Paging Phoenix

[Asscherhalo_lover]

Wow so many doctors here. How much do these specialty surgeons make per year? Over $1m or close to it? A few million a year? Ok. Off topic. Feel feee to ignore.

Compared to what most professional athletes make, it's sure not enough!

 

[elizat]

Wow so many doctors here. How much do these specialty surgeons make per year? Over $1m or close to it? A few million a year? Ok. Off topic. Feel feee to ignore.

You can look up average salaries for basically every job in the US at the bureau of labor statistics. Again, average and ranges, but it's there for every position and you can search by states, etc. I wish I would have known about it picking a career!

Overview of BLS Wage Data by Area and Occupation : U.S. Bureau of Labor Statistics

Overview of BLS Wage Data by Area and Occupation

www.bls.gov

 

[evergreen]

Anesthesiologist (not cardiac, phew!) here: girl, THERAPY. I mean that with love. Just to have someone to talk to, and focus on YOUR needs, who really understands where you've been and that it's more than one human can honestly bear. Meanwhile, sending smiles from the other side of the curtain. I have been part of the care team during two intraop deaths for elective or semi-elective cases, one as the attending, and I will never ever forget those two patients. It takes a lot to process, and I'm sure you've seen a lot more. If you are behind in taking space for yourself, and how could you NOT be with a call schedule like that, I hope your hospital is working on making things more humane so they don't run you into the ground before your time. You are a gem and I am THRILLED to see they are starting to appreciate your worth, at least. ETA: I and everyone I know either have a therapist or they wish they did. So it's not just you, it's the whole actual world.

But, honest truth, I also recently upgraded from a 1.3 to 4+ct solitaire and I do look at that big new diamond winking its big chunky sparkles and feel that peace for a tiny second in the midst of chaos. It is absolutely good for my wellbeing to have a big-ass diamond. Get it. But if money is not really an obstacle, I would also invite you to look into different shapes (I kept my 1.3 and set as a 3-stone; it's a transitional round, and the new 4ct is an antique cushion). Different shapes have such different personalities and it is really nice to choose among different beautiful options. Probably it's also a good cognitive trick to use, switching between diamonds with different performance characteristics to help your adornments continue to draw your attention and feel fresh to you.

 

[mrs-b]

Hey there, @allycat0303

So here's my 2c.

I think I'd LOVE a 7-9ct on your petite fingers! I mean - if you want to make the BIG ring statement, go big or go home, in my opinion.

I DO think it's possible to go too far with a round brilliant - but I don't think 7, 8, 9ct represents that. On ME, I think a diamond that size would look silly - but mostly because I don't have fingers beautiful enough to wear it! But I think you could definitely rock it.

However, can I ask what clarity and color you're considering? I do think if you're going to go for that sort of size, it would be nice to do it with a very high quality stone - not just one that's big. This should be a collector's piece. An 8ct I SI2 is one thing. But an 8ct E VVS2 is a completely different kettle of fish. Big diamonds are one thing. But big, colorless, eye clean, perfectly cut diamonds? Now *that's* a WOW.

No matter what you decide to do, I wish you much enjoyment from your choice; in your job, I think ANYthing that puts even the slightest smile on your face - even for a nano-second of each day - is worth whatever amount you're happy to spend.

Good luck - and please take us along for the ride!

 

[Peary]

I was just wondering income to bling ratio. Not anyone’s pay specifically. And how people like to spend their money.

Growing up, my friend’s cardio surgeon dad owned a Ferrari and a few less expensive luxury cars and lived in a super huge house in a very very upscale area and he was a single income household with a stay at home wife and 2 kids. Nowadays my own friends in a dual income 2-doctors household, one being an anesthesiologist, also 2 kids, are living well but far from Ferrari well. They only own 1 normal house.

Then there’s a neurosurgeon in Beverly Hills my friend’s friend “dated” years ago (aka mistress) who was taken on exotic vacations around the world, and was given a credit card and a condo. Back in the 90s I heard this guy made like 5m a year. Don’t know how much of that is true or not.

I visit this hip plastic surgery office to get regular touch up work done and a couple of nurses there wear HUGE diamonds, or diamond stimulants. I don’t know how big but definitely double take big. Maybe similar to the 5 ct pictures shown above.

I’d probably say beyond 5 ct may be a tad too big for my personal taste for everyday life. It starts to venture into celebrity territory. Not just from a cost perspective, but more like celebs tend to be more showy with whatever they wear, be it dresses or jewelry or makeup.

 

[icy_jade]

income to bling ratio

Surgeons earn a lot more. Cardiac, neuro, etc. Other non-surgical specialities typically earn less.

 

[Peary]

Surgeons earn a lot more. Cardiac, neuro, etc. Other non-surgical specialities typically earn less.

Surgeons can make multiple millions a year? I thought that neuro guy was a special case bc supposedly he operated on sports ppl? I had no idea! Learn something new everyday.

 

[Peary]

I think it’s fine to go big as long as the bling to income ratio remains small. If it’s too large it’d seem like the person is trying too hard.

 

[icy_jade]

Surgeons can make multiple millions a year? I thought that neuro guy was a special case bc supposedly he operated on sports ppl? I had no idea! Learn something new everyday.

Yeah, but they can have shitty schedules and it’s high stress. I thought it’s pretty well known how much they can earn. But it can take years before they complete their training and start raking in the big bucks. By which much of their youth is spent in the hospital/working. Trade offs and talent.

 

[Peary]

Im only familiar with tech pay. Google search says neurosurgeons in the bay area average more or less about 1M, which is about what a senior engineer makes at a place like google or facebook, and the engineer works a fraction of the hours with about a 10 year head start earning-wise.

@allycat0303 - A 10 ct ring will look excessive, like trying too hard to flex, for a cardio surgeon that's 1 year out of training and not living in nyc or bay area, unless of course, hubs is making bank or there's generational wealth. heck, it may not even be enough for wall street standards.

 

[icy_jade]

A 10 ct ring will look excessive, like trying too hard to flex, for a cardio surgeon that's 1 year out of training and not living in nyc or bay area,

If she is comfortable with it, then go for it. It’s easy to adjust to the size. I regularly wear coloured stone rings that are huge and my colleagues now have skewed perspectives too (apparently some of my rings are now “too small” ha). It sounds like they can well afford it.

=====
But… beyond a certain point, I would urge @allycat0303 to consider your personal well-being and whether the money is worth the stress of the job. Or maybe it is but you need a less stressful and more reasonable working environment. You sound burnt out. I totally understand retail/bling therapy but honestly it only works for that very short period of time based on my personal experience. Please take care.

 

[allycat0303]

I’m not in cardiothoracics, but another Emergency doctor here. I know the panic. That moment when everyone looks to you to fix it, and you freeze. Or can’t. Or you’re not sure about what to do next. It drags you down, even after it’s over. Your inner voice is there criticising, repeatedly analysing what happened, coming up with what if’s.

If getting a bigger diamond makes you happy, go for it. I completely agree with Yssie though… and I don’t think the diamond is necessarily the fix for this. It may be a nice distraction for a bit, but you are suffering, on so many levels. You have no self compassion whatsoever… and ally, I know our inner voices try to persuade us otherwise, but that does NOT make you a better doctor. Killing yourself by being on call 24/7 does not make you better. You need some time out. At some point, you WILL need to choose between yourself/a loved one and your work because life demands it. I know it is difficult (guilty of doing the same!), but you need to see YOU as a priority before that happens. It’s ok to see yourself as a person with needs too. I’m still working on this myself.

My workplace was so worried about the impact the last few years had had on us, that they hired a psychologist who specialises in seeing critical care doctors, because of the particular set of traumas and issues that we are faced with. She asked me to view this talk after one of our sessions:

I hope you can relate.

The 24/7 call is just necessary because we do such high risk cases and have terrible locums. The hospital fired 3 locums this year for bad outcomes. I’ve stopped using them. What’s the point? They did 5 elective cases in 3 weeks coverage. 2 died. Every cardiologist has their patient sign out AMA and waits for me to come back. We did 13 pump cases and 4 TAVR in 7 days when I got back. But at least they went well.

I burn out the cardiac anesthesia team, the OR heart team. And SICU gets slammed as well. It’s just a bad system and we have no solution. There’s no way out.

I do think I need therapy and psychology. I just can’t keep appointments.

The despair in this post takes my breath away. This is… Not about a diamond. This is not even a little bit about a diamond.

I’ve always considered my work to be a huge part of my identity too. I work in the tech behind federal social health policy. I don’t do what you do (I couldn’t if I wanted to, frankly), but my hours are often grueling, and you’ve seen some of my team’s failures stropped out on the evening news. My career has always been my pride and my motivator and I’ve always felt that I wouldn’t know who I’d be if I didn’t have it.

But y’know what. In the last four weeks two people in my immediate family have been diagnosed with cancer. The same d*mn cancer, although it appears to not be hereditary, just sh*t luck. Prognosis is… Well, the oncologist made a point to remind us that “statistics don’t determine an individual’s outcome”.

And I’m struggling. I can’t count the number of times I’ve prioritized work over my family. So many times I could have gone over for dinner or taken the trip or watched the movie or even just called and I didn’t… Because something at work was melting down… And it’s urgent, I can always do {that} later... I wouldn’t even call it an “assumption” because I was too stupid to even question it enough to actually assume anything.

I hope your nearest and dearest stay healthy. But Ally, if they don’t, if one day you discover that someone you love has a health crisis that you can’t do anything about - your work will very very suddenly not matter nearly as much to you.

Time with the people we love really is the most valuable thing we’ve got. Everyone always says that. I get why, they don’t want anyone else to deal with the guilt of not getting it. But I guess a lot of us, we have to live it ourselves to understand. I understand now. There wasn’t ever anything that was worth sacrificing so much time with the people I love most.

You *can* reinvent yourself outside your career. You won’t suddenly cease to be, or to be worthy, if your existence doesn’t revolve around your work. It might feel like it right now but it doesn’t have to be your truth unless you choose to keep making it so. And pointless though it probably is to say, because you’re human just like I am, you’ll spare yourself a lot of sadness if you can figure that out now rather than once it might be too late.

Sock the money away. Retire early, or scale back so you can enjoy your family and friends whilst they’re here and healthy. Move to a bigger hospital so you aren’t the only surgeon on staff and the only person bearing that functional and emotional burden - you don’t sound like you need the money and any ego bruising will heal. There are so many things you and your husband could do rather than buy a bigger diamond, that would make you happier for so much longer than 0.1 seconds.

I’m switching jobs. Same industry, but I broke every interview rule in the book by making clear that my life outside work will come first. And I think they respect me all the more for that confidence.

Good luck Ally.

Yssie,

In December 2020 my Dad was diagnosed with terminal cancer. My brother (oncologist) said he had days to live. At that time he was delirious, unable to control any body functions, immobile. My brother and sister strongly advocated for palliative care.

I was in the US, finishing fellowship, I returned home, didn’t work for 1 year, and lived with my parents. It was so much. Overwhelming. But he didn’t die. He got better over the first few months, and then I took the job here. They were so happy. I just wasted away at home. I acted. Helped. But was suicidal. Empty. I felt like a part of me was missing. So after 1 year, I took this job.

I FaceTime my parents and grandma for 20-30 minutes everyday. And that’s hard because it feels like my only free time. I also get home every 3 months. 3 weeks vacation, 10 continuing education days.

In the last 12 months I operated on 326. On the days when I have a run of good cases I’m ok. But the clusters of bad… hammers. And then I’m on overnight taking care of patient.

Patient is sick at 2:00 AM. I’m bedside managing. It’s my patient. It’s my responsibility to get them through it. But that’s not the part that kills me. It’s when I talk to family and I feel their pain and fear.

They trust me and have faith in me, and I let them down. Its unacceptable. And then the family is so grateful. And I just hate myself. Like the sweet 82 year old that had a massive heart attack and I took her to OR at 2AM. I warned them it was hard, dangerous and recovery etc. She’s old, fragile and now struggling. And the daughter left me a gift. A gift. I literally told the nurse that gave it to me “I tried to kill her mother and she’s thanking me for trying to assassinate her” and the nurse laughed because she thinks I’m kidding. But I’m not. I feel so guilty. These are nice people. They don’t deserve this. I have to get her out of the hospital. I just have to. Nothing bad happened in the OR. It was clean, fast. But she’s old. I knew the chances were 50/50. Maybe I shouldn’t have offered surgery. Palliative. Then at least they have a few days.

have

Anesthesiologist (not cardiac, phew!) here: girl, THERAPY. I mean that with love. Just to have someone to talk to, and focus on YOUR needs, who really understands where you've been and that it's more than one human can honestly bear. Meanwhile, sending smiles from the other side of the curtain. I have been part of the care team during two intraop deaths for elective or semi-elective cases, one as the attending, and I will never ever forget those two patients. It takes a lot to process, and I'm sure you've seen a lot more. If you are behind in taking space for yourself, and how could you NOT be with a call schedule like that, I hope your hospital is working on making things more humane so they don't run you into the ground before your time. You are a gem and I am THRILLED to see they are starting to appreciate your worth, at least. ETA: I and everyone I know either have a therapist or they wish they did. So it's not just you, it's the whole actual world.

But, honest truth, I also recently upgraded from a 1.3 to 4+ct solitaire and I do look at that big new diamond winking its big chunky sparkles and feel that peace for a tiny second in the midst of chaos. It is absolutely good for my wellbeing to have a big-ass diamond. Get it. But if money is not really an obstacle, I would also invite you to look into different shapes (I kept my 1.3 and set as a 3-stone; it's a transitional round, and the new 4ct is an antique cushion). Different shapes have such different personalities and it is really nice to choose among different beautiful options. Probably it's also a good cognitive trick to use, switching between diamonds with different performance characteristics to help your adornments continue to draw your attention and feel fresh to you.

I just need to say thank you to all anesthesiologists. I have 4 cardiac anesthesiologists that I work with that i love to death. They keep the patient alive and give me strength. I can’t tell you the amount of time they have saved us. At least once a week. I look over, with fear in my eyes. And they say “You got this. You’re fine.”

It keeps this bearable. Being surrounded by cardiac anesthesia and SICU who are like family. Thank you for all you guys do. You don’t get any gratitude and you deserve it.

Ally, like others I also hope you are taking time to care for yourself and have self compassion. As women I think we are heavily encouraged to be caregivers and sacrifice our wellbeing for those of us around us. We get criticized for saying no, and called selfish for taking time to take care of ourselves. The medical field intensifies that 10-fold, since we are always told to keep the best interests of our patients in mind whenever making decisions, and our job is literally to be taking care of others.

I hope you can take some time to tell the "drunk monkey" voice in your brain to be quiet. The Drunk Monkey is what one of my mentors told us to call that negative self-talk voice in your brain that throws up all the doubts and criticisms. If you like, give him or her a name, and tell Copernicus to have a time out and sit in the corner. Hopefully the idea of a hyperactive, poo-flinging, drunk monkey swinging through your brain and shouting those things makes you chuckle, and helps you put Copernicus in his place.

My mentor once told me. “Don’t ever kid yourself. It’s your fault. The patient was alive before, and then they aren’t. The only intervening factor is you.You killed them. Operate better. Think more and they will be alive.” And I think that’s how it has to be. No family cares about “I did my best” they need their loved one alive.

I think I am critical of myself but I need to be continually getting better. I think I can deal with that. But the guilt when I fail….. that’s what I need to work on.

I can’t wait to see what you decide upon, I’m sure it’ll be out of this world stunning.

On a purely practical note, have you double checked that your insurance actually covers your ring being in a locked drawer/secure place while you’re working? I only ask as my insurance coverage specifically states that my ring is covered whilst on my finger, or in an approved type of safe.

My husband said “don’t worry about it” apparently it’s covered for “disappear”

Hey there, @allycat0303

So here's my 2c.

I think I'd LOVE a 7-9ct on your petite fingers! I mean - if you want to make the BIG ring statement, go big or go home, in my opinion.

I DO think it's possible to go too far with a round brilliant - but I don't think 7, 8, 9ct represents that. On ME, I think a diamond that size would look silly - but mostly because I don't have fingers beautiful enough to wear it! But I think you could definitely rock it.

However, can I ask what clarity and color you're considering? I do think if you're going to go for that sort of size, it would be nice to do it with a very high quality stone - not just one that's big. This should be a collector's piece. An 8ct I SI2 is one thing. But an 8ct E VVS2 is a completely different kettle of fish. Big diamonds are one thing. But big, colorless, eye clean, perfectly cut diamonds? Now *that's* a WOW.

No matter what you decide to do, I wish you much enjoyment from your choice; in your job, I think ANYthing that puts even the slightest smile on your face - even for a nano-second of each day - is worth whatever amount you're happy to spend.

Good luck - and please take us along for the ride!

Right now, my husband’s parameter is F VS2…GIA triple X, with excellent HCA score. He prefers a 13 mm diamond. Whatever carat that is. He also must like it more then my current stone which has been difficult so far to find.

Im only familiar with tech pay. Google search says neurosurgeons in the bay area average more or less about 1M, which is about what a senior engineer makes at a place like google or facebook, and the engineer works a fraction of the hours with about a 10 year head start earning-wise.

@allycat0303 - A 10 ct ring will look excessive, like trying too hard to flex, for a cardio surgeon that's 1 year out of training and not living in nyc or bay area, unless of course, hubs is making bank or there's generational wealth. heck, it may not even be enough for wall street standards.

There’s no generational wealth. I support my parents. My husband bought his mother a house 10 years ago.

I am Canadian. I didn’t know anything about the US. I signed the contract without negotiation. Fixed salary. I did not even google how much I should be paid.

Surgeons in the US (from what I understand) can be paid by production (RVU) how much they operate, OR salary. So hospital hires young surgeon (me) because most can’t operate. It’s hard to recruit so they give us salary at “loss of revenue to them” they hope that in 4 years the surgeon starts being “productive”

In my case, hospital needs cardiac surgery to maintain their trauma accreditation (need to have cardiac surgeon on call 24/7) and for cardiologist to do high risk stents, pacemakers. So if I’m not here, they would have to hire a temporary cardiac surgeons to be “here” in order to keep their other programs going. The temporary cardiac surgeons cost about 2.7 million a year. They sit in their office and “exist”. But they allow the hospital system to keep running.

Starting salary for new grad in cardiac surgery is 1 million/ year+ student loan repayment + sign on bonus etc. So it’s a bargain compared to the 2.7 million that a temporary one costs.

In cardiac surgery, there’s a wide spectrum of what a surgeon can “do”.

Procedures:
1. CABG (easiest)
2. AVR
3. MVR
4. Mitral repair
5. Aortic
6. Complex aortic
7. Complex cardiac (most difficult)

So most US grads can do 1 and 2 when they graduate. They refer everything else to better centers. But just doing 1 and 2 well is good because a typical cardiac surgeon doing that will bring the hospital about 50 million if they do 50 cases per year. In addition, the “presence of a cardiac surgeon” brings in another 50 million for the “programs they support” so that’s at 100 million. Between 80-85% of cardiac surgeons in US stay at procedures 1 and 2.

I’m Canadian and did multiple fellowships. Our system is different. We train forever and would have zero employment opportunities with doing only 1-2 types of cases. I do 1-7 which is exceeding rare in US. The hospital didn’t know that when they hired me (they were desperate) So I came here, and just did what I was asked. When they fired the other two surgeons, I just kept operating. In 12 months, I did 301 pump cases. A typical American surgeon is 75-100 case a year. Because I can do difficult cases, I don’t refer them out.

When my friend, a cardiac surgeon (male) came for 3 days to help me out. And he said the hospital tried to recruit him for 2X my salary.

He said “I’m here to empower you.” And that’s where men and women are different. I didn’t think I was worth what he was. He’s 15 years experienced, he was at Mayo for 10 years. But he said “you are a better technical surgeon right now then I am, you can do more. All you need is confidence.” I debated it for months. I don’t need the money so even the 10 minute discomfort of asking felt too much. I lost 5 pounds just “thinking about asking”.

The CEO didn’t even blink. Didn’t negotiate. He said “I’ll have legal draft it up for you in 2 hours. What other amendments do you want?” So I asked for hiring power, and call pay. Women are afraid to ask. Men know their worth and demand.

I would be paid more if I was paid by “how much I operate” but in my case I am terrified of becoming “unethical” I might lose objectivity. On salary I can always do what I think is best for patient.

However, my pay is irrelevant and always has been. My husband has supported me for the last 25 years. He’s old fashioned in that way. He makes much more then I do and has for over a decade.

If she is comfortable with it, then go for it. It’s easy to adjust to the size. I regularly wear coloured stone rings that are huge and my colleagues now have skewed perspectives too (apparently some of my rings are now “too small” ha). It sounds like they can well afford it.

=====
But… beyond a certain point, I would urge @allycat0303 to consider your personal well-being and whether the money is worth the stress of the job. Or maybe it is but you need a less stressful and more reasonable working environment. You sound burnt out. I totally understand retail/bling therapy but honestly it only works for that very short period of time based on my personal experience. Please take care.

Yes. The mind does that. Adjusts quickly. The environment is very supportive. The team is family. The problem is me. I don’t deal well when patients don’t do well. The worst part of being alone is no one knows how you really feel. Can’t give you a second opinion. And that’s the hardest, agonizing over if I made the right decision.

 

[nala]

After reading this thread, I’ve never been so happy about being a teacher. Next time I come close to feeling burn out or complaining, I will just remember all that surgeons go through. I never realized how hard it could be for some professions to create boundaries. Crazy. Here I am whining to hubby bc I have to return to work on Monday after 2 weeks off for winter break. Sigh. I would get me the biggest diamond, too, as a reward.

 

[Polabowla]

@allycat0303 with your criteria I would have your husband contact harry winston or Graff, they have exceptional stones.
But more importantly you said you need to know your worth and I agree. Not to demand more financially, but to demand more support. Either they hire more competent surgeons so you're not always on call & you can get much needed therapy; or to move to a larger hospital with more surgeons. Believe me, the hospital will survive without you.
But how much longer will you survive in this situation?
And what good will you be to anyone once you mentally and physically collapse from the workload and trauma?

Unfortunately I have seen the results of people in helping professions who never take that break or get therapy and eventually their own mind or body will force them to stop. And it's terrible. Don't wait until you get there.

 

[Asscherhalo_lover]

The 24/7 call is just necessary because we do such high risk cases and have terrible locums. The hospital fired 3 locums this year for bad outcomes. I’ve stopped using them. What’s the point? They did 5 elective cases in 3 weeks coverage. 2 died. Every cardiologist has their patient sign out AMA and waits for me to come back. We did 13 pump cases and 4 TAVR in 7 days when I got back. But at least they went well.

I burn out the cardiac anesthesia team, the OR heart team. And SICU gets slammed as well. It’s just a bad system and we have no solution. There’s no way out.

I do think I need therapy and psychology. I just can’t keep appointments.



Yssie,

In December 2020 my Dad was diagnosed with terminal cancer. My brother (oncologist) said he had days to live. At that time he was delirious, unable to control any body functions, immobile. My brother and sister strongly advocated for palliative care.

I was in the US, finishing fellowship, I returned home, didn’t work for 1 year, and lived with my parents. It was so much. Overwhelming. But he didn’t die. He got better over the first few months, and then I took the job here. They were so happy. I just wasted away at home. I acted. Helped. But was suicidal. Empty. I felt like a part of me was missing. So after 1 year, I took this job.

I FaceTime my parents and grandma for 20-30 minutes everyday. And that’s hard because it feels like my only free time. I also get home every 3 months. 3 weeks vacation, 10 continuing education days.

In the last 12 months I operated on 326. On the days when I have a run of good cases I’m ok. But the clusters of bad… hammers. And then I’m on overnight taking care of patient.

Patient is sick at 2:00 AM. I’m bedside managing. It’s my patient. It’s my responsibility to get them through it. But that’s not the part that kills me. It’s when I talk to family and I feel their pain and fear.

They trust me and have faith in me, and I let them down. Its unacceptable. And then the family is so grateful. And I just hate myself. Like the sweet 82 year old that had a massive heart attack and I took her to OR at 2AM. I warned them it was hard, dangerous and recovery etc. She’s old, fragile and now struggling. And the daughter left me a gift. A gift. I literally told the nurse that gave it to me “I tried to kill her mother and she’s thanking me for trying to assassinate her” and the nurse laughed because she thinks I’m kidding. But I’m not. I feel so guilty. These are nice people. They don’t deserve this. I have to get her out of the hospital. I just have to. Nothing bad happened in the OR. It was clean, fast. But she’s old. I knew the chances were 50/50. Maybe I shouldn’t have offered surgery. Palliative. Then at least they have a few days.

have

I just need to say thank you to all anesthesiologists. I have 4 cardiac anesthesiologists that I work with that i love to death. They keep the patient alive and give me strength. I can’t tell you the amount of time they have saved us. At least once a week. I look over, with fear in my eyes. And they say “You got this. You’re fine.”

It keeps this bearable. Being surrounded by cardiac anesthesia and SICU who are like family. Thank you for all you guys do. You don’t get any gratitude and you deserve it.



My mentor once told me. “Don’t ever kid yourself. It’s your fault. The patient was alive before, and then they aren’t. The only intervening factor is you.You killed them. Operate better. Think more and they will be alive.” And I think that’s how it has to be. No family cares about “I did my best” they need their loved one alive.

I think I am critical of myself but I need to be continually getting better. I think I can deal with that. But the guilt when I fail….. that’s what I need to work on.


My husband said “don’t worry about it” apparently it’s covered for “disappear”



Right now, my husband’s parameter is F VS2…GIA triple X, with excellent HCA score. He prefers a 13 mm diamond. Whatever carat that is. He also must like it more then my current stone which has been difficult so far to find.



There’s no generational wealth. I support my parents. My husband bought his mother a house 10 years ago.

I am Canadian. I didn’t know anything about the US. I signed the contract without negotiation. Fixed salary. I did not even google how much I should be paid.

Surgeons in the US (from what I understand) can be paid by production (RVU) how much they operate, OR salary. So hospital hires young surgeon (me) because most can’t operate. It’s hard to recruit so they give us salary at “loss of revenue to them” they hope that in 4 years the surgeon starts being “productive”

In my case, hospital needs cardiac surgery to maintain their trauma accreditation (need to have cardiac surgeon on call 24/7) and for cardiologist to do high risk stents, pacemakers. So if I’m not here, they would have to hire a temporary cardiac surgeons to be “here” in order to keep their other programs going. The temporary cardiac surgeons cost about 2.7 million a year. They sit in their office and “exist”. But they allow the hospital system to keep running.

Starting salary for new grad in cardiac surgery is 1 million/ year+ student loan repayment + sign on bonus etc. So it’s a bargain compared to the 2.7 million that a temporary one costs.

In cardiac surgery, there’s a wide spectrum of what a surgeon can “do”.

Procedures:
1. CABG (easiest)
2. AVR
3. MVR
4. Mitral repair
5. Aortic
6. Complex aortic
7. Complex cardiac (most difficult)

So most US grads can do 1 and 2 when they graduate. They refer everything else to better centers. But just doing 1 and 2 well is good because a typical cardiac surgeon doing that will bring the hospital about 50 million if they do 50 cases per year. In addition, the “presence of a cardiac surgeon” brings in another 50 million for the “programs they support” so that’s at 100 million. Between 80-85% of cardiac surgeons in US stay at procedures 1 and 2.

I’m Canadian and did multiple fellowships. Our system is different. We train forever and would have zero employment opportunities with doing only 1-2 types of cases. I do 1-7 which is exceeding rare in US. The hospital didn’t know that when they hired me (they were desperate) So I came here, and just did what I was asked. When they fired the other two surgeons, I just kept operating. In 12 months, I did 301 pump cases. A typical American surgeon is 75-100 case a year. Because I can do difficult cases, I don’t refer them out.

When my friend, a cardiac surgeon (male) came for 3 days to help me out. And he said the hospital tried to recruit him for 2X my salary.

He said “I’m here to empower you.” And that’s where men and women are different. I didn’t think I was worth what he was. He’s 15 years experienced, he was at Mayo for 10 years. But he said “you are a better technical surgeon right now then I am, you can do more. All you need is confidence.” I debated it for months. I don’t need the money so even the 10 minute discomfort of asking felt too much. I lost 5 pounds just “thinking about asking”.

The CEO didn’t even blink. Didn’t negotiate. He said “I’ll have legal draft it up for you in 2 hours. What other amendments do you want?” So I asked for hiring power, and call pay. Women are afraid to ask. Men know their worth and demand.

I would be paid more if I was paid by “how much I operate” but in my case I am terrified of becoming “unethical” I might lose objectivity. On salary I can always do what I think is best for patient.

However, my pay is irrelevant and always has been. My husband has supported me for the last 25 years. He’s old fashioned in that way. He makes much more then I do and has for over a decade.



Yes. The mind does that. Adjusts quickly. The environment is very supportive. The team is family. The problem is me. I don’t deal well when patients don’t do well. The worst part of being alone is no one knows how you really feel. Can’t give you a second opinion. And that’s the hardest, agonizing over if I made the right decision.

I don't know if this can bring any measure of comfort, I have been that family waiting in the room more than once. With my Father, my Mother, my Grandmother, the list goes on. I have always waited in that room knowing that there was a great chance the outcome would not be good. Especially with my Grandmother who was 87. She survived her surgery but then had a stroke two days later and passed four days after that. Zero "blame" to anyone in the hospital. Zero. I have had emergency surgery, scheduled surgery, etc. Each time going in knowing it could go wrong just by chance. I'm grateful that doctors like you are willing to even try. I would hope if I were ever in need that a doctor with your skill was available and me and my family would be grateful just for your effort, even if it were not successful. Thank you for your service and please get whatever brings you joy! I know that's why I wear my jewelry.

 

[evergreen]

I have 4 cardiac anesthesiologists that I work with that i love to death. They keep the patient alive and give me strength. I can’t tell you the amount of time they have saved us. At least once a week. I look over, with fear in my eyes. And they say “You got this. You’re fine.”

This honestly brought tears to my eyes. Lean on them - I can say there's no greater professional joy than when my surgeon knows we're fully in this together doing the very best we can, and if I have extra emotional bandwidth to help them heal after a tough case, I'll gladly use it. Do you have a close friend at work? Do you feel like you can open up about how hard it is to anybody at work who genuinely understands, or do you need to keep it inside? I wouldn't still be in my job if I didn't have that, I think. It's just too hard as an island. You might feel that your schedule leaves no time for maintaining a work-friendship, and you might be right, but -- even remotely, via text, I get a lot of support from my residency friends still.

Can you set aside one hour per week as an inviolable time just for yourself? Maybe, if you have a clinic day, block the last couple of appointments (or otherwise reserve, e.g., 5-6pm) for your professional responsibility to yourself? And if you have a true emergency, promise yourself you'll reschedule within 3 days. You sound like you are everything to everyone around you, and that leaves nothing for yourself. Use the hour for meditation, a massage, see a therapist, listen to music staring at the wall, whatever helps settle you. Because I don't think you can keep going like this, and investing in slowly refilling your completely drained "tank" will unquestionably help you be a better version of yourself.

You are exactly what we need more of in medicine. Do whatever you can to help your career stretch its full 30+ years - wellness time is like any other CME you might need to do, in terms of its importance to your performance at its highest possible level.

 

[Fancy C]

Phoenix,My husband has a very definitive “vision” of what he wanted. He wants stone to span my entire finger. He underestimated with 5ct.

In the last month… I’ve had 3 deaths in my family, with my father probably being next on the list. Life is short. And if there is something I’ve learnt in the last year, all the wealth in the world cannot buy time or health for my family. I currently support my parents and have purchased ridiculous gifts for every member of my family. My husband felt that for all I have given to my family, patients, charity, people I work with, I probably should get a Christmas gift (and for the record, I didn’t get anything. Like: nothing. Unless you count the VCA sweet bracelet that I was supposed to get.. but VCA sent me the wrong one). And chocolates. Lots of chocolates.

In terms of milestone? I can say the hospital doubled my salary to keep me here. But that doesn’t mean much. I made a lot before and I make more now.
But money has not been an issue for us for a long time.

The hospital was trying to recruit surgeons with much less publications, and technical ability then me at 1.5x my salary.

I am on call 24/7 a year except for 2 weeks vacation. Most of the surgeons they were recruiting were not willing to come here for 1.5x my salary and 1:2 call (one day out of 2) and I’ve been on call everyday for 1 year. So I could say it’s a accomplishment to be the highest paid physician in 14 bed hospital system, a woman, and only 1 year out of training. BUT. That’s not the reason. I only stood up for myself in December and my husband decided it would be upgraded long before I got an increase in pay (just took effect January 1). He decided in March/April.

The real reason is life is short, so why not?

Y'all are hugely missing the point.

Household income, doctor's salary, halo or solitaire, 13 or 15 millimeters of finger coverage, 7 carat or 9 carat, are all just distractions and red herrings, falling into this man's trap.

If your man has a history of infidelity and various other bad behavior given the prior threads, suddenly wants to upgrade from a 5 carat diamond he purchased just a year ago to a 10 carat diamond, with no major milestones other than your own pay increase and life is short, I wouldn't be asking about carats or halos, my only 3 questions would be:

1. Who is she?
2. How long has it been going on?
3. How many others are there besides her?

 

[Cerulean]

Y'all are hugely missing the point.

Household income, doctor's salary, halo or solitaire, 13 or 15 millimeters of finger coverage, 7 carat or 9 carat, are all just distractions and red herrings, falling into this man's trap.

If your man has a history of infidelity and various other bad behavior given the prior threads, suddenly wants to upgrade from a 5 carat diamond he purchased just a year ago to a 10 carat diamond, with no major milestones other than your own pay increase and life is short, I wouldn't be asking about carats or halos, my only 3 questions would be:

1. Who is she?
2. How long has it been going on?
3. How many others are there besides her?

So you created an account to make a cheating accusation your first comment?

Yuck, take a hike. YOU are missing the point and are being totally inappropriate.

 

[MissGotRocks]

@allycat0303, I hope someday you are able to turn the negative around to the positive. Your skills give people a chance to live even if they don’t. The living do matter and your work clearly makes a tremendous difference to many. You are so hard on yourself and I just don’t hear any pride in what you do from you - which literally brings tears to my eyes. How blessed your patients are to have you as their surgeon! A caring, smart and skilled surgeon is all any of us could ask for on a good day. You can’t erase age, degeneration and disease of the heart all of the time. I honestly think the public at large is aware of that as well. Your patients and their families obviously view you in much better light than you do; I hope you find the ability to listen to them and not the voices in your head. Burn out is real and it sounds like in your current situation there isn’t much room for reprieve. Sometimes you have to make that for yourself - find the courage to ask for what you need - otherwise that facility will end up losing you altogether for a different employer. This clearly goes way beyond a diamond ring but if that will bring you a glimmer of happiness then go for it!
Lastly, please find a way to love yourself as many others do. The balance is missing and your suffering seems almost intolerable. Let something give before you break because humanity needs you!!

 

[allycat0303]

This honestly brought tears to my eyes. Lean on them - I can say there's no greater professional joy than when my surgeon knows we're fully in this together doing the very best we can, and if I have extra emotional bandwidth to help them heal after a tough case, I'll gladly use it. Do you have a close friend at work? Do you feel like you can open up about how hard it is to anybody at work who genuinely understands, or do you need to keep it inside? I wouldn't still be in my job if I didn't have that, I think. It's just too hard as an island. You might feel that your schedule leaves no time for maintaining a work-friendship, and you might be right, but -- even remotely, via text, I get a lot of support from my residency friends still.

Can you set aside one hour per week as an inviolable time just for yourself? Maybe, if you have a clinic day, block the last couple of appointments (or otherwise reserve, e.g., 5-6pm) for your professional responsibility to yourself? And if you have a true emergency, promise yourself you'll reschedule within 3 days. You sound like you are everything to everyone around you, and that leaves nothing for yourself. Use the hour for meditation, a massage, see a therapist, listen to music staring at the wall, whatever helps settle you. Because I don't think you can keep going like this, and investing in slowly refilling your completely drained "tank" will unquestionably help you be a better version of yourself.

You are exactly what we need more of in medicine. Do whatever you can to help your career stretch its full 30+ years - wellness time is like any other CME you might need to do, in terms of its importance to your performance at its highest possible level.

Evergreen,

I have to figure it out. As situation will not change, and I signed a 3 year contract. I thought of “better help” but I’m not sure that it would work.

I cannot (CANNOT) stand when surgeons blame. One of the cardiac anesthesiologists is new and *fragile* his confidence is shaky. He only started in July.

The locum surgeon did a case. An elective CABG. The patient died on the table. And he blamed the cardiac anesthesiologist (he also blamed perfusion. The scrub tech. Lots of screaming etc). The anesthesiologist then avoided hearts for 3 weeks. When he came back he asked me “Do you think there’s anything I could have done better to save the patient? Do I need to go back to fellowship?”

My answer “Yes. Next time tell the surgeon not to operate”. The patient had no LAD target. It was an error in judgment to bring them to the OR.

That’s why my mentor focused on responsibility. It is my fault if a patient dies. If I don’t admit that then I won’t self critique… Or get better.

I am well surrounded. It’s a team in the truest sense of the word. SICU team (all trauma surgeons and nurses) Cardiac Anesthesia, perfusion, and the heart OR team. They are truly here for the patient.

A few weeks ago one of my patients coded in SICU about 45 minutes after arrival. It was 6 pm. 2 cardiac anesthesiologists (not even on call) were there within 2 minutes. One of them ran to get the TEE probe, other one stayed with me to run the code. They aren’t even on the code team. SICU is a closed unit. But that’s what they do. Go above and beyond to help the patient (and me).



Picture of turtle for those who asked. It’s my first attempt at crochet.

 

[lulu_ma]

Ok, that turtle is the cutest!

Has your husband seen stone? Looks like is close to AGS 0, too!

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[allycat0303]

So you created an account to make a cheating accusation your first comment?

Yuck, take a hike. YOU are missing the point and are being totally inappropriate.

Thank you Cerulean (I hope you are well) Eagle eye.

I didn’t notice the comment. I do feel the need to respond to this. My husband and I have been together since I was 16 years old. He was 18 at the time. When you grow up together you go through everything. You mature (or don’t) change. Over the last 26 years, it has been hard work. On both our ends. To stay together.

He means something to me that I could never explain. He’s pulled me out the darkest places, and believed in me when there was no rational reason to believe I would amount to anything. And he’s made immense personal sacrifices to let me pursue this dream.

What I do know for sure is that we will love each other for the rest of our lives.

As to upgrading the diamond because he cheated? No. He wasn’t happy with it from the beginning. He never saw it before he purchased it. He found it online and he trusted Leon’s eye for it. It is beautiful, but smaller then he mentally imagined.

I actually posted back in July asking about the HCA of a stone he was interested in but it didn’t score well. So it’s not sudden at all.

Is he cheating now? No one can ever be sure of anything. But I do know neither of us have to stay married. We don’t have kids. We were a signature away from divorce 8 years ago. And you know what? It was completely amicable. He’s wealthy, and handsome. He can be with someone else if he wants to be. He doesn’t have to buy me with a diamond to apologize for cheating. And it’s not exactly a way to “buy my good graces” I could buy it myself if I wanted to.

@allycat0303, I hope someday you are able to turn the negative around to the positive. Your skills give people a chance to live even if they don’t. The living do matter and your work clearly makes a tremendous difference to many. You are so hard on yourself and I just don’t hear any pride in what you do from you - which literally brings tears to my eyes. How blessed your patients are to have you as their surgeon! A caring, smart and skilled surgeon is all any of us could ask for on a good day. You can’t erase age, degeneration and disease of the heart all of the time. I honestly think the public at large is aware of that as well. Your patients and their families obviously view you in much better light than you do; I hope you find the ability to listen to them and not the voices in your head. Burn out is real and it sounds like in your current situation there isn’t much room for reprieve. Sometimes you have to make that for yourself - find the courage to ask for what you need - otherwise that facility will end up losing you altogether for a different employer. This clearly goes way beyond a diamond ring but if that will bring you a glimmer of happiness then go for it!
Lastly, please find a way to love yourself as many others do. The balance is missing and your suffering seems almost intolerable. Let something give before you break because humanity needs you!!

MissGotRocks,

It’s just heavy. I’m having trouble coping with the responsibility and when I get tired, I am more emotional. And this week, one of the patient’s families (she is not doing well) gave me a gift to thank you. And it just made me feel even more inadequate, ashamed and guilty because I’m not sure we can save her. My anxiety over her status. The fatigue.

For some reason, gifts or thank you cards make me feel awful. Even when a patient thanks me, it makes me emotionally unstable. I don’t know why. I just feel like it’s undeserved, and I do an awful job.

Everything you say is absolutely right. I intellectually know that. But emotionally is different.

 

[allycat0303]

Ok, that turtle is the cutest!

Has your husband seen stone? Looks like is close to AGS 0, too!

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Lol. He asked me to make a smaller one with a different color shell so he has a pair. It’s not perfect, there were errors in the crochet. It’s hard to count the stitches!

That stone is a flawless. I can’t imagine he would go beyond VS2 or VS1… I don’t think he should pay for something I can’t see. My eyes aren’t that good! It would also have to be a stone Leon could get easily.

 

[evergreen]

I thought of “better help” but I’m not sure that it would work.

ALL the hugs. I'm really glad you feel like you're supported at work (even though there's just too much work!!).

I think it would be worth trying Better Help because when you describe the way you process "failure" and how hard it is to accept gestures of gratitude, those are almost universal challenges I see in female colleagues in medicine, they're far from unique. If you take the emotion out of it, do you feel that the cognitive patterns are draining your energy?

I *often* have to deliberately reframe my first instinct response ("UGH, I can't believe I did that, I was so stupid, how could I have screwed that up so badly?"). Instead, I back myself up and force myself to think, "I did the best I could, or made the best decision I could have, given the information I had." And, sometimes, "now that I know more, I won't make that mistake again." That helps me process failures and I *know* it's objectively true. The emotional response to failure can be destructive, but - a wise mentor once told me to "turn a vexing problem into an interesting one by taking the emotion out." Once you view the failure without the punitive emotion, you can identify how to grow from it, and maybe put it behind you more easily knowing that that patient's contribution to your growth, painful though it was, will resonate in all similar situations for the rest of your career.

Receiving gratitude is another skill that can be learned and practiced, and as much as I and other docs on here and your colleagues and your patients can tell you you DESERVE gratitude, you won't viscerally believe it without some work. But having someone walk you through how to process these really common scenarios that, maybe, take over your mind at times and make it hard even to enjoy the limited leisure time you have, could end up being really helpful while taking only a few hours scheduled at your convenience. I assume it would be easy to find someone who can do this well on BetterHelp or a similar tele-therapy service. Or even, frame it as a career coach! Failure and success are both constant companions in medicine. Tuning your reaction to them to best support your mental health will help you preserve balance.

Also I'm very excited to see how this diamond search progresses. I love to imagine you with an enormous diamond in a perfect setting bringing you joy.

 

[MissGotRocks]

Thank you Cerulean (I hope you are well) Eagle eye.

I didn’t notice the comment. I do feel the need to respond to this. My husband and I have been together since I was 16 years old. He was 18 at the time. When you grow up together you go through everything. You mature (or don’t) change. Over the last 26 years, it has been hard work. On both our ends. To stay together.

He means something to me that I could never explain. He’s pulled me out the darkest places, and believed in me when there was no rational reason to believe I would amount to anything. And he’s made immense personal sacrifices to let me pursue this dream.

What I do know for sure is that we will love each other for the rest of our lives.

As to upgrading the diamond because he cheated? No. He wasn’t happy with it from the beginning. He never saw it before he purchased it. He found it online and he trusted Leon’s eye for it. It is beautiful, but smaller then he mentally imagined.

I actually posted back in July asking about the HCA of a stone he was interested in but it didn’t score well. So it’s not sudden at all.

Is he cheating now? No one can ever be sure of anything. But I do know neither of us have to stay married. We don’t have kids. We were a signature away from divorce 8 years ago. And you know what? It was completely amicable. He’s wealthy, and handsome. He can be with someone else if he wants to be. He doesn’t have to buy me with a diamond to apologize for cheating. And it’s not exactly a way to “buy my good graces” I could buy it myself if I wanted to.



MissGotRocks,

It’s just heavy. I’m having trouble coping with the responsibility and when I get tired, I am more emotional. And this week, one of the patient’s families (she is not doing well) gave me a gift to thank you. And it just made me feel even more inadequate, ashamed and guilty because I’m not sure we can save her. My anxiety over her status. The fatigue.

For some reason, gifts or thank you cards make me feel awful. Even when a patient thanks me, it makes me emotionally unstable. I don’t know why. I just feel like it’s undeserved, and I do an awful job.

Everything you say is absolutely right. I intellectually know that. But emotionally is different.

@allycat0303, I know you are an ultra smart girl and you know the truths. I do understand though that emotionally it is a whole different ballgame for you. Your posts are proof positive. I know too that words alone can’t change your way of thinking and feeling but we have to try to spark something within you that will allow you to begin to heal a bit. I am so glad that your husband is loving and supportive of you. I am sure that means the world to you. Other physicians have chimed in here and it is clear the struggle is real. I just hate the self deprecating thoughts as it tears you down in spite of the wonderful, caring work you do. Such a catch-22. I too understand that exhaustion has to make it all worse. I hope you can find a path to rest, therapy and self love…I can think of no one that deserves it more! If there is anything that any of us can ever do, we are but a post away. Please remember that!

 

[LLJsmom]

@allycat0303 - clearly other posters saw you and the real issue and I didn’t. It’s not about the ring. It’s all about you. Regardless of what stone you buy or don’t buy, the important thing is you, your mental, emotional and physical health and well-being. The world is a better place with you in it. More people are alive because you are. Your patients appreciate and value everything you do. Hope you can see yourself through their eyes.

 

[icy_jade]

@allycat0303

I didn’t know there are so many salty people around, but I just want to say that you fully deserve whatever bling happiness you get from a bigger diamond, if that is what you want.

Me being lazy and all that would probably use the money for early retirement as some other posters have suggested, but we are all different and what you are doing really makes a difference to other people’s lives as opposed to the paper pushing that I do at work. Be kind to yourself. If you have done your best, don’t beat yourself up.

 

[finerthings]

@allycat0303 I am so encouraged by reading the kindness in these recent comments. It is clear that many in this unlikely jewelry community support you and wish we could all get together and lift you up with our support. I am not a doctor, however I am a retired nurse and your insecurity resonates with me and my former career. My first year after graduating as an RN on the Neurosurgical floor was a shock or maybe I should say more like hell. I remember well that feeling like I was swimming ... more like drowning - but nothing like your stress. Maybe you will find a mentor or fellow here on is forum that can be an objective sounding board/release valve. I can sense that you are a person with such great moral character and we need more doctors like you. Do not be so hard on yourself, you are not alone in your insecure thoughts, you are worthy and normal. Essentially there is a mental health crisis in the medical field that existed even before COVID and the mass exodus of medical professionals. The medical profession demands perfection, but doctors and surgeons are humans, not machines programmed with artificial intelligence. I am glad that you can express your feelings here. Take care @allycat0303, we are on your side... and BTW get that big ass ring and wear it proudly and with a huge smile!

 

[Dandi]

@allycat0303 scrub nurse here...I used to scrub for cardiac and also did cardiac anaesthetic nursing years ago, but have since changed specialties. I know how much you lean on your team, but it truly is an honour and a privilege to work alongside people with the type of skills and knowledge you possess. Even after 20 years of nursing, being able to say that I work with such talented people still gives me goosebumps. You deserve a ring of more than a bajillion squillion carats.

Get ye the big biiiiig rock.

 

[diamondyes]

Have you used this tool? It might help hubby picture the size!

10 Carat Diamond (Round, 14×14×8.44mm) - Actual Size

Check finger coverage of this 10 carat Round cut diamond. Actual size of 14×14×8.44mm with 60.3% depth and a face-up area of 153.94mm².

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