I'd say, scanning my schedule for the day. "And the 3:00 is talkative, so if she comes late, room the 3:15 first."
I was speed-walking through the corridor to my next patient, clutching the check-out folder in my hands, before I realized that I had now been working at the clinic as an attending provider for a year.
And what a tumultuous journey it had been! A year ago that day, I started my first day of work without a proper orientation, seeing patients and having to visit HR on my own time. I signed my contract as an ambitious, single woman who thought that working a 0.8 would be a breeze after residency. I erroneously imagined my life continuing much as it always had as a single woman, not imagining what 0.8 FTE would mean for my future-husband and our life together. I started my life as a physician with a large and complex panel of 1200 patients and barely the clinic hours to see them all in a timely fashion. In addition to this, I took obstetrics and medicine call at the hospital periodically and worked one night a week at urgent care.
It was a busy time of life to say the least, and steep was the learning curve.
I remember a flurry of firsts. The first time I placed an IUD without a preceptor. The first time I removed a toenail without supervision. The first procedure I did without having done it in residency. The first labor and delivery I managed as an attending. The first week as attending on service, residents looking to me for education while I struggled to remember, after 2 months off the grid, how to succinctly explain the E/A ratio when reading the echo report for a patient with suspected heart failure.
In clinic, I was transitioned slowly from one patient every 30 minutes to the standard 4 patients an hour schedule. And for months afterwards, it was a struggle. If only life were just work, it may have been easier, but I was also juggling the work-life balance as my role as a girlfriend morphed to fiance, and from fiance to wife. I went from living on my own to living with the man I would be building my life with. Life outside was metamorphosing at the same time as I was transitioning from an ex-resident to a true attending. Hard is an understatement.
Yet somehow, here I was, one year out, and everything seemed much easier. My one year workiversary seemed less of a feat and more of a any-other-day. I wasn't even as well adapted to the clinic as I am now. I probably still was taking an inordinate amount of work home, charting early mornings on my mornings and day off, addressing tasks and lab results for 1-2 hours before starting my day. But it wasn't as hard as those first months.
Sometime in that first 9 months, I had hit my sweet spot. My large panel didn't intimidate me. I had met most of my patients (but I still haven't met all of my patients). M and I had gotten into a rhythm for our days and I was starting to become more efficient. Some days were still crazy. Like, "how did I get 4 ultrasounds booked onto my schedule in one day!" crazy. Or, "everyone is having a crisis today," crazy. But I came into each clinic day ready for it, used to it, expecting it, making the easy days that much easier.
I ended another hectic Thursday half-day after patient number 11 or 12, M clocked out at 5pm and my finishing my 4:30pm visit at 5:20pm. I plopped down at my desk in the back provider room and stared at my 9 unclosed charts and inbox full of tasks. I slipped my shoes off under the desk, crossed my feet, and prepared to finish my charts and my tasks, hopefully within an hour so I could get home at a reasonable hour. The workiversary would end up being one of the grander anticlimaxes I had experienced professionally.
One year had been nothing. It wasn't the point where I finally got the hang of things and it wasn't a particular milestone. M later admitted to me that she was unsure if I was going to stick around a year.
"Why?" I'd asked.
"Well, a lot of people come in and out of here," she said. Nothing personal, essentially.
It had been one year as an attending, learning how to make my hours reasonable, learning how to balance career and evolving life. It had been one year of, God-willing, many more in my community health center, meeting patients where they were, helping some of them to dream beyond.