Parallel Universe

Sometimes when I'm dealing with other medical students, I feel like I'm entering a parallel universe where human interaction and expression of emotion has become some weird hybrid of what it should be. Granted, I was born and raised in New England which makes me a bit emotionally stunted, thereby warping my perspective slightly. But I digress...

Seriously though, a production is made out of every little happening. Case in point: I tried to go out to dinner with my room mates last night...a simple task in my former life. But here in the Twilight Zone, the roommates disagree on time and no compromise can be reached. This leads to other grievances being aired, crossing of arms/stamping of feet, awkwardly silent rides to the restaurant, awkward silences over dinner, and general discomfort for the Bostonian in the middle of all of this. Oh and the temper tantrums...don't forget those.

I've noticed that this toddler/kindergarten level of maturity also extends thorough a good portion of my class and it's frustrating to think that I will have to cater to these types of personalities for the rest of my career. Hooray future doctors of America!!!

SOX WIN

Obligatory post...sorry. I love this piscture of Pap...

Overall, this year was probably the best years of baseball that I can remember, but the World Series was kind of bittersweet. Do I miss Shaugnessy's Curse of the Bambino? NO! But there is something missing in my soul...it's that potent longing that only a lifetime of being a lovable loser can bring. 86 years of disappointment no longer tug at my heart strings. Billy Buckner letting the ball through his legs in the '86 series doesn't make me quite as angry. Falling to the Tribe in '95 and '98 and losing to the Yanks in '99 are just distant memories from my adolescence. The heartbreak of the 2003 game 7, 11th inning ALCS loss that forged my love of the Sox no longer makes the bile rise in my throat. 2004 put all of those things to rest. The fatalist Sox fan is gone from my soul.

There was no elation this year for me, just satisfaction and a lot of hope for the next few years. With the young core of players that have come up through the farm system, a passionate owner that cares about his fans and team, competent management at the helm and another red banner hanging over Yawkee Way for me to look up at, I am satisfied.

Getting my groove back

So a funny thing has happened over the past two weeks. After my last post, I found myself battling some of the same feelings that I had addressed: Med school sucking, wondering why I would ever put myself through this, wondering what my motivation in all of this is, etc. The motivation problem is what has come to the forefront of my mind as of late. I just can't seem to come up with a single concrete answer other than the $94,000 that I've racked up in debt over the past year and a half.

Is it for my family? No, my parents are proud of me no matter what. Is it for my kids? No, I probably wont have them for a while thanks to the inter-state relationship that I'm in for the foreseeable future. Am I doing this for me then???

At one point, somewhere back in the application process, I was doing this for me, to give myself a solid career where I wouldn't just be a cog in the wheel of industry like my father and brothers, merely making a product to make a paycheck. I would much rather a career where I could look back at the end of every week of work and see that the hours of my life that I am investing into my career had a positive impact on the lives of others...and be compensated for my skills and time.

Well, I wish the naive younger version of me had known the sacrifices he'd be making in the near future for that fulfilling career and decent paycheck. I look at other people my age that are traveling the world in their free time, keeping themselves healthy at the gym, starting their marriages, starting their families, broadening their social networks, finding their niches in careers and generally living life.

And then I look in the mirror and see my life, filled with sitting in front of a couple of books, in a small group discussing that pile of books or in an auditorium listening to the highlights of those books. No impact on other people, nothing but the same 200 faces day in and day out, the same books day in day out, nothing to look back on at the end of the week to say to myself "wow, I actually contributed to humanity today."

I think the lack of a rewarding feeling in the pursuit that I spend the majority of my time in is the worst part of this whole process. I'm literally working my butt off, spending weeks of my life glued to a chair for nothing but a number on a piece of paper...ok so couple of numbers (Exams, USMLE, Clinical Evals and shelf exams, Deans letter, interviews and the actual match). My life for the next 3 years is lined up for me and I feel like a cog, just what I wanted to avoid... pointless, unrelenting, unrewarding toil.

Like I've said a couple of times now: It's hard to look past all of this to the actual practice of medicine when your head is burried in the pages of a book and won't be coming out for some time now.

Advice about med school blowing hard...

I received a comment on one of my older posts commenting that the writer had found me by Googling the phrase "Med school blows." In the absolute lack of anything else to write about, I'm gonna throw down some knowledge/experiences...be prepared for awesomeness!!!

So you've spent the last 5-10 years of your life working towards this moment: getting into medical school. Now that you're here you think it sucks and you might have made the biggest, most expensive mistake of your life? Yeah, welcome to the club Anonymous. Many medical students have what I like to call an "Oh Shit" moment once they get into the day to day slog of medical school. I had one of those moments myself about 3 weeks into school for my first set of exams, and look at me I survived it!

It's VERY easy to get caught up in the feeling of "THIS STUFF BLOWS A GOAT" especially around exam time. It's even easier when you've just left a fairly easy job where you worked 40 hours a week, drank your paycheck away and really had very few cares when the clock hit 5PM. The transition was rough for me anyway. I imagine you have just come to the painful realization that you didn't want to study Anatomy and Histology. To be completely honest, you're going to realize that you don't really want to study Biochem, Physio, Neuro, Psych, Path, Pharm, Micro or Ethics either. So that begs the question why you signed up to be tortured for the next 4 years of your life whilst paying out of your ass for it?

Well it took me almost the entire first year of school to figure this one out. You'd figure someone who made it this far would be bright enough to conjure a silver lining somewhere in the midst of the shit-storm. Well, after a particularly rough final set of exams for Neuro, including a mini-board that was actually my worst exam performance in medical school, I did some soul searching. As with any good Irish fellow, my soul searching included copious amounts of whiskey and beer. I find that they help to slow down my brain to the point where instead of just making decisions based on the immediate situation, I take time to evaluate the entirety of the situation...it may sound like BS, but it works for me.

I looked at the big picture: Was this truly what I wanted? What am I doing here? What would I be doing otherwise? Why don't twinkies go bad for 40 years? Where did I put that bottle of scotch? You know, the important global questions.

I came up with a few very important answers that changed how I look at things:

1.) Medical School is not truly what I wanted out of life. Anyone who want's that is just plain SICK. What I wanted was to have a nice easy life where everything comes to me with minimal effort and I don't have to work very hard at all to get where I want, and I want oompa-loompas to bring me candy while I swim in a river of chocolate. That sort of life is not a possibility for me since my parents are neither wealthy nor willing to let me waste my life like that (and oompa-loompas aren't real either...sadly).

Short of that, what do I want out of life? I want to pay back my loans, to have a medium sized family and a good dog that will actually listen to me off the leash, to leave a lasting impression on a few of the people that I encounter in life and a job that changes on a daily basis and is somewhat unscripted so that I don't get too bored with it. In short, I want to look back on my life 45-50 years from now on my death bed and be able to say "Damn, that was a good life!" How can I have all of that? By going through with this beast.

2.) I am here at school to learn to be a physician. Physicians are not born, they are not pampered into existence. They are nearly ordinary people, broken down to a steaming pile of humanity by medical school, and then rebuilt into a slightly less steaming pile of humanity that is then baked by the heat of residency, forged by the flame of fellowship, and then made to crumble by the weight of debt, malpractice insurance, and CME obligations.

In other words, the training process sucks. It was designed by a bunch of single geeks at JHU with no aspirations outside of medicine. It always has sucked. It will suck more for the people that come after me...but it's not what the reality of your medical practice will be. If you can just look past the mountains of stuff that you have to learn in order to be certified competent by the NBME as a physician, you can then be tortured by a state liscencing board and allowed to pass and live your life how you want and take your career/life whereever you choose! I know it's tough when you're staring at Netter trying to memorize the Brachial Plexus (Roots, Trunks Divisions, Cords), but there is more to medicine than rote memorization.

3.) If I weren't here, I would probably be sitting in some analytical chemistry lab at some Ginormous Pharmaceutical Company in Connecticut (which shall remain nameless) pushing samples of the latest batch of "old-wrinkly-penis de-wrinkling" pills into a GC/MS while slowly growing my pension and counting down the days until I could retire. I could get married, pop out 1.5 kids, buy a modestly sized house in a modest neighbor hood, sending my kids to modest schools, living a modest life as quality inspection monitor number 1234 of 2000. There could be no imaginable fate worse than that for me. So whatever cool ideas that you've concocted in your exhausted, sleep-deprived mind as an excuse to quit, make them seem mundane and temper them with the fact that you'd have to pay for them somehow and the act of paying for them would take more time than the fun you'd actually have.

4.) Twinkies, Cockroaches and Dick Cheney will be the only things to survive the next nuclear holocaust. Hostess designed them as the perfect food, and well they did a little bit too good of a job. By the way, the bakery where the twinkie was originally created was torn down and replaced with a Nordstrom/Neiman Marcus. Hows that for progress??? Yeah, I got to visit (was dragged into) the Tiffany's that stands where the loading docks once were with the girlfriend a couple weekends ago...the place got a slightly different feel to it these days. I digress...

So anyway, Anonymous here's my advice, all wrapped up in a nice package:

-The first year of Medical School is not what the rest of your life will be like. You're studying random medically-related trivia at this point. Next year, you'll learn more medically relevant trivia, but it's when the good stuff your learned first year goes bad, which makes it slightly more interesting, like a Fox special. Third year, you lose all of your freedoms by becoming the lowest ranked person in the hospital...but you get to see patients and tell their stories to everyone else and pretend to be a doctor. Fourth year, they let you think you've learned something and allow you some freedom to sleep to choose what you do. Then depending on your specialty you get paid too little to work too much in residency for a few to several years. Finally, when all that's over, you can get a real job and have President Hillary Clinton (in her second term) signing your paycheck. (Or you can join the rebel forces and strike out on your own in private practice.) (Or you can avoid the whole ordeal and do a few fellowships and wait for the next fix.)

-It doesn't get better, you just learn to accept the crap they pile upon you more easily.
-You'll slowly realize that you will indeed, some day, need this knowledge to figure out what the hell is wrong with someone. That is why you're studying it after all.
-As much as this profession sucks, someone has to do it...it might as well be you doing it.

My suggestions
for the short term:
Go back and read the lies in your personal statement and secondaries, realize how naive you were. Laugh at yourself for not thinking this through better a year ago. Have a beer or 3. Write "I will not commit to 7 years of torture without thinking it through ever again" on a white board 50 times for emphasis. Pass out, wake up and remember the previous night from the white board, laugh because it's so true.

Medium Term:
Schedule a day to shadow in the ED of your school's affiliated hospital, put on your short white coat of indignation and listen to the patients' stories about why they're there, listen to the doctors' story about why they show up there day after day. Schedule a day in the Pediatric Oncology ward, read stories to the kids, play with them, talk to the doctors and nurses about why they go back to that floor day after day after day. Go to Hospice for a day, go to psych for a day. Lather, Rinse, Repeat with anyone else in the hospital.

Longer term
Go back to your room. Sit by yourself in the quiet and listen to why you're there. Write it down on your blog, read it whenever you're feeling like all of this isn't worth it. If you can't hear anything, you're not listening hard enough. If you honestly can't find one redeeming reason deep down in your soul to grab on to that makes all of this worth it, give up your spot, give as much of your loans back as you can, and get the hell out of dodge before you've bought a house that you'll never live in. Being miserable for the rest of your life is not worth a couple letters after your name.


What's the point?
Remember who you were, learn who you'll be, do something about it...that's all there is to it.

Best of luck
~Bostonian

Back in the saddle...

Well, I've had a busy past few weeks that have completely derailed my blogging. Between a transcontinental flight, baseball and barely surviving my path exam, I've been somewhat distracted. However, stay tuned for more regular updates to the drama that is my life. I'm going to try to mix in some different styles of writing other than just ranting about how much reading about/being tested on the pathological happenings of the human body sucks the life out of you. Stay tuned...
~Bostonian

PS- As much joy as I feel at the downfall of the Yankees, I also feel a great deal of empathy for Joe Torre and the position that he has been forced into by account of the maniacal George Steinbrenner III threats/whims. To quote Seinfeld: The man fires people like it's a bodily function

P=MD?

Well, I actually managed to survive and pass both of my exams. Path was probably the most angst-inducing exam that I have ever been subjected to. 3 hours, 168 questions. I'd say for about 20%, the extent of my knowledge of the subject was covered in the question and the answers were just flat out beyond what I had absorbed from the readings.

Micro was mercifully fair, except for the level of depth we were expected to know about fungi...which I neglected to cram into my already over-full brain. Overall, last friday was a rough go at it for me and I'll need to severely modify my exam preparation techniques if I'm going to make it out of this year alive. I questioned my worthiness as a medical student a few times, and even pondered a career in the fast food industry for a few minutes. But I survived, with only a few gray hairs to show for it.