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@smilesandscrubs

Jessica Ashley

smilesandscrubs

Choosing You while Choosing [to live & love] Medicine OBGYN, PGY3, DO Endorphins & Healthy Eats Newly Wed & Cat Mom #ChooseYou

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Thoughts while crossing the bridge to PA this afternoon ... “I wish I knew obgyn as well as I know every song on the pitch perfect soundtrack I’m jamming out to right now”. I first and foremost shared that thought with my co residents. One of them responded with a GIF of Fat Amy saying “Crushed It”. I LOL’ed then I let it sink in.  There’s a reason I know every word to every song on the pitch perfect album - because I’ve listened and watched and sung along to it hundreds of times. Plus, there’s only 13 songs to memorize and I can easily stumble over the words with the volume up high yet it still sounds good to my ears.  The same can be applied to medicine. I’m not one of those people who can read something and know it forever. I more often than not read something, forget it completely, and have to re read it again and again before it even makes a dent.  While I may review a practice bulletin or chapter in Williams once or twice it usually takes me actually reading and re reading and making a study sheet and doing questions then applying those things I learned to real life and looking them up again and again to actually recall it from memory.  In fact, for the things I do know by heart, its taken hundreds of times of repetition, of performing the same surgery or treating the same disease until I finally could recite it from memory. [Like I’ve mentioned in other posts, routine OB visits in the office are my JAM]. And there’s a high likelihood I’ll never master everything there is to know about woman’s health. [by high I mean certainty]. What I do know is that I love both pitch perfect and OBGYN. Here’s to getting to the point where I can rap off PAP smear guidelines or treatment of infertility or ovarian cancer staging with the same confidence I do when belting along to cups.  Until then I’m gonna keep on crushin’ it. || #chooseyou
Nothing to help ensure confidence like a new lipstick and your favorite glasses. Believe it or not, in middle and high school I used to hate my glasses. I begged my parents for contacts and wore them pretty much straight through to medical school. When I started rotations I quickly learned that contacts and 4am wake ups don’t go hand in hand for me. Not to mention the additional issues with naps and adjusting them mid surgery or on call. Now I proudly rock my glasses most days of the week. For one, I feel more like myself which directly translates to being more comfortable during tough surgeries or long call days. For another, they’re easier and add style to my usual scrubs and hospital jacket. One day I want to get lasix but I’m kinda nervous I’d miss my four eyes. Either way, today and for the foreseeable future (see what I did there) I’ll proudly rock these babies.  I’m curious, are you a glasses or contacts wearer? Why?  Oh and another uterus has successfully been removed ✌🏻|| #chooseyou
Alarm went off at 445 this morning and I so badly wanted to snooze. Instead I got up and hit play on my morning workout. It wasn’t my best but I got it done. And ya know what? I’m setting myself up for success this Monday morning and every other day of the week. Now it’s almost 8am and I’ve sweat, listened to a lecture on my drive into work, rounded on my post op patient, turned in PTO forms, and am currently reviewing questions.  Bottom line - your productivity is a direct correlation of your choices and you have the power to create your own motivation. Don’t ever underestimate your capability or resilience. || #chooseyou #nevermissamonday
Marry someone who tells the world he’s proudly married to a [an OBGYN] strong woman. || #chooseyou
#realwomanmoments  I feel depressed. I said this as I rolled over into my husbands arm the night before starting back on the OB service in January. I start crying. I desperately know how the next few months are about to go down and despite being aware that I’ve done it before and can do it again, I’m in pain.  I’m already mourning all the nights and weekends I’m about to give up for boards studying or exhaustion. I’m already grieving the loss of social events and me time that hardcore studying while working full time in residency requires. I’m already feeling the loss of myself and it hasn’t even happened yet.  Thinking of what I’m about to go through on top of surviving residency and starting another month on a busy service overwhelms me. I’m exhausted in a down to your core, my bones ache and my spirit is gone type of way.  I lean in closer and say would you still love me if I weren’t a doctor. He says maybe. And that sounds harsh but he means it out of love. He knows how much I enjoy being an OBGYN on the good days. He sees the light inside me that medicine brings. He squeezes me hard and in that hug I know he’s absorbing half of the struggles the next months will bring.  Since that day most of those feelings I knew would surface have. When I’m succeeding at studying I’m inevitably slacking at work. When I’m trying to teach and be present on the floor, I feel guilty for not doing the same at home. When I’m somehow managing to workout and sleep and study and be present at the hospital I’m almost always sacrificing time or energy or closeness with those I love. I chose to become a doctor. It’s the only thing I’ve wanted to do for my entire life. I chose to become an OBGYN. Women’s health is my absolute passion.  And yet burning the candle at all ends takes a tole on every aspect of my life.  I don’t have it all together. I feel failure and pain as much as anyone else. I fight back against the sadness and sacrifice by
It’s a no makeup, bags under my eyes, wish I coulda slept in longer but thankful I showered, at least I got DD on the way to work kinda Saturday. Ya know the type? Hoping this caffeine kicks in soon! Already finished rounding, had a baby, and admitted a patient for her CS. Call is off to a busy start || #chooseyou
Your mood is contagious so why not spread joy and laughter and positivity around like confetti. // Feeling on top of the world after a rewarding surgery curing a patient of her pain and abnormal bleeding. Had a wonderful grand rounds on reducing c sections for education Friday. And found out who were welcoming for new interns to our obgyn family 💕 // #chooseyou
Some nights you’re in the zone, no distractions, hitting your study goals and feeling on top of the world.  Other nights it takes everything you have to sit still and concentrate for more than 5 minutes at a time, you hit pause and rewind pause and rewind constantly, and nothing you read seems to stick.  Long term boards (and life, because we chose to be forever learners) studying is hard work. No one I know wants to come home from work and go right back to work, without pay, without a break, without reward.  But we somehow do it anyway. It may not be our best but it’ll do.  Today is one of those latter days where things just feel harder than normally. My husband is away for the weekend in NoLa and I’m jealous. I’m working Saturday for 24 and the warmer weather makes me feel like I’m missing out. I want to be done boards so badly it hurts.  Giving myself permission to feel however I feel in the moment helps me a lot. Giving myself permission to take a break when it’s not working helps me a lot. Giving myself permission to accept that I’m only human and doing the best I can with what I’ve got helps me a lot.  I didn’t always give myself this grace or leeway. I didn’t always grant myself permission to feel or be anything less than perfect. I didn’t always realize how hard I was on myself.  But I’m learning and I’m practicing what I preach and I’m sharing it so that if any of you out there feel stuck today too you know you’re not alone, it’s normal, it’s okay.  Finishing up the bare minimum to stay on track and calling it quits tonight. Tomorrow I know will be a better day but today was pretty good (in other non-study ways) too.  Tag someone who could use this reminder tonight too 💕|| #chooseyou
Today has been another crazy day of running around doing consults between surgeries and I’m just now sitting down to dictate my cases and notes. While dictating and EMRs are awesome there is no better way to learn how to document that tried and true repetition. One thing I love and highly recommend is getting a good dictation booklet to use as a basis for surgical procedures. Once I can say a case step by step without thinking twice about wording or instruments I create a template for my future self but only after I can adequately do it on my own. In fact I encourage my interns not to cheat themselves by making saved templates for c sections or hysteroscopy or LEEPs and I hold myself to the same standard for hysterectomies and other bigger procedures too. Why? Because what if one day the computers shut down (I mean we all survived the social media outage of 2019 yesterday!). You’ve gotta know how to do things without relying on technology. So I’m curious, can you dictate from memory or do you use saved templates or books for help? Next time you sit down to chart test yourself and see how much you can get through without needing to pause and look something up. After all, it’s how ya grow. || #chooseyou
Feels leaving the hospital after a 24 hour call ✌🏻 out, see ya never. [tosses zone phone to day team]. Jk, I’ll be back tomorrow for more || #chooseyou #residencylife
Smiling wide this afternoon because I rocked (read - didn’t suck) on my side of a hysterectomy and am slowly gaining confidence both in and out of the OR.  Anddddd I bought this new badge holder made from hospital medication bottle caps by a fellow resident. It may be a 24 hour call day and I may have been awake since 445 am, but it’s a good day to have a good day. || #chooseyou
My heart goes out to all of you who opened an email today that decided the next 3-7 years of your life.  Whether it was the best or worst news, whether it was expected or a surprise, whether it makes you feel better or more anxious, remember this — it does not define you. You define you. 💚 Rewind to my audition season 4th year of medical school. I worked my butt off at my dream hospital. I got told I’d never be considered for a spot if I didn’t take USMLE step 2. I interviewed the same day as a friend. She left saying she’d never in her life rank this place. I left knowing they would never rank me. 💚 This realization broke my heart and spirit. It lead to a monumental breakdown outside the Cheesecake Factory in Philly that my husband and I still laugh about every time we pass it. (A story for another day but essentially someone stole the last piece of cheesecake I wanted and it caused a spiral of life isn’t fair, I never get the things I want, woe is me stress of MS4). To this day, we haven’t gone back. 💚 Yesterday I shared the version of my Match story that I choose to remember - being happy, being proud, being relieved.  Today I’ll let ya all in on a secret. When I opened that email saying congratulations .... I genuinely thought I didn’t deserve it. I had gone through interview season so in my own head and heartbroken over that dream program not wanting me that I no longer wanted me. 💚 You will end up exactly where you need to be. If I had matched into that “dream” program I’d never have met my best friends in the entire world in my residency. I also wouldn’t have thrived and developed into the type of doctor or person I’m on the path to becoming today. It turns out the universe knew I needed to be where I am and gave me time and resources and support to slowly but surely prove to myself (because everyone else already saw it) that I do indeed deserve to be a doctor, an OBGYN, a women’s advocate and that I am allowed to
You always remember your first time.  Some firsts, like delivering a baby or taking lead on a surgery, are memorable for good reasons.  Other firsts, like witnessing and caring for an eclamptic seizure patient, scare the living hell out of you and are memorable because you never want to experience them again. ••• I was on call. The floor was jam packed with laboring moms. We had a patient on magnesium sulfide for preeclampsia with severe features (high BP >160/110). I had just ordered IV labetalol for her persistently elevated pressures when my zone phone rang. I rushed to my patients room to find her in a full blown eclamptic seizure. I froze. I was shocked. I was terrified. I ran to check on the baby. Multiple other teams and care givers poured into the room. Finally we stabilized her. We delivered baby. We continued her medications. She stayed a few more days in the hospital and left with her newborn. ••• She was the first eclamptic seizure I ever witnessed and since that time I’ve helped care for a handful more.  In the US today maternal mortality is climbing and heart disease is a top contender for for first place.  Like many diseases is pregnancy, eclampsia doesn’t end when the seizure stops. Patients with HTN or preeclampsia or eclampsia have increased risks in subsequent pregnancies and decades down the road too. Therefore, pregnancy is a warning state. It’s your body saying “hey, you may only be 25 now and can handle a little stress but when you’re 50 if you don’t make changes to improve your health, I’m gonna shut down and try to kill you”. ••• In honor of improving maternal morbidity and raising awareness for the complications of pregnancy I’ve teamed up with @mamadoctorjones and @everymomcounts to shine light on this topic. For every view of her YouTube video reacting to an eclamptic seizure on Down town Abby (the first seizure I saw was for sure on Greys Anatomy!) her and her husband are donating $1 to those in need
In honor of tomorrow being match day here’s a throwback to my match week at PCOM.  Unlike many of you guys tomorrow, I participated in the AOA match and was lucky enough to find out I matched and where I matched on the same day.  Like many big moments in medicine, I remember my match day vividly. I was at our community clinic sitting in my seat at the table looking up patients when I opened the email that would determine the next 4 years of my life. The clock clicked 751am, I checked and double checked my gmail, saw the screen saying “congratulations”, called my then boyfriend, texted everyone I knew that cared, and smiled with joy. I then went to see a patient and missed a call from my now program director congratulating me on joining the OBGYN family. I was shaking I was so excited and nervous and happy and so many more feels.  I realize that match day won’t be this way for everyone and I promise that even if you match somewhere you weren’t expecting or don’t match at all, everything happens for a bigger reason. Many of my friends who didn’t match their specialities or programs they wanted were devastated in the moment but now, 3 years later, are stronger and better and dare I say it, HAPPIER because of it. Some of my co residents that never wanted to live on the east coast are now my absolute lifelong best friends because of said match algorithm. And they’re changing peoples and patients lives on the reg. ••• Tonight you have no control over what happens.  Tomorrow you have no control over what happens.  Friday you have no control over what happens.  Remember you did your best with whatever you could in all the moments you could.  That will be enough. You are enough.  And no matter what happens, you’ll be okay.  Good luck everyone, enjoy tonight (you all better be doing something fun!) and may the odds be ever in your favor ☺️ ••• Also, we are just as excited on the residency side of it to find out who’s joining our baby
A few weeks ago this guy greeted me at the door with a hug and card from my kitty and him saying they wanted to chip in buy me a new phone for all the hard work studying I’d been doing. It ended in tears of appreciation and laughing that of course the cat wasn’t helping pay for a new phone at all. Well today we made the official upgrade to an iPhone XR and I’m in love (with the phone and them...!) We then went to china town for dim sum and ate at a table with 4 complete strangers where we all shared pieces of our very different lives. Needless to say, today was a good day and I’m so very full on love and laughter and food 💕 || #chooseyou
Anyone else channel their inner Elle Woods #legallyblonde and head straight to a nail salon when life feels overwhelming? Me too.  Woke up this morning and started with some review questions but after an hour was left feeling stressed and not focused. Instead of struggling though with growing frustration I plugged in my headphones, threw on a review lecture and left the house. The second I sat down to have my nails done I felt my stress level dissipate and just enjoyed a solid hour of reviewing while pampering myself.  Did it solve everything? Nope. Did it help to change up my environment and mindset? You betcha.  Long term studying requires big and mini goals with lots of flexibility to your methods and self grace where appropriate. Sunshine and sparkles generally help too. Happy study(ish) Saturday y’all || #chooseyou
I’m post call and totally lacking motivational captions but in short ••• Support other Women. Period. ••• #internationalwomensday
I’m a perfectionist in recovery.  I’m not the first to use this term it to describe themselves and I surely didn’t coin it but I also won’t be the last. Especially in a cohort of medical professionals.  I’m the girl who gets a 99 on an exam and wonders which question she got wrong.  I’m the girl who completes 8 out of 10 things  on her to do list and beats herself up for missing the last 2.  I’m the girl who gets an excellent on her progress report and questions what she can do to get a higher mark.  I focus so intensely on the areas of improvement that sometimes I can’t allow myself the moment of celebration that comes with doing well.  It’s something I’ve been working on for a while and every so often I catch that perfectionist self sneaking back in.  Today I got some good news of hard work that paid off. I immediately jumped to the thoughts of I should have, I could have, done better. Even when my husband and program director and my logic said “Jess you did great” “keep doing what you’re doing” “you should be proud”. Moments like these I realize how self destructive perfectionism can be.  No one is perfect. There will always be someone smarter, taller, more fit, happier, blonder, funnier, etc than you.  But appreciating where you are and what you’ve done, especially when it’s not perfect, is what makes you better.  And happier.  I’d rather be an absolutely average person who’s happy than a perfectionist constantly chasing nonexistent rainbows.  Now time to go have a baby! || #chooseyou

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