Lost & Found
SYNOPSIS
Illustration by Stephanie Singleton
Meghan needed to lose her dog, her wallet, and her dinner before she realized she’d also lost something more important: herself. She reflects on what it meant to lose her way and how she went about finding it again.
LISTEN
storyteller
Dr. Meghan Rothenberger is an infectious disease/HIV physician at the Minneapolis VA. She attended medical school at Johns Hopkins and completed her Internal Medicine residency and Infectious Diseases fellowship at the University of Minnesota. The best part of her job is being able to listen to her patients' stories. Since childhood she has loved creating her own stories but only recently found the courage to start sharing them outside of her own home (her kids and pets have been great listeners for years!). Her favorite things are her family, being outside, coffee and animals of all kinds.
Host
Emily Silverman is an internal medicine physician at UCSF and Creator of The Nocturnists. Her writing has been supported by MacDowell and published in The New York Times, The Virginia Quarterly Review, JAMA, CHEST, McSweeneys, and more. She was the Hellman Artist-in-Residency at the UCSF Memory and Aging Center in 2020 and served on the COVID Crisis Group, which recently published the book, "Lessons from the COVID War." She lives with her husband and daughter in San Francisco, and tweets @ESilvermanMD.
CREDITS
Hosted by Emily Silverman
Produced by Emily Silverman and Sam Osborn
This episode’s interview was recorded at Aerial View Studio in Minneapolis (January 2024)
Edited and mixed by Jon Oliver
Meghan’s story was coached by Kristin Moe and Molly Rose Williams. This season’s stories were originally performed live in Minneapolis in April 2023 at "Rebirth", a performance by The Nocturnists and The Center for Art in Medicine at The University of Minnesota
The Nocturnists original theme music by Yosef Munro
Additional music by Blue Dot Sessions
Illustrations by Stephanie Singleton
This season of The Nocturnists is sponsored by The Physicians Foundation
The Nocturnists is made possible by the California Medical Association, and donations from people like you!
CME
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TRANSCRIPT
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The Nocturnists: Stories from the World of Medicine
Season 6: Episode 1: Lost And Found"
Episode Transcript
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
TRANSCRIPT:
Emily Silverman
You're listening to "The Nocturnists: Stories From the World of Medicine". I'm Emily Silverman.
Have you ever lost your keys? A sweater? A coffee mug, maybe? How about multiple things in one day?
In today’s episode, infectious disease doctor Meghan Rothenberger talks about the day a series of small losses gradually accumulated until she realized that what she had really lost was herself.
In the conversation after the story, Meghan and I talk about the changes she made to find her way back to herself, which included rethinking her relationship to her job, and the definition of success.
Meghan is an infectious disease and HIV doctor at the VA in Minneapolis. She went to medical school at Johns Hopkins and did her Internal Medicine residency and Infectious Disease fellowship at the University of Minnesota.
Take a listen to her story, "Lost and Found".
Meghan Rothenberger
It's 4am on a very cold and dark January morning, and I'm sitting in my pajamas in front of my computer desperately trying to finish a research abstract by a 3pm deadline. I've been working on this abstract for weeks, but have embarrassingly little to show for the hours I put in. And this morning is no different; I can't write. So I'm staring out the window at a streetlight on our corner. It's shining down on a nice blanket of freshly fallen snow. And the familiar thoughts start to come. How have I tricked so many smart people into thinking I know what I'm doing? I know nothing about research. I don't think I know anything about being a doctor either. I use UpToDate like every day and I'm an attending. Stop Meghan, focus. I shifted my seat but I can't get comfortable because my butt hurts and my butt hurts because I'm in the middle of a cycle of IVF and I had a bad reaction to one of the injectable medications. And it made my butt swell up and turn red like one of those embarrassing primates you see at the zoo and thinking about my baboon butt and IVF makes me think about what a bad mom I am. I have a three year old, conceived after years of trying. But I'm not the kind of mom I thought I'd be. I'm too busy. My husband's too busy. He's heme-onc fellow, not exactly a joyful walk in the park. So we bring our son to daycare at 6:30 in the morning. We pick him up at 6 at night and then we pray that he sleeps so we can sit in front of our computers. And here I am sitting in front of my computer. I hear rustling downstairs and I look at the clock, shit. It's 6am. I have nothing to show for the last two hours of work. So I head downstairs, sort of a simmering sense of panic. The kitchen looks way too bright. My husband is bustling around getting ready for work and my son is sitting in his highchair flinging globs of oatmeal onto the ground. Our good dog Yoshi is dutifully cleaning up the oatmeal, and our bad dog Wilbur is incessantly scratching at the back door, leaving deep gouges on the nice wood. I kiss my husband goodbye as he leaves for work and I let the dogs out. Yoshi respectfully pees in the corner. But Wilbur trots across the yard and without missing a beat miraculously flattens his body into the shape of a pancake and slides underneath the fence. If I didn't see his little asshole prints leading up to the side of escape, I never would have believed it was possible. The fence is literally three inches off the ground. So I run outside and I just stand there thinking this is not good. Now let me tell you a little bit about these dogs. So good girl Yoshi has the most beautiful brown eyes and the softest velvety ears. She was our first baby. Bad dog Wilbur has stocky legs, wiry hair and a mouse that will consume anything in his path, including a leather couch, curtains, and all of the carefully wrapped presents under our Christmas tree. I unilaterally made the decision to bring Wilbur into our lives about a month before because I convinced myself that Yoshi needed a friend. Ever since then, I've got Yoshi staring at me with a look that says, "What were you thinking?" In fact, it's this look that she gives me now as I'm standing in the backyard after Wilbers Great Escape. So I step out of my daze, I run inside. I grab my son out of his highchair, I wrap him in my winter coat, and I hit the sidewalk in my pajamas and slippers going out and hunt for the dog. We cover a lot of ground but the only living soul we encounter is a middle aged lady with frizzy hair, who frantically waved me down to tell me that when her dog was lost in the neighborhood, he was smashed to smithereens by a truck that never stopped. I smile. And I thank her for her very hopeful story, because that's the kind of person I am. And then I scooch home in a state of defeat with my cold son in my arms. And when I get home, I think for a minute, maybe I should just pretend I never adopted Wilbur. But that's a mean thing to do. And I'm a nice person. And I know deep down that if it wasn't for my niceness and my above average work ethic, I would have accomplished very little in this life. And so I pick up the phone and I call the adoption agency that we got Wilbur from, and an annoyed sounding woman answers the phone. I tell her what happened. And she said, "Well, you transferred the microchip to your name, right?" And I say, "Well, I've been so busy. I'm in the middle of a cycle of IVF." She cuts me off. She could care less about my stupid IVF. She says, "Well, what about his tags? Well, Wilbur makes a lot of noise at night. He like jangles his tags around so I've been taking his collar off at night, and I forgot to put it on in the morning." She's super pissed now. She's like, "You let your dog out naked?" And in my mind, I think I mean, he was wearing his fur, but I just say, "Yeah." And she says, "Well, we're gonna have to activate the protocol." And I say, "I'm sorry, what's the protocol?" And she says, "The lost dog protocol." And before I can ask her what that is, she hangs up. So for the second time in the morning, I scoop up my poor son out of his highchair. This time, I stuffed him in his car seat and we zoom off to daycare. When I get home, I am absolutely desperate to get working on this abstract; the minutes are ticking by. But I sit down to write and it feels like labor. Like every word I eke out is like a painful contraction. I can't take it. So I'm staring out the window at that same streetlight. And out of the corner of my eye, I see a car driving slowly down the street, and it looks suspicious. And so I keep watching it. And as it pulls in front of my house, I'm shocked to see that every window of this car is plastered with giant photos of Wilbur. With the words, "Lost dog, if found, please call Meghan." And it has my phone number. And then I'm even more shocked when I realized that this car is not acting alone; there's at least half a dozen cars behind it. And all of their windows are plastered with photos of Wilbur. And at every corner, this parade stops and people jump out and they hang giant posters of my dog to anything that will hold a staple. So this is the lost dog protocol. My internal shame is being broadcast to the world. But I don't even have a minute to think about it because my phone starts ringing and it just keeps ringing. I talked to dozens of people who do not have Wilbur. I apologize profusely to the really mad ones that call and yell at me for losing my dog. And I listen very sympathetically to the sad ones that call and just want to reminisce about their lost or dead pets. And in between these phone calls, I'm laboring on my abstract. And I keep thinking like, "Can I just get an epidural or could like you do like a C section like cut it out of my brain?" But finally, with 34 minutes to spare, I finish. I do one final spellcheck, it's fine. I do one final character count. Not fine. I am 31 characters over the limit, like a character, like a letter or a space. And I panic. It's as if someone said to me, "Guess what? You weren't even fully dilated before, you weren't even pushing. And guess what else? It's the 1800s. There's no epidurals. There's no C section. There's not even a doctor in this town." And then I imagined in my head Yoshi downstairs frantically boiling some water and gathering clean towels. So I enter the final phase of labor. The first thing I do is I invent some very creative compound words because spaces count, like I told you. And then I use my thesaurus and I turn long words into short words that mean sort of the same thing. And by the end, I have no idea if the abstract makes any sense, but I'm done. I birthed this baby all by myself. She's not that cute, but like all good parents, I totally ignore that fact. And I submit it. I have eight minutes to spare. I wait to feel relief, but it doesn't come. Maybe I'm just worried about Wilbur. And then as if on cue, my phone rings. I pick it up and it's a chipper sounding woman and she tells me she has my dog. I keep waiting for her to ask me how I could let him out naked, but she doesn't. I love this woman. I get her address and I say I'll be there ASAP. And then because Wilbur is just chillin' a couple miles away with this amazing woman and the sky is suddenly blue and my body has a lot of energy, I decided I'm going to jog to get Wilbur. So I put on my gear, and I run down Selby Avenue, like Chariots of Fire style. And as I'm running like a big smile is coming across my face, and I'm feeling good, triumphant even. I get home a little while later with a completely unscathed Wilbur. And shortly after that, my husband comes home with our son, still in his oatmeal covered pajamas. I tell them the story of the day and we laugh, hard. And then we decide to immediately go to the pet store to buy a little plastic tag silencer for Wilbers collar, so we never have to let him out naked ever again. So we go to the pet store, I buy 12 tag silencers because you can never have too many. And I also buy some $42 organic dog treats from Boulder, Colorado, because that's not really Wilbers fault that he's such an asshole. And then we're all hungry. And so we get takeout noodles from a restaurant next door to the pet store. And on the way home, the car is warm. I glance in the backseat, and I see my son, and he's looking out the window and he has a little smile on his face. And I think you know, maybe I'm not such a bad mom, after all. I have a good sense about this abstract, maybe it will actually get accepted. Maybe this in vitro cycle will work. Maybe Wilbur and Yoshi will be BFFs. And as we pull into our garage that's filled with bicycles, strollers, burleys and other junk, a sense of peace comes over me that I haven't felt in weeks.
Meghan Rothenberger
I lean over to get our bag of dinner. But all I see are my unlaced winter boots and an empty coffee cup. I twist around to the back seat. Where are the noodles? Where the fuck are the noodles? I turn to my husband. "Where the noodles?" He looks confused. I think back, like wait, I walked out of the restaurant, I had my son in one arm, I had the bag of noodles in the other. My son looked kind of jaundiced in that light from the restaurant. I put him in his car seat. I got in the warm car. But what I do with the noodles. Oh my god, I left the noodles on the roof of the car. So I say to my husband, "I left the noodles on the roof of the car!" And he senses my immediate breakdown. So he's like, lightning fast. "It's okay. We'll just eat here. It's no problem." And like, "Okay, right? We'll just eat here. No problem. I just need to find my wallet." Looking around, trying to find my wallet. Can't find my wallet. Where's my wallet? I turn to my husband. "Where's my wallet?" He's like, "I don't know." And then I think, it dawns on me. I left my wallet in the bag of noodles I left on the top of the car. Now, this could be funny. This could be very funny. But at the time, this is anything but funny. The tears come fast and hard. And I feel like I can't breathe. I've been working so hard to hold so many things together. And it's as if all those things just suddenly shattered into a billion pieces and slipped out of my hands. I don't know how long I was sitting in the car in the garage, crying. But then I felt my husband's hands on mine. And he led me inside. He set a glass of red wine in front of me and an iPad in front of our son. And he said I'm going to find your wallet. And while he was gone, I just thought, "This is not the life I want to live. How did I get here?" And the next thing I know, I hear the backdoor click and then I see my husband's hand setting down my wallet in front of me. It's all smushed and misshapen. And there's a tire track right across the center. And then there's like mutilated fettuccine in all the seams. But I open it up and everything is there, my license, my credit card, everything. So on this day, I eventually found all of the things I lost. But of course it was never about the things. On this day I discovered that I was lost. So what happened? First, just some facts. My abstract got accepted. I have no idea how that happened. Wilbur was re-homed and Yoshi lived out her days in glorious peace without her BFF. The cycle of in vitro I was in at the time was unsuccessful, but two of the eggs that were harvested and frozen at the time became my twins. But what about me? You know, I wish I could say that this was a story about my instant rebirth, that I suddenly found my way. But instead, the path to becoming unlost has been a long one. I've made big changes, I've made little changes. And all along the way, I've worked hard to gather up the little parts of myself that were inadvertently left behind when I was so focused on powering forward through this world. And sometimes I like to think about those little lost pieces of myself as being like my wallet and fettuccini being launched silently from the roof of my hurried car, landing unnoticed in a dark road and then just waiting patiently to be rediscovered. A treasure meant only for me.
Emily Silverman
I am sitting here with Meghan Rothenberger. Megan, thanks so much for speaking with me today.
Meghan Rothenberger
Yeah, thanks so much for having me.
Emily Silverman
So your story went first in the lineup in our Minneapolis show. It kicked off the night. And I'm so glad that we sequenced the stories that way because your story just had so much energy and so much humor and the audience was like in stitches, and it just really set the tone for the evening. And so I'm wondering, how was it for you to get up there and perform and to go first?
Meghan Rothenberger
When you first sent out the email with the list order, I was terrified, like, how could you put me first? But actually, once I got there and realize I'll go first, I'll get it done with and then I get a chance to relax and enjoy the rest of the night, I felt better about it. And I knew my partners' stories were going to be amazing and that if I was going after them, I wouldn't have a chance to actually really deeply listen. And so it ended up working out well.
Emily Silverman
And the story was so well-rendered, all of the little details that you included, and the pacing of it, it felt almost literary to me, which not all of the stories do, which is great and fine. Not everybody has that kind of literary flair to their storytelling. But you do. And I'm wondering if you have any background as a writer or where that came from, because just the attention to detail was so striking.
Meghan Rothenberger
You know, it's funny, actually, just last night, my parents called me and they were like, we needed to go through your old closet, from the bedroom I grew up in, because they were remodeling and they needed to do the floors. And so I ended up going last night and digging through this closet of stuff. And I never really thought of myself as a writer, but there were pages and pages and pages of random journals and poetry and some stories. So they never went anywhere other than from my brain to the paper to my closet. But I guess I have been writing for a long time.
Emily Silverman
What kinds of things did you write when you were younger? Was it personal journal entries? Or did you write fiction? Or what was the stuff you were finding in the closet?
Meghan Rothenberger
You know, I wrote a lot of poetry, really cringey poetry like seventh grade, heartbreak poetry. So awful to read and like immediately went to the recycling bin. I wrote some short stories that were a bit weird. And then, I did a lot of journaling, like dozens and dozens of notebooks of just journal entries.
Emily Silverman
And did the writing habit peter out as you got older or do you keep it up? What was the situation with your writing throughout med school and residency and so on and so forth?
Meghan Rothenberger
It really like abruptly stopped when I went to med school. And it makes me really sad because it was a really regular part of my life all through college. And I think I just got too busy and didn't make time for it in med school and then never really got back to it. I always intended to and I never did.
Emily Silverman
I bet your medical notes are really good though. I just have a feeling you're like HIV or infectious disease or what's your area again?
Meghan Rothenberger
Yeah, I'm infectious disease and HIV.
Emily Silverman
Yeah, so I feel like the ID notes tend to be more descriptive and narrative in nature. And you can correct me if I'm wrong, but I imagine you might be the type of person who infuses a little bit of flair into their medical notes, at least.
Meghan Rothenberger
Oh my gosh, people make fun of me for my notes because they're like your social history was really long and it included all the names of their pets and all of their vacation destinations for the next year. That's what I do with my patients. I'd love hearing what they're doing and what their daily lives are like and then I do try and put little bits of that in my note just to make them more human, I guess.
Emily Silverman
Yeah, that doesn't surprise me at all. I just again really feel like you have the soul of of a writer. Which brings me back to your story. So this incident that you talk about in the story occurred many years before the performance evening. And so there must have been something about that day, that experience of losing, I think you said your dog, your keys, and then your lunch all in one day. That really stuck with you all those years later, such that when you saw the call for stories for rebirth, you were like, "Oh, I'm going to send in a story, I'm going to write about that day." So tell us about that. Did that day live on inside of you for many, many years just waiting to be written about or explored? Or did it just come to you spontaneously, or is it just a very specific day in your life that you decided to dive into? So how did that come back up for you?
Meghan Rothenberger
In part, it has been something that I've carried with me, I mean, it was over 10 years ago. And I think it was just the level of despair that I felt for sort of a dumb reason. And medicine, you have terrible days where terrible things happen to people. And those are awful. But for some reason, this stuck in my head just because of I think how truly rock bottom I sort of felt on this day. Which you know what, it was funny. It was a funny day. So I think it was maybe that juxtaposition of despair in the midst of this funny series of events that made it stick with me.
Emily Silverman
Have you ever written about it before?
Meghan Rothenberger
No, I ride my bike to work. And it's my favorite time of the morning and my favorite time of the evening. And usually when I bike, I don't listen to anything. But that's when I pull together stories. And so I think I've been working this around in my brain for a while. So then when the call for stories came out, they were sort of there, sort of partially formed.
Emily Silverman
And in the story, you open with this feeling of barely holding it all together. So you talk about how you're working on this abstract, and you're trying to write it and it's not coming out. And then you talk about being a mom and how you feel like you're falling short in that department. And then you talk about same thing with being a pet mom, and feeling like you're falling short in that department. And I just found that really relatable. Like, when you feel like you've taken on so much that you're kind of not doing a good job in any domain, just like you said, the feeling of barely holding it together. And you described it just now as rock bottom, which has a bit more of a serious tone than what I just said. So bring us into that time in your life, what was going on with you? And why did we start there?
Meghan Rothenberger
You know, I think I had always been under the impression that you can do whatever you really set your mind to if you work hard enough. And there were a lot of things I wanted to do. And so I kept saying I can do these things if I just work hard enough. And so I wanted to be a really good doctor, I wanted to be a good researcher, I wanted to be a good mother. And so I put in like 110% effort for everything. And then it got to this point where I'm like, wait, I can't do all of this. And that realization is really pretty awful. And I think that's where I was at the time of this story. And I think it was really at this point in my life that slowly I started to crawl out of the hole, I guess that I dug myself into that was based on this misconception that you just have to work hard enough and everything will end up the way you want it to be.
Emily Silverman
As you're working on the abstract, this metaphor keeps coming up of birth. Like you're trying to birth this piece of writing and it's getting stuck. And you even joke like, Can't I just get a C section? Can't they just cut it out of my brain?" And that was striking to me because the theme of the show was rebirth. And so seeing that metaphor come up there was interesting. And I'm wondering if you felt like the fact that the writing wasn't flowing, was that a sign of "I'm not supposed to be doing this. This isn't right"? Or was it more like, "I'm just being torn into many different directions. And maybe if I had more mental space to focus on this, the writing would flow"?
Meghan Rothenberger
I think it was actually a deeper moment of questioning, which like I said, I didn't ever really recognize that I would get there. And then I was having that complete block. And I'm trying to think if I actually recognized it at the time or if it's only in retrospect, but that block I think was definitely a sign that this is a place that is not a good fit for me.
Emily Silverman
Do you remember what it was you were writing about at the time?
Meghan Rothenberger
Yes, I do. I have been involved in a project looking at HIV reservoirs in lymphatic tissues in the setting of a treatment interruption, and what happens in the lymphatic tissues. It was a ton of work that I'd already done. Like I just needed to spit it out onto paper. But it was somehow that process where it just got stuck.
Emily Silverman
And you're still working in HIV. So it sounds like the topic is something that you're passionate about. Was it the research that you felt wasn't a fit? Or what was it that wasn't fitting for you?
Meghan Rothenberger
Yeah, it was the research. There were parts of it that I really enjoyed. But honestly, I'm not very talented in research, I think it would always be harder for me than it was for a lot of people. And then I found that I was pretty lonely when I was spending most of my time doing research, I spent a lot of time alone on my computer. And it just wasn't fulfilling on a day to day basis for me.
Emily Silverman
Yeah, I remember when I was in med school, you get that summer off between the first and the second year. And most people do some kind of research project. And I decided I was going to work in a basic science lab in ophthalmology, staining chicken embryos to look at photo receptor differentiation and development. And I laugh looking back at that, because it was just so not my thing. Like not only did I not really like it or find it that interesting. I mean, I guess on some level, like all sciences, cool, right. But like thinking something is cool is very different from spending nine hours doing an experiment, again and again, for an entire summer. And I remember this one day, I had some kind of probe that I was using to mark some molecule in the retinal tissue. And I accidentally left it out on the counter overnight. And when I saw it, the next morning, my heart dropped out of my chest, because I'm pretty sure this particular probe was like $17,000. And it had just gone bad because it needed to be refrigerated. And that was the moment where I was like, "I don't think I meant to be doing this. Someone out there is meant to be doing this. But it's not me, like I'm not I'm not talented at this. This isn't what I'm here to do." And so was that kind of like the feeling that you had?
Meghan Rothenberger
Oh, definitely, definitely. And there is that sense of like, that's what you do. And I think having been in a subspecialty fellowship, you just did research as part of it. And so I kind of didn't even really question it. Like, I'd always done what people told me I needed to do to get to the next place. And so I was just like, sure that sounds great. I'll do it.
Emily Silverman
Yeah, it does seem like research is just an expectation. And the point of research is to answer a question, like that there's a curiosity about what is true. And then you design an experiment to try to chip away at truth and figure out what is true. And I don't know about others. But that wasn't how I looked at it at all. I didn't feel like an actual drive to understand what was going on these chicken embryo retinas, it was more like checking a box on my resume. And I think that's a shame. And I'm wondering, how do we help medical students and other health professionals going through this whole process? For those who really love research, and it gets them excited, and it gets them up in the morning? Absolutely pour the resources into them, give them all the opportunities, but for the rest of us? For whom maybe that's not what gets them up in the morning? Like, how do we offer alternative scripts? Because sometimes there aren't so many alternative scripts, it feels like.
Meghan Rothenberger
No I mean, I think you're absolutely right. There aren't role models out there to say like, "oh, you could do this, instead of spending all your free time getting this research done and these publications out there." It's sad as far as medicine has come in terms of looking at holistic applications, I think we still are very much in this rut where research does count a lot. And it is really important. Like you said, the people who are really good at research should get resources to do research, because they could really change the world. But then there's a handful of people like me and sounds like you too Emily, "I'm never going to change the world through my research." And I look at these applications of students because I interview for residency a lot. And people have spent hours and hours and hours and hours doing research projects that they don't find particularly fulfilling. But as you said, it checks the box on their application. And I think if you had really had the opportunity to use that precious time to do something that you're really passionate about, what would that look like and what would you look like as a physician? You would be probably a happier person. And I think you would give a gift to the world that we're not seeing right now.
Emily Silverman
Yeah, and you mentioned that your career has pivoted since that event on that day or those series of events. And I want to get there in a minute. Before we do, just staying in the story, staying in the day. It wasn't just the abstract, it was these other things, it was losing Wilbur, the dog, and you report the missing dog, the woman on the phone is kind of annoyed at you. And the fact that you let the dog out without the collar or the tags. And then she says we have to initiate the lost dog protocol. And then an hour or two later, you look out the window and you see this parade of cars with your name and your dog's photo in the window. And you use the word shame, which always stands out to me since The Nocturnists did a whole series on the notion of shame in medicine, and you say something like this parade of lost dog announcements, in some ways felt to you like your shame broadcasted for everyone to see. And so I was wondering if you could bring us into that moment.
Meghan Rothenberger
I was just feeling like I was absolutely sucking at everything I was trying to do. And then I think I had this guilt around. This just popped into my head, you know, I felt guilty about adopting a second dog. Like why would I get a second dog when I already had a dog I couldn't take care of? But I I just realized I think I also had a lot of guilt about being a mother and then trying to have another child. And so I think there was a lot of shame about that, that like who are you if you don't have the time and energy to be the kind of parents you want to be whether to your human child or your dog child? Why are you trying to bring more of those beings into your life? And so that was shameful. And then it was shameful that I did it. And I did a bad job of it. In terms of my dogs, at least, a very bad job of it because I lost my dog, and everybody in my neighborhood knew.
Emily Silverman
So by the time the day ends, everything you've lost has been found again, and then you say something about how what you had really lost was yourself. So did this day catalyze a shift for you? Was this the day when you decided, "I'm quitting research? Or I'm going to rehome the dog?" Was it that concrete, where it was like the next day you sprung into action and changed your plan? Or did things evolve more slowly or what happened afterward?
Meghan Rothenberger
They sadly evolved way more slowly than I'd like to admit. I think the level of discomfort that I had did prompt me to think like, "Okay, I need to do things differently." The first thing that I did do was rehome the dog, which was painful and awful, but it needed to happen. So that happened actually not too much longer after. But from a career perspective, it took me a long time. I think actually, I ended up getting pregnant with my twins, I think about a year after this. And I did end up at that point leaving the research world, which was nice. I mean, I looked back and like I didn't need to wait for the excuse of having twins as like my exit strategy. But it worked that way. And fortunately, I had this job as an Associate Program Director for our residency program that sort of opened up at the same time. So I've transitioned from research to education, which was at least a step in the right direction. But it wasn't until far later that I feel like I finally made the big switch that has really changed my overall relationship with work.
Emily Silverman
And the big switch, that was the research to education or that was a different switch?
Meghan Rothenberger
No, it was a different switch. From the time I finished fellowship, I was at the University of Minnesota and I was working in education at that point. And I was doing clinical work. I was working with a nonprofit and in 2018, hit a really bad period, I guess I would say. You know, it's funny, because there's no good term for it. I keep coming back to the old 1950s housewife term of like nervous breakdown, like you imagine some histrionic lady in a housedress. But I feel like that's sort of where I was, and I just wasn't able to really function. And so I took a leave of absence from work. You know, I got therapy and good mental health, kind of got back on track and came back to the exact same job. And then in 2020 with a pandemic, I was like, "Oh, wait, this is going to happen again." And so I ended up leaving the university and I took a half time job at the VA hospital. That was the big shift where I dropped my Associate Program Director job, I gave over the medical directorship of the nonprofit. I left the clinic that I swore I would have until I retired and now I'm working at the VA.
Emily Silverman
And was it the full time to part time that made the difference? Or was it getting out of the academic environment that made the difference, or what made the difference?
Meghan Rothenberger
I think it was kind of a combination of all of them. Finally having some time to think I was just working, as I'm sure, almost everybody in medicine is. Like, you just don't have time to think. And so all of a sudden, I had all this time to think and let my mind wander a little bit in a way that it hadn't for a really, really long time. And then it was a step away from the rigamarole of the academic world, it was nice to give myself permission to say, "I'm not going to do that, at least for now." And then just the change of environment was really big for me. A totally new start, and a new place with new everything was really good for me.
Emily Silverman
Yeah, that quiet you're talking about reminds me of a friend of mine who I just went on this long walk with. And he had just gotten back from a silent meditation retreat, I think it was like five or seven or ten days, I can't remember where he went off to some retreat center. And it was a rigid protocol where they would wake up at four every morning, eat these delicious plant based meals that were grown on the property. And then they would sit and meditate multiple times a day, have lunch, there might have even been some manual labor involved, or at least doing dishes or something like that. And then meditate all afternoon, and then have dinner and then it was like a spiritual talk. And then they went to sleep. You have no phone, you have no internet. And he was just describing what his brain was doing. During that time and how like, the first day, it was kind of exciting. And then by the fourth day, he was ready to quit and leave. And then by the sixth day, he had pushed through that and was starting to enjoy it. And it was just interesting to hear the progression of how that went. And I've always wondered, "Oh, if I did something like that, what would my brain do? What would my brain do with the quiet?" Which is not to say that what you did amounts to a silent meditation retreat. But I do think that when you create some space, whether it's time off, or going from full time to part time, there is a void that's created, and something has to rush in and fill that void. So what was that like for you? What did rush in to fill the void?
Meghan Rothenberger
At first, I was terrified that I would... This is embarrassing to admit, I was like, I'm gonna start drinking wine at 11 in the morning. And I'm gonna, like, eat a bunch of cookie dough and watch Netflix all day. And just be like, just a lump. I'm just gonna turn into this slovenly person that like makes up for the fact that I've been working my ass off from the time I was like a kid to get here. Like finally, I'm going to just cut loose. And I thought that maybe it's dangerous for me to have all this time. Honestly, that was my first thought. The other thing I thought is, maybe I'll volunteer at my kids' school, or like, I've always been really interested in getting way more into some sort of sport. Or maybe I'll start painting again or something. I didn't do either of those things. So I didn't go to the bars at 10 in the morning. And I didn't become an amazing volunteer at my kids school. I just sat around a lot and thought. There was so much quiet, I would just sit with my dog, and just let my mind go. And it took me probably six months longer than I thought before I felt any motivation to do anything else in my time off other than sit and think. And my thoughts, I just really let them go. And it was fun to feel where they went. I tried hard to pull out of the regret world because that tends to be sometimes the worry and regret is where my brain sometimes goes. But other than guiding it away from that, I just let my thoughts come.
Emily Silverman
That reminds me a bit of when I was pregnant with my daughter in the first trimester, I had this incredible drop off of energy. I just had no energy at all, couldn't do anything. I also felt pretty sick and nauseated all the time and I couldn't even open my laptop for 10 or 20 minutes. My brain just couldn't handle it. I would try to read and that was too much. I would even try to listen to a podcast and it was just like too much stimulation for my mind. And I swear to God, there was a period of a couple of weeks where all I could do was pull up a chair to the window, open the window so that there was fresh air. And I would just sit in this chair and watch the cars. And it was so boring. But it was the only thing I could do.
Meghan Rothenberger
Yeah. And you probably hadn't let yourself do anything like that for years, years.
Emily Silverman
Yeah. And I remember texting a friend of mine. And she was like, "Yeah, you're not used to that, are you?" And I was like, "No, I'm not." And she was like, "You know, I think what you really need to do is just embrace the indolence of pregnancy." I'll never forget that word that she used, indolence. And I feel like in a way, when you lean into that, the fear is like, "Oh, am I going to be like this forever? Am I just gonna do nothing forever now, but the energy comes back when it wants to?" Do you know what I mean? Yeah, I heard somebody describe it this way, once. Let's say you're really tired. And you decide that you want to lay in bed and watch TV all day. But the whole day, you're laying in bed disgusted with yourself. And you're like, "Oh, I'm such a disgusting slob. I'm just laying in bed eating this cookie dough watching TV, I should really get up, I should really go for a walk, I should really answer my email." And your mind is going that you actually don't get the relaxation whereas if you just get in bed, and you're like, "Ah, I'm just gonna be a slob today." And you embrace it and you eat the cookie dough, that you actually end up well-rested. And then the energy comes back. Does that resonate with you?
Meghan Rothenberger
Oh, yeah. It's so true. I mean, that's why I said when I would sit, I would be aware of the negative places my thoughts would go and try and bring it into a place of like, this is rest that I need and that I deserve.
Emily Silverman
That's a big one.
Meghan Rothenberger
Yeah. Yeah. After like, literally decades of "You're tired. Oh, that's too bad. Drink a little more coffee."
Emily Silverman
Did you go straight through from high school to college to med school just nonstop for decades? Or did you have any breaks?
Meghan Rothenberger
I went straight to college. And then I took a year off between college and med school, I should have taken much longer. It was actually this amazingly dreamy year that I spent in Colorado, but it went fast. And then yeah, that I went straight through. And once you're in, you're in, you know?
Emily Silverman
Yeah. So are you still in your part time job? Or what's your career status now? And is it feeling balanced? Or is this a kind of a continual balancing process?
Meghan Rothenberger
Yeah, I'm still in my half time job. I wish I could say like, oh, it's absolutely perfect. And I feel wonderful and fulfilled. You know, there's still times to be honest with you and I think it's just because of the environment that I've been immersed in and so long that I, especially when I'm having kind of a rough day, you know, I think like, "I'm such a loser, I'm working like half time." I look around and like everyone is working harder than me. And that's like a sad, really sad thing to think. But I do honestly think it sometimes and I have to actively counter that and say, the things that I feel most proud of now at work is that I'm a really good doctor, to my patients, like a really good advocate for them. And someone who can actually take the time to talk to them and go out of the way to help them navigate the healthcare system or meet whatever extra needs that they have, that I never used to have the time to do. And so I try and remind myself of that. And at some point, when I was talking about promotion, like before I left the university and I met with one of our Deans of Faculty Affairs, and they were talking to me about my CV and they said, "You have to better demonstrate that you have a wide sphere of influence." And that was like a stab to my chest, I think, when she said that. And I wanted to yell back and be like, "How the hell do you know like, what my sphere of influence is? You're not with me all day, you don't see how I interact with like, trainees and patients and my friends and my family, like the sphere of influence feels very personal." I think about now, I may not be putting in the same number of hours as my colleagues. I'm not publishing any papers. I'm not bringing in grants. But I feel like by being a happier person who has a little bit of time, to sort of listen and be present. I hope that in that way, I'm influencing the people around me.
Emily Silverman
Yeah, I love that reframing of the sphere of influence, comparing the sphere of influence of a Nobel Prize winning physician who makes a discovery that completely revolutionizes medicine. How do you compare that to something like the sphere of influence of raising a child or being a friend or even having an impact on one patient's life?
Meghan Rothenberger
Yeah, exactly.
Emily Silverman
It's just a interesting to think about how we think about promotion up the professional ladder in academic medicine. Do you still have a ladder in your job where you go up from assistant to associate to full? Or is that not really the framework where you're at now?
Meghan Rothenberger
I do still have that. It's something that I feel like I have finally stopped caring about. It was something that for a while after switching my job, I kept in the back of my head, like, "How am I going to get promoted if I do this? And well, how does this count?" And then slowly, those cares fell away in a really like lovely and freeing way. And I'm so proud of my friends and colleagues who have achieved their promotions and are really excited and motivated to continue to be promoted. I would never discourage anyone else from doing it, as long as it feels like it's important to you and holds value to you. And I think that's what I realized is for myself, I don't feel that that is a valuable endeavor for me to pursue.
Emily Silverman
So what's next for Dr. Meghan Rothenberger? Do we have any more writing or storytelling coming in the future? Or maybe retreating back into work life and home life? Or what do you envision for yourself in these months, two years moving forward?
Meghan Rothenberger
I actually am really enjoying not having any long term goals. At this point, it feels funny to not have it because I've never not had it. I've always had those goals as my guiding motivator, there's a nice, clear path for me like this is my next step. And that's my next step. And I'm sort of enjoying not having that. And that's really enabled me to spend more time with my children, which they're getting older and older. And I feel like I will never regret the time that I've been able to spend with them. And so yeah, I don't really know. I've continued to write a lot of stories in my head. So someday, I need to get those down on paper, probably. But no clear plans.
Emily Silverman
Have you lost your wallet recently?
Meghan Rothenberger
Oh, my gosh, my poor husband. He has to listen to me every day. "I'm like, where are my recently? It's been the airpods, where my airpods?" Where are my...? Oh, I found the case. And I found one airpod. But I didn't find the other airpod." I lose things all the time. All the time. But not my wallet recently, luckily. And not the dog. Yes. And not the dog and not the children? No, no, we're keeping track of all of them.
Emily Silverman
Yeah, I feel you on the airpods. I just lost one of my airpods. I have no idea where it went. And it might have to do with my two year old who will sometimes find the airpod case, open it up. And then she takes the airpods out and puts them in her ears. Except she puts them in with the long skinny side first. Right? Yeah. So that they're sticking out of her ears pointing horizontally. That might have something to do with the fact that they've disappeared. I can only hope that she didn't swallow one of them, but I don't think she did. Anyway, thank you so much for bringing this story to The Nocturnists. It's truly a unique story. One of those stories where on the surface, it feels like it's about something small and minor. But then the more you look at it, the deeper it goes. And I've just really enjoyed working with you and having the opportunity to speak with you today and learn more about your background and the story and it's just been really fun. So, thank you so much.
Meghan Rothenberger
Thanks so much.