Thread by @usnehal

Okay.this is stress induced. I just committed to moving..mid-semester, am sleeping 3-4 hours a night, leading a major event, in an accelerated grad school program, and amid a tense election. I do have intermittent pain, but my migraines have not been this bad for a while.

The last time I felt this way was 2018 when daily the @AmerAcadPeds was sending advocacy emails with images that I found personally triggering from my own past experiences, then this was in the news wbur.org/news/2020/01/0… about Boston Public Schools reporting students to ICE.

Meanwhile at work was dealing with weird comments made about minority patients, errors in the medical record w/ staff gaslighting minority patients, & my being seen as the same as the non-white clinician in our small group of less than 10. Now, this week: linkedin.com/posts/usnehal_…

What that is above is my doing a community service cuz, well, being part of a community is healthy & I'm encouraging folks to engage in secular & civic processes to have a voice and be an engaged citizen and I get called a terrorist for that. It's not new. I rarely talk about it.

And I'm a long way from being this kid who was bullied on race.

I did not have a mom who could pull a "Karen" (as term goes) - despite her PhD level education was assumed to be illiterate, ignorant (maybe not know how to raise kids). Cultural chauvinism.

https://twitter.com/usnehal/status/1257691096928456704?s=20

What really hurt: to see this not different now. When do we get better? Am so deeply disappointed by my peers who respond with ego, defensiveness, retaliation & only think of their reputation/narrative making it clear Black babies lives don't matter 2 them
usatoday.com/story/news/hea…

Only we don’t have enuf Black doctors. Those we have are pushed out. Tho am leaving clinical medicine (do folks “need” me to stay in? Maybe.. does system deserve me or am I wasting my time, talent, & skills on low quality, even harmful outcomes?), can’t just abandon the bear cubs

https://twitter.com/usnehal/status/1312699668833460226

This is 1 of 3 I submitted to @PASMeeting, let’s see. I don’t flee & leave a mess even if someone else made the mess. Is a toxic system. Had a PM convo w/ @MAhealthforkids a while ago. Frankly I warn WOC seeking to enter the field. But can I do more personally? Am trying like:

Yes, I am super resilient

I may be full of these brave words below

but sometimes is hard to dig down deep enuf to keep the faith

when #blackexcellence + past public servant + Muslim treated like this

Gets scary to know my/our identity/faith is increasingly “illegal”/banned

What gets me:
self obsessed #MedTwitter & #Academic peers having panic attacks over perception a tweet was “subtweet” & use #BLM for equity points/optics yet contribute to gaslighting, attacking, & harming #URM via direct or indirect ways
coco-net.org/problem-woman-… #BlackintheIvory

So, my head feels better.
1- I admitted this is exacerbated by stress - acute on chronic
2- A friend is picking me up and we are going for a drive out of the city
3- I accept: I going to move my “mess” yet again, but I cannot set goals for before the move right now

I think that is all I can do to reduce stress/load. There really is nothing else I can drop or delegate or delay. It’s an intense year. It’s an intense time. Being Muslim in America is not going to get easier. I have always set ambitious goals then convinced others to join me.

The problem with #MedTwitter partly maps to the reason I am leaving clinical medicine (despite, even the ppl who dislike me for other reasons, consider me an excellent, careful, compassionate clinician): controlling/shaming others is *your* anxiety you are in denial over & harms

But #MedTwitter only replicates all the ego-driven jockeying for recognition, power, metrics, reputation, budgets that goes on in hospitals and academics.

Meanwhile, patients? Patient care? Quality? Safety? First do no harm?

It’s not #MedTwitter that is the source of stress right now...but what I have seen about how people think & act is just deeply disappointing

more so now

when I think of where I am going next (not exactly sure, building the road forward now).. what/who will I find in the future?

My 360 says I need to experiment more (lowest domain but all is on a scale of 1-7 ..so “lowest” score of 5.94 needs to be taken in that context.. because how much more do I really “need” to do?).

Well, have many experiments cooking and this whole year is one massive experiment.

Hi all. Activated operation stress reduction. Also, before I share that, this week along with the weirdo post about my being Muslim (yes, I am), I had had a freaky dream that felt real that someone super close to me died. It felt real. And I experienced grief over that dream.

I’ve lived through a lot. Gas marks passed out while I get sent off and my parents stay behind in a war zone at 14. A potentially fatal dose within inches of being administered. Living where I heard gunshots in the neighborhood. 4 potential cancerous (all cleared). This, now?

I have a successful business now. I am trying for more, higher, better, more impact. I want to change systems

Yes.. I had unexpected severe pain w/ near miss fainting on Friday

But I have my systems of self care. I stayed safe and managed..like I always do

Pain will happen:

It’s about managing, not controlling. The bad days will be bad but how do I maximize the other days and/or reduce bad days?

And how do I keep from anticipatory spiral?
Stay in the now.
It often gets better and in those moments, grab productivity or fun or sleep.

Today called a trusted friend
I need OUT

*now*

So got out of the city

No ambitious hike
No required goals

Be grateful for whatever is
Just a beautiful autumn day
Sunlight on bright leaves

And OMG... fresh cider donuts
Nothing is better than melt in your mouth warm donuts

It is important to have the friends who can jump into action
and

GO

OUT

AWAY

Humans in a car
&
hit the road

See trees
Sun
No city

(Did not get to mountains)

Thing. I didn't prioritize making a lot of money: feds & public health. In my first job I was hired for $12K less than someone with fewer credentials (no MPH or fellowship). So my parents, seeing me struggling with getting sick, are supporting me in a career transition. =Guilt

But I can't do nights and weekends clinical to support myself through this degree and stay well or do right by patients like peers might do. This is the money my dad earned by not leaving his job when war broke out. He and my mom stayed at risk of their lives to for this money.

There's just a lot of different reasons for stress all at once. And now that I'm back in the city in my apartment again
a bit hard to breathe
so much to do
I love NYC
but it's time to leave
to be in the same location where I am actually studying
I need space, sky, nature

My flower pics today

More flower pics