I got to the point where I needed to ask for help because I'm struggling physically.
My hands are getting worse and worse. It's getting harder to keep up with tasks like typing and writing notes by hand. At home, as often as I can, I'm using dictation software. If I write a lot, my hands get so stiff it's hard to do other things.
Considering how much of my life has been centered around expressing myself by writing, having so much trouble writing is hard. The fact that my work requires so much of it is even harder. Documenting everything in medicine is so essential and I can't just not do that. But I need to save my hands for the really critical stuff.
I can write without using my hands, but I can't do physical exams without them. I need my hands to work and so I can be a mom and take care of my kids. So I need to reduce the amount of demands on my poor, unhappy fingers.
After a lot of struggling with myself, I asked my program for disability accommodations.
The main areas where my RA is being problematic are extended fine motor tasks like writing and typing, managing my fatigue (especially as relates to call shifts,) and getting sick a lot. So I've asked for access to dictation software, flexibility with scheduling (eg. not doing Friday/Sunday call, but straight 1:4 call so I don't have shifts too close together,) and masks for when I'm examining patients with respiratory symptoms.
Thankfully, my program was super responsive. They just jumped on it when I said 'hey, I need some support here.'
Pretty frequently, I am pleasantly surprised by how good my program is. No residency is perfect, but I think I'm in the best possible place for me to become the sort of doctor I want to be.
Even if that means I'm going to be spending a lot of time talking to computers.