Intentional friendships

Starting in residency and amplified ten-fold as we transition to early career, many physicians realize that close friendships take more intention. Often, we are oblivious to it early in our career as we’re so busy working in a new setting and raising families, but it eventually catches up. Over several years, I eventually connected with some special friends in Florida, especially when my work life wasn’t insane.


After moving from Florida to Alaska (another story for another day), I was profoundly grateful to have a group of three other women that became instant friends. Someone had networked us together and we hung out regularly. Over the following year, I became consumed with my academic job and one by one those friends moved out of state.


The loss of connection was insidious. Do you know when it hit me?  When I needed someone to help pick out paint colors! My daughters were grown and living out of state. I had been through burnout and changed to part-time ambulatory medicine. I wasn’t close enough to anyone that could look at color swatches.  It may sound superficial, but it was a devastating realization at the time.


I finally connected with a friend as a running partner. She had such a full busy life with all her family in town and so many friends. I felt guilty taking up her time.


Then in 2017, at my first women physician’s conference (organized by the amazing Sasha Shillcutt, MD) I heard it from the stage. “You must be intentional in seeking out and maintaining friendships.”  It had never occurred to me that it should take effort on my part. Shouldn’t it just “happen?” A trauma surgeon then told how she watched a Grand Rounds by an internist and walked up to her afterwards and said, “We need to be friends.”  And, so they became. Everyone there was challenged to think of five people they could call at 2am to bail them out of jail, and if there weren’t five, to go home and intentionally start to cultivate those relationships.


On the plane back to Seattle, two other women physicians brainstormed an idea for women to connect. They decided we would have a story slam - similar to The Moth. The topic would be #BeMyFriend. Each person invited could take the topic and speak for 5 minutes – it had to be an original, true story in any form and portraying any emotion. One amazing weekend in Seattle, story slam became reality. The stories ranged from tragic to hilarious – but each gave a transparent glimpse into the speaker’s mind and heart. It was fabulous. Unfortunately, I didn’t live in Seattle. So, I came back to Alaska and began intentionally asking friends to be one of my five. Over three years, friends moved, but I always kept my five.  Some weeks and months, I’m more consistent in my gatherings -lunch, walk, run, or ski. Sometimes it’s just coffee or tea. Often, it’s just an email or text. But I have connection (and someone to call at 2am from jail 😊).  


I think the take home message for residents is this – friendship can at times in residency seem natural and other times seem impossible.  It can seem you’re too busy to make time for a friend. And yet, one of the things that helps us keep our bearings during chaos is a friend who can listen, understand and just be. Be prepared, more intention may be needed after leaving your mandated peer group. Maybe you don’t start with five, but start with at least two. That human connection, even for introverts, is healing and resetting. Don’t see it as a “I should” or an obligation but see it as an “I get to.” You won’t regret it.




Tonya Caylor

Story Slam, Seattle

November 17, 2017


I think of so many things when I think of friendship.  I think of adventures and lunch and laughter.  And words – how powerful they are.


Many friendships are forged as a natural outcome of having children.

Think about it – going to playgroups, sitting in the stands for hours at sporting events, milling around at school functions.  Many of our hours as moms are spent chatting, for better or worse, with other moms. 


It can be quite difficult to forge friendships though when you are the mom of the “problem child.” 


My husband and I were patting ourselves on our backs for our parenting prowess after raising our first daughter for 4 years. We had her during our undergraduate years, as a somewhat wonderful surprise.  We had many rules and knew exactly how we would raise our kids.  Our first, was a typical compliant child with people pleasing tendencies and the capacity to follow a gazillion rules and be the model of perfection. (Hear the angels singing?)


So, when we were in medical school, we decided it was time for another baby.  We wanted our kids to be in the same generation, after all.  Despite advice to the contrary, we marched forward with our naïve idealism.  Baby #2- was a bit different (can you hear “on the day I was born….”).  She didn’t appreciate our multitude of rules. Strong-willed, she was going to forge her own way in the world.  That, combined with our chaotic medical school and residency training life, was great medium to foster some appalling behavior.  We were not prepared for outright rebellion- the refusal to sit in story time at age 4 or throw objects. She’s the only kid I know who was on probation from daycare at age 4.  One more major event, and she would have been expelled. I had to walk the long hall of shame to pick her up each afternoon – saw the looks from the other workers and parents. It seemed everyone knew. I could hear the “tsk, tsk tsk” in my mind. I’d listen to the list of allegations before they would release her each afternoon, hang my head in shame, apologize, and promise to either punish her or talk her to death. I got a knot in my stomach having to pick her up – Every. Single. Day.


Well, fast forward about four years, after some “counseling” for her (i.e. parenting classes, who knew?), a diagnosis of early onset ADD, Ritalin, and a bit more order and calm in the home as at least one of us had finally completed training.  We moved to a new town. Her emotions were steadier, outbursts less often, and she would respect authority figures, sometime. We found a new church. I kept her in services with me, not trusting how she would interact with Sunday school teachers. I wasn’t ready to risk her getting deemed the “bad kid” and me as the “mom of the bad kid.” You can likely imagine how conflicted I when vacation bible school rolled around. A great time for kids with great lessons and free! We decided to let her go, but we had our oldest daughter volunteer to be the class “helper” so she could head off any potential meltdowns. (She of course was more than happy to oblige, being the angel she was.) I picked them up 4 days in a row with my oldest leading my youngest out of the room and meeting me in the hall. It seemed there were only a couple of minor infractions and no one suspected my youngest was difficult.   


On the 5th day, I was picking them up and the teacher came out as well. “Oh no,” I thought, “here it comes!”  She said, “I just LOVE your daughter!” I said, “Oh, isn’t she the best? She loves to help and is good at knowing what the youngest needs – thank you for letting her help.” There was a slight look of confusion on her face and she said “Oh, your oldest?  Yes, she was an amazing helper and so sweet. But, I’m talking about your youngest.”


I stood stunned; “Really?”  No one that wasn’t forced by blood-relation had ever said those words. And, I could tell she meant it. She said, “Yea, she’s spunky! She reminds me of my middle daughter.”


The power in those words made me realize my daughter was lovable by people unrelated. Something changed inside me. I lessened the judgement on my parenting. I saw her differently. I began approaching and talking to her differently. I believe she began to see herself differently. She ultimately began to make friends of her own – with “good” kids. And that dear VBS teacher became one of my closest friends. 


Many friendships are forged as a natural outcome of having children.  It’s harder for some.


Words are powerful as they can change perspective.


The next time you see that ‘problem child’ – reach out.  Who knows, you may be a change agent in that child’s trajectory and even make a forever-friendship.


Have a joy filled day!   Tonya


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