Isn't it strange how quickly time flies?
If I earned a dollar for every time I heard that as an intern, I would likely end this year by walking up to the Gods of Residency and Improbable Living On A Little More Than Minimum Wage, coolly handing in my sickly, pen-and-crumb-stained coat and announcing, "Later, suckers - The Good Life just called, and it wants me back."
Or would I? Well, maybe it's my annoyingly evanescent, cheery, comeback-kid naivete speaking here, but...the answer for me is no. Apologies, grouchy, disillusioned doctor brethren .
(And somewhere, a prototypical wizened, gray-haired, overworked, be-spectacled physician-father still owing $10K in loans watches in despair as his bright-eyed five-year-old dresses up as a doctor for show-and-tell, and heaves a sigh: "Sonny, let me tell you: stay far away from medicine, okay? Go buy some lottery tickets. Or maybe try out for that famous show - what do they call it - American Idolism or somesuch?")
You see, after years of desensitization to such things as, say, watching thoracentesis procedure videos while chomping on a lunchtime salad, or thumbing through "Nummular Eczema and Guttate Psoriasis: A Diagnostician's Dilemma" powerpoints while sipping a nonfat extra-hot extra-foam cappuccino at Starbucks, medicine has gleefully invaded my soul. As a result, it's hard to imagine doing anything else, even if someone offered me an Out.(Unless, I suppose, such an Out involved being a Mystery Shopper at Anthropologie...or the person who gets paid to write those airplane magazine travel articles where they critique various 5 star hotels and fancy restaurants. Seriously! I'm good at that kind of thing: "The creme brulee at Chez Panisse, a delectable, buttery vanilla-infused flan capped with a crispy wafer of perfectly caramelized sugar coating, is the exclamation point on a sophisticated, blissful gastronomical sentence." Yes? Do any travel magazine writer scouts read this blog?)
That being said, no intern is immune to the Residency Rut.
The Residency Rut comes on slowly, insiduously, just as that once-pleasant salmon pink shade of daily progress notes begins to resemble partially digested Pepto Bismol. It's the point where days seem to congeal together in endless repeat...where the passage of time is measured in cycles of laundry (and renewed resolutions to purchase yet more underwear, until my entire closet is brimming with an endless supply of socks, underwear and scrubs - no more laundry!!), numbers of acne cream tubes (futilely, sigh) purchased, bottles of multivitamins consumed (Trader Joe's Gummi Bear Vitamins are my secret weapon in the battle against hospital food).
The Residency Rut, of course, in true medical form, carries its own pathognomonic signs and symptoms. A sampling:
- IOWS (I Only Wear Scrubs) Syndrome: the repudiation of the social norm of wearing tailored clothing in favor of sporting reversible, drawstring-based apparel to locales other than the hospital. Associated signs include more than 2 sets of scrubs in afflicted person's dressers, relegation of all non-sneaker shoes to the back of the closet due to disuse, and wearing of scrubs to public places such as grocery stores and gyms. As a result, the sensation of wearing jeans, slacks and dresses becomes strangely foreign (not to mention, rudely tight (yikes). Unfortunately, scrubs are false friends; that drawstring reassures you that you're svelte when in fact you've grown by half-a-person.
- Pen-Resistant White Coats: White coats are unable to succesfully contain a black ballpoint pen for longer than 2 minutes. This may, in turn, provoke the telltale reflex manifested by the seasoned resident - See Stray Pen on Table/Hand of Unsuspecting Fellow Resident; Mindlessly Grab and Place in Own Pocket.
- Weather Dissociation: Sunshine and blue skies become phenomena to be witnessed in snatches, i.e. through hospital windows in front of the seventh floor elevator as one makes their way down to the emergency room to admit a patient. Moreover, such glimpses underscore the truth of the anti-intern weather truism: the sun is guaranteed to be shining, the temperature beach-perfect and the air glorious precisely on the day you are on call.
- Food Pyramid Remodeling: The definition of "edible food" grows more inclusive, embracing such items as 2-day-old leftover pizza abandoned in a tepid resident lounge, or an 8-oz can of prune juice that beckons nonchalantly in the communal resident fridge. (I will name no names, but I have sighted a fellow resident sipping from a can of Ensure - vanilla flavor, to wit - one particularly brutal post-call morning.) As a result, the "food pyramid" transforms into a "food square" founded upon the four C's (Croissants, Coffee, Chocolate and diet Coke.)
- Mint Aversion: Okay, this one requires some background explanation. So let's face it, medicine is full of Smells. One's nose quickly learns that, in order to survive in the hospital, it must recalibrate, raising its threshold for defining a Truly Intolerable Olfactory Insult. But when a scent tests the limits of even this recalibrated nose - manifesting a "Code Brown" of sorts - hospital personnel know it's time to break out the CPR/defibrillator of olfactory codes: oil of wintergreen. Oil of wintergreen is the aromatic equivalent of a fire extinguisher: every unit has an emergency supply, stashed next to the unit assistant's secret (or not so secret anymore, heh heh) oatmeal raisin cookie supply. At the onset of the code, simply uncork the diminutive-appearing bottle and let the battle of the vapors begin. Unfortunately, the result is often a disconcerting olfactory tug-of-war wherein your nose and mind are conflicted (Brain: think wintergreen thoughts! think wintergreen thoughts! Isn't that wintergreen just so pleasantly non-malodorous? Nose: I don't care how much you try to brainwash me with dubious mint; there is some stank going on in here). In any case, the result of this odor antidote is that over time, an intern quickly develops a Pavlovian aversion to the scent of mint. It's like one veteran nurse confessed to me as we braved through one particularly challenging aromatic emergency: "I can never eat another York Peppermint Pattie again."
When the Residency Rut hits, there's only one antidote. That is: the rite of passage \of being an intern, otherwise known as Complaining.
By mid-year, interns are apt to crab about anything that is crabbable: cafeteria food, the weather, parking/driving/traffic, 4-hour rounds (too long), 1-hour rounds (not enough learning), sit-down rounds (too passive), walk rounds (too much exercise), overnight call, call until 7, call until 3, the very task of being in the hospital, too much autonomy, not enough autonomy, last-minute admissions, early-morning admissions, lack of space/computers/TV's/pager battery life/bathrooms/coffee cups/coat-pocket room, computer-based medical records (where did my note go? why did it delete my note? the computer ate my note! I HATE COMPUTERS), paper-based medical records (My hand hurts. Why is this paper pink? Writing notes is so 1998), messy handwriting, too many lectures, too few lectures, conference food (a favorite complaint), too many forms, paperwork, the smell on the sixth floor ward (okay, the smell on the sixth floor ward is a legitimate complaint - hands down wins the Most Minty Ward of 2009 award. What is going on up there??).
Talking to fellow interns across the nation, it seems that Complaining is a universal attribute of residency. It doesn't matter if you live in a place with four seasons (too much variation and high heating bills, can't wear open-toed shoes in the winter) or one (too boring, can't really justify coat/boots purchases); if you live in a bustling city (too crowded; expensive; parking nightmares; why are there so many people on the road at this hour??) or quaint town (nothing to do; dust storms; why are all my patients truck drivers?). Case in point: one might be mere minutes away from a glorious beach, living in a city with 300 days of sun. And yet, even this scenario carries complainability (where the complainants invariably seem to be So-calite females trying to find parking on a foggy Friday night in North Beach...)
Lest the gentle reader begins to perceive America's future doctors as a crop of whiny, ungrateful minions, let me hasten to elaborate a bit further on the role Complaining really carries. Much like oil of wintergreen's questionable efficacy in masking unseemly odors, Complaining - more accurately, commiserating - is a coping mechanism of sorts...if we didn't have some way to vent, we'd probably explode. (And you can imagine what that would do to patient care.) Every intern is going to experience the "I Got Slammed" days, which evolve somewhat like a bizarro, macabre "12 Days of Christmas": 12 hours of working; 11 hours since a real meal; 10 new admissions; 9 notes to write; 8 labs that didn't get drawn (and have to be re-ordered and re-followed up); 7 family members waiting for updates from you; 6 studies to chase down (and a hibernating radiologist that can't be found); 5 discharge paperwork sets to complete STAT; 4 consultants to call; 3 rectal exams to adminster; 2 patients that are crashing/hypotensive/septic, and - all together now - a pager on steroids.
In such cases, the bond of commiseration is part of what draws interns close together. Chances are, during those two-month marathon sessions without weekends off, there's someone else who can empathize with the plight of eating Cheerios and chocolate for dinner for a week straight. Or someone else who understands the incongruity of waking a soundly sleeping patient at 6:05 am to chirp contritely, "Hi Mrs. Adams! How's that diarrhea? And how are you feeling today? Uh - that is, before I, uh, rudely and inconsiderately woke you up from the rare snatches of actual decent sleep you managed to steal - sleep made all the more valuable in the context of your noisy neighbor who keeps yelling for the pirates to leave him alone?"
And then comes the turning point: where the trivialities, trials and tribulations of internship begin to transform from mint-green-scrub-filled monotony to a bizarre, Scrubs-esque, zany and quirky world to which You, gentle intern, have now gained access. It's like celebrity gossip - you're amused, enthralled and secretly drawn despite having a million catty things to say (oh come on. Don't pretend you didn't at least look at the picture of Seal with a mullet.
So here's to surviving the Residency Rut in one piece. Did I mention how much I miss having weekends off like normal people? Or how my brain has completely forgotten what it feels like to get 8 uninterrupted hours of sleep? Or how Trader Joe's just stopped making my favorite chocolate-chip date-nut bar? Or why we no longer have papaya at our morning conference breakfasts?
Grrr.
Thursday, April 30, 2009
Friday, March 20, 2009
Match Day Musings: A Blast From The Past
So for those of you in the know, last week marked a rather momentous occasion in the world of future doctors: Match Day.
This event, however, is more than a "Day". It's the culmination of four years of willingly adopting an alternate lifestyle: Friday nights in the anatomy lab trying to make sense of a cadaver's arteries and nerves; Friday nights on call struggling to subdue a hyperactive pager; Friday nights cramming the brachial plexus pathways and Krebs cycle enzymes to coax out a few extra points on Step 1 (somehow these tasks take on a special poignancy on Friday nights).
This is the Day of Reckoning, where the universe is supposed to right itself according to the karmic equations of justness, where finally (finally!) money (money!) is to be earned Doing Something I Truly Love (or for a certain subset of folks, Something That Truly Makes Bank). In some cases, the outcome appears not quite so karmically just, leading to the day's semi-bittersweet tinge. But, when the dust settles, there is still solace in the pretty awesome fact that yes, you're going to be a doctor.
So one year later, here I was, walking down the street to the hospital to take another night of call. The bars and lounges lining the street seemed to be pulsating with a particuarly heightened sense of happiness, brimming with rather, shall we say, "happy" looking individuals toasting their future careers. That's when it hit me: today was match day! I stopped for a second, surveyed the scene and smiled benignly, like a mom who sees her young child eagerly begging to take out the trash every day and clean up Fido's "mess" since he's now become a "big boy". Ah, the happy, happy innocence of youth.
In the spirit of nostalgia that such occasions always seem to bring, I managed to dig up my own innocently happy musings during Match Day 2008. Here it is, in honor of match day and all the stellar folks who are now going to - heh heh - be interns next year!
-------------------------------------------
Written on Match Day 2008
Congratulations! You win a million dollars!
Congratulations! You've won a lifetime supply of Loeffler Randall boots!
Congratulations! You have been hired as Zingerman's International Chocolate Cherry Bread and Magic Brownie Consultant, involving daily taste-testing responsibilities!
Okay, so maybe not literally any of the above. But on March 20, as my shaking fingers ripped open that little white envelope to read my destiny in internal medicine, it pretty much felt like the same thing. (Well, the Loeffler Randall boot thing might be slightly, just slightly, more amazing. But I digress.) All the dreary days spent in Step 1 and Step 2 studying limbo, running on the treadmill to the pleasant entertainment of anatomy and pharmacology flashcards, languishing in the scrub-wearing rut and clothing erosion of third year, nursing shoulder injuries from Overstuffed White Coat syndrome and Prolonged-Retracting-in-the-OR-itis, falling asleep in the middle of dinner post-call....After years of relative modesty ("Oh no, Ms. Jones, I'm not a doctor yet - still got a few years to go!" *insert pleasant hearty chuckle*) and acting as lowest rung on the totem pole ("Can I get you a refill on that motor oil acid backwash - uh, coffee?"), here, FINALLY, was our day to shine.
Yes, for those eternal cynics and naysayers out there, I'm fully aware that in just a few short months we will essentially go back to being both modest and the lowest rung on the totem pole once more. But let's just try to stay in the sentimental, mushy feel-good mood for the moment, hmm?
On match day, as M4s on the brink of being *real* doctors, we stood wiser and older (as - sigh - my cavernous undereye circles will attest...future business for some generous dermatologists in my class?); having whittled down our white coats to the essential tools and cheat sheets we needed (hint: incoming M1s, resist urge to buy $400 ophthalmoscope), finessed our history taking and physical skills to the point where we no longer spent 2 hours obtaining a careful review of systems from a new patient ("So what were you saying about that tingling in the middle of your left pinky toe that comes once a year? And can you tell me more about that problem you have with your teeth itching?"). After a nerve-wracking month of waiting, largely spent rehearsing the task of saying, artfully and convincingly, "Hi, I'm Dr. K and I'll be taking care of you today" without breaking into a cold sweat, here it manifested: our futures in medicine.
Of course, the moment of suspense was only intensified by the super long process, planned by the powers that be in your typical, drawn-out, let's-make-them-agonize-as-much-as-possible-to-give-them-their-money's-worth-since-they-did-pay-us-a-month's-rent-in-fees NRMP fashion.
So you all know about the month of waiting after ranking our choices in February. The next step happened three days ago (March 17), at 12 noon EST, where we all received a "Did I match?" email from the NRMP. Hopefully, this would inform all of us that "Congratulations! You have matched!" (If not, though, then one would get ready to Scramble.) I was all set to check my email exactly on time. However, at 12 noon EST, my moment of reckoning was slightly shattered by the fact I got pulled over for driving with an older license plate. Unfortunately, reasoning with the police officer that today was You Find Out If You Match Day, or that I was just coming out of Waiting to Find Out If and Where You Match Month didn't quite work. So, after driving home, carefully rescuing a screwdriver from the depths of my supply closet, cleaning up all the old shoeboxes, toilet paper rolls and batteries that came toppling down after removing said screwdriver, wrestling off my old plate in the freezing Ann Arbor wind and replacing it with the a snazzier BNX 9007 - and then lovingly placing my Obama '08 sticker I had just received in the mail on the dusty depths of my rear bumper - I finally turned on my computer and affirmed that, indeed, I had matched. Whew.
And now as I'm beginning to reflect that drawn-out NRMP style of information conveying, I guess I should come to the point and return to that memorable Match Day at the Sheraton three days later. Amidst swanky chandeliers, hors d'oeuvres and a throng of family and friends, us nascent matchees placed our names in a giant fishbowl and waited to be randomly selected to come up on stage, where (if our hands were functioning) we were to open our envelopes and share our fate with the entire class. Suspense was obviously the theme of the day -and not just to find out where you'd matched. Did I mention the huge bowl of $$ on stage, filled by contributions from generous faculty and not-so-generous M4s, to be gifted to the last person who was called?
With each name called, I found myself even more on edge, hoping that everyone had matched into a place they loved, waiting to see where friends and classmates had matched, awed by the stellar places that were read. And while there are always the initial disappointments and bittersweet moments, I think we did, overall, really well.
So, at this point, inquiring minds likely demand to know, what about me? Well, right smack in the middle of the pack, I finally got called up to stage. It's funny how almost every moment is just framed in minute detail: pushing back chair, standing up (smoothing down skirt to make sure none of those unflattering bumps or wrinkles would detract from zee moment - I mean, Match Day is picture haven!), taking deep breath, clutching onto wrinkled unspecified amount of money to deposit into fishbowl, maneuvering gingerly to stage, entering in the wrong direction at first and being gently guided to the other side, then walking across the stage, receiving the envelope of destiny from the Dean with my name printed in official Times New Roman, wondering tangentially why anyone would pick Times New Roman - such a blase, anti-climactic font, really - to convey such important news; wouldn't a more celebratory Castellon or embossed Cursiva be more appropriate?, tugging hard at the envelope with fumbling fingers to open it, wishing I hadn't clipped my nails quite so short because now I was having diffulty getting the damned thing open, finally extricating the little plain piece of paper and unfolding it, scanning down the page to read:
Congratulations! You have matched! (At least *this* was in bold.)
And then I discovered that, despite all the doubts and hand-wringing and second-guessing and more agonizing of the past month, I was looking at the program name of my Number One Choice. The program that I'd fell in love with when I interviewed, the one that spoke to my goals and interests in medicine, that appealed to me in its uniqueness and friendliness, and, yes, location. And this means: I'm moving to California! I will officially live in a box and pay a good 180% markup in rent - but I will be minutes from the beach! the mountains! the view! the fog! Peet's Coffee and Tea! Farmer's markets! my own gourmet salad fixings garden! and SF shopping!! I will ride up cute little crooked streets on my bike and stroll by Fisherman's Wharf and eat Ghirardelli chocolate and sourdough bread - on days off. So come visit me!
The rest of the day was pretty much a haze. One of the more memorable points was receiving a voice mail from my best friend in Texas, in which she stated, "At this point, there's only one thing that needs to be said-" and then proceeded to sing/rap our old song-to-blast-with-windows-down-anthem-of-college-days, 2Pac's "California Love". (I'd post it on here, but sadly, she's threatened to disown me if I ever make this fabulous message public.) I remember eating a lot of chocolate, hugging a lot of people, taking pictures and then celebrating a few hours later. Let's just suffice it to say that it was, overall, a pretty good day.
A good day, of course, but also definitely bittersweet...for those that didn't end up where they wanted, for those experiencing the disappointments that are invariably part of this day. Bittersweet for everyone leaving, I'd say, regardless of where they matched. Probably more than one of us felt that underlying sadness that comes from leaving the cocoon that you've called home for 4 years (or even longer) - the place, after all, that helped us to get where we're going next.
Ann Arbor, after all, is where I learned how college football can consume a city (and how fun it is to back a team that's actually good!), what exactly one means by "freezing fog advisory", proper usage of the nifty terms "catacorner" and "yooper", how to use one's hand to depict state geography, the intricacies of Thinsulate vs down vs fleece. This is where I bought my first Nalgene bottle (trust me, peer pressure forces you to have one in Ann Arbor), found that I could literally treat a grocery store as a second home (yea Whole Foods!! It has food, samples, free internet, chocolate, coffee, and bathrooms. What more do you need?), and that two little heavens on earth exist; one in a little place called Zingerman's Deli and the other Nichols Arboretum in full bloom. This is where I learned how gloriously beautiful spring is when it follows a nasty winter, the art of planting cherry tomatoes and cilantro on your patio, and how running from Dexter to Ann Arbor with brave souls from your class makes for a not-so-bad half-marathon. Oh yeah, and this is also where I learned all the medicine I know, too. (So, for the record, at least I have someone to blame. Heh. Heh.)
So - swallowing little old lump in throat - this is officially the transition to goodbye. Time to join the ranks of all the M4s unloading books, furniture, electronics, real estate, socks (yes, socks), and sundries to all those eager thrifty spenders in classes below me. And as I pack, I'm wondering: how on earth did I accumulate so many shoes in 4 years?? And, grrr, time to start going through and archiving the 4000-odd emails I have in my university webmail account, which apparently is - gasp! - being sent to cyberspace wasteland after we graduate. (And I thought they really loved me.) But apart from that, I'm clinging on to the good month or so I have of being a relaxed, cheery M4, awaiting graduation in May.
*********************
This event, however, is more than a "Day". It's the culmination of four years of willingly adopting an alternate lifestyle: Friday nights in the anatomy lab trying to make sense of a cadaver's arteries and nerves; Friday nights on call struggling to subdue a hyperactive pager; Friday nights cramming the brachial plexus pathways and Krebs cycle enzymes to coax out a few extra points on Step 1 (somehow these tasks take on a special poignancy on Friday nights).
This is the Day of Reckoning, where the universe is supposed to right itself according to the karmic equations of justness, where finally (finally!) money (money!) is to be earned Doing Something I Truly Love (or for a certain subset of folks, Something That Truly Makes Bank). In some cases, the outcome appears not quite so karmically just, leading to the day's semi-bittersweet tinge. But, when the dust settles, there is still solace in the pretty awesome fact that yes, you're going to be a doctor.
So one year later, here I was, walking down the street to the hospital to take another night of call. The bars and lounges lining the street seemed to be pulsating with a particuarly heightened sense of happiness, brimming with rather, shall we say, "happy" looking individuals toasting their future careers. That's when it hit me: today was match day! I stopped for a second, surveyed the scene and smiled benignly, like a mom who sees her young child eagerly begging to take out the trash every day and clean up Fido's "mess" since he's now become a "big boy". Ah, the happy, happy innocence of youth.
In the spirit of nostalgia that such occasions always seem to bring, I managed to dig up my own innocently happy musings during Match Day 2008. Here it is, in honor of match day and all the stellar folks who are now going to - heh heh - be interns next year!
-------------------------------------------
Written on Match Day 2008
Congratulations! You win a million dollars!
Congratulations! You've won a lifetime supply of Loeffler Randall boots!
Congratulations! You have been hired as Zingerman's International Chocolate Cherry Bread and Magic Brownie Consultant, involving daily taste-testing responsibilities!
Okay, so maybe not literally any of the above. But on March 20, as my shaking fingers ripped open that little white envelope to read my destiny in internal medicine, it pretty much felt like the same thing. (Well, the Loeffler Randall boot thing might be slightly, just slightly, more amazing. But I digress.) All the dreary days spent in Step 1 and Step 2 studying limbo, running on the treadmill to the pleasant entertainment of anatomy and pharmacology flashcards, languishing in the scrub-wearing rut and clothing erosion of third year, nursing shoulder injuries from Overstuffed White Coat syndrome and Prolonged-Retracting-in-the-OR-itis, falling asleep in the middle of dinner post-call....After years of relative modesty ("Oh no, Ms. Jones, I'm not a doctor yet - still got a few years to go!" *insert pleasant hearty chuckle*) and acting as lowest rung on the totem pole ("Can I get you a refill on that motor oil acid backwash - uh, coffee?"), here, FINALLY, was our day to shine.
Yes, for those eternal cynics and naysayers out there, I'm fully aware that in just a few short months we will essentially go back to being both modest and the lowest rung on the totem pole once more. But let's just try to stay in the sentimental, mushy feel-good mood for the moment, hmm?
On match day, as M4s on the brink of being *real* doctors, we stood wiser and older (as - sigh - my cavernous undereye circles will attest...future business for some generous dermatologists in my class?); having whittled down our white coats to the essential tools and cheat sheets we needed (hint: incoming M1s, resist urge to buy $400 ophthalmoscope), finessed our history taking and physical skills to the point where we no longer spent 2 hours obtaining a careful review of systems from a new patient ("So what were you saying about that tingling in the middle of your left pinky toe that comes once a year? And can you tell me more about that problem you have with your teeth itching?"). After a nerve-wracking month of waiting, largely spent rehearsing the task of saying, artfully and convincingly, "Hi, I'm Dr. K and I'll be taking care of you today" without breaking into a cold sweat, here it manifested: our futures in medicine.
Of course, the moment of suspense was only intensified by the super long process, planned by the powers that be in your typical, drawn-out, let's-make-them-agonize-as-much-as-possible-to-give-them-their-money's-worth-since-they-did-pay-us-a-month's-rent-in-fees NRMP fashion.
So you all know about the month of waiting after ranking our choices in February. The next step happened three days ago (March 17), at 12 noon EST, where we all received a "Did I match?" email from the NRMP. Hopefully, this would inform all of us that "Congratulations! You have matched!" (If not, though, then one would get ready to Scramble.) I was all set to check my email exactly on time. However, at 12 noon EST, my moment of reckoning was slightly shattered by the fact I got pulled over for driving with an older license plate. Unfortunately, reasoning with the police officer that today was You Find Out If You Match Day, or that I was just coming out of Waiting to Find Out If and Where You Match Month didn't quite work. So, after driving home, carefully rescuing a screwdriver from the depths of my supply closet, cleaning up all the old shoeboxes, toilet paper rolls and batteries that came toppling down after removing said screwdriver, wrestling off my old plate in the freezing Ann Arbor wind and replacing it with the a snazzier BNX 9007 - and then lovingly placing my Obama '08 sticker I had just received in the mail on the dusty depths of my rear bumper - I finally turned on my computer and affirmed that, indeed, I had matched. Whew.
And now as I'm beginning to reflect that drawn-out NRMP style of information conveying, I guess I should come to the point and return to that memorable Match Day at the Sheraton three days later. Amidst swanky chandeliers, hors d'oeuvres and a throng of family and friends, us nascent matchees placed our names in a giant fishbowl and waited to be randomly selected to come up on stage, where (if our hands were functioning) we were to open our envelopes and share our fate with the entire class. Suspense was obviously the theme of the day -and not just to find out where you'd matched. Did I mention the huge bowl of $$ on stage, filled by contributions from generous faculty and not-so-generous M4s, to be gifted to the last person who was called?
With each name called, I found myself even more on edge, hoping that everyone had matched into a place they loved, waiting to see where friends and classmates had matched, awed by the stellar places that were read. And while there are always the initial disappointments and bittersweet moments, I think we did, overall, really well.
So, at this point, inquiring minds likely demand to know, what about me? Well, right smack in the middle of the pack, I finally got called up to stage. It's funny how almost every moment is just framed in minute detail: pushing back chair, standing up (smoothing down skirt to make sure none of those unflattering bumps or wrinkles would detract from zee moment - I mean, Match Day is picture haven!), taking deep breath, clutching onto wrinkled unspecified amount of money to deposit into fishbowl, maneuvering gingerly to stage, entering in the wrong direction at first and being gently guided to the other side, then walking across the stage, receiving the envelope of destiny from the Dean with my name printed in official Times New Roman, wondering tangentially why anyone would pick Times New Roman - such a blase, anti-climactic font, really - to convey such important news; wouldn't a more celebratory Castellon or embossed Cursiva be more appropriate?, tugging hard at the envelope with fumbling fingers to open it, wishing I hadn't clipped my nails quite so short because now I was having diffulty getting the damned thing open, finally extricating the little plain piece of paper and unfolding it, scanning down the page to read:
Congratulations! You have matched! (At least *this* was in bold.)
And then I discovered that, despite all the doubts and hand-wringing and second-guessing and more agonizing of the past month, I was looking at the program name of my Number One Choice. The program that I'd fell in love with when I interviewed, the one that spoke to my goals and interests in medicine, that appealed to me in its uniqueness and friendliness, and, yes, location. And this means: I'm moving to California! I will officially live in a box and pay a good 180% markup in rent - but I will be minutes from the beach! the mountains! the view! the fog! Peet's Coffee and Tea! Farmer's markets! my own gourmet salad fixings garden! and SF shopping!! I will ride up cute little crooked streets on my bike and stroll by Fisherman's Wharf and eat Ghirardelli chocolate and sourdough bread - on days off. So come visit me!
The rest of the day was pretty much a haze. One of the more memorable points was receiving a voice mail from my best friend in Texas, in which she stated, "At this point, there's only one thing that needs to be said-" and then proceeded to sing/rap our old song-to-blast-with-windows-down-anthem-of-college-days, 2Pac's "California Love". (I'd post it on here, but sadly, she's threatened to disown me if I ever make this fabulous message public.) I remember eating a lot of chocolate, hugging a lot of people, taking pictures and then celebrating a few hours later. Let's just suffice it to say that it was, overall, a pretty good day.
A good day, of course, but also definitely bittersweet...for those that didn't end up where they wanted, for those experiencing the disappointments that are invariably part of this day. Bittersweet for everyone leaving, I'd say, regardless of where they matched. Probably more than one of us felt that underlying sadness that comes from leaving the cocoon that you've called home for 4 years (or even longer) - the place, after all, that helped us to get where we're going next.
Ann Arbor, after all, is where I learned how college football can consume a city (and how fun it is to back a team that's actually good!), what exactly one means by "freezing fog advisory", proper usage of the nifty terms "catacorner" and "yooper", how to use one's hand to depict state geography, the intricacies of Thinsulate vs down vs fleece. This is where I bought my first Nalgene bottle (trust me, peer pressure forces you to have one in Ann Arbor), found that I could literally treat a grocery store as a second home (yea Whole Foods!! It has food, samples, free internet, chocolate, coffee, and bathrooms. What more do you need?), and that two little heavens on earth exist; one in a little place called Zingerman's Deli and the other Nichols Arboretum in full bloom. This is where I learned how gloriously beautiful spring is when it follows a nasty winter, the art of planting cherry tomatoes and cilantro on your patio, and how running from Dexter to Ann Arbor with brave souls from your class makes for a not-so-bad half-marathon. Oh yeah, and this is also where I learned all the medicine I know, too. (So, for the record, at least I have someone to blame. Heh. Heh.)
So - swallowing little old lump in throat - this is officially the transition to goodbye. Time to join the ranks of all the M4s unloading books, furniture, electronics, real estate, socks (yes, socks), and sundries to all those eager thrifty spenders in classes below me. And as I pack, I'm wondering: how on earth did I accumulate so many shoes in 4 years?? And, grrr, time to start going through and archiving the 4000-odd emails I have in my university webmail account, which apparently is - gasp! - being sent to cyberspace wasteland after we graduate. (And I thought they really loved me.) But apart from that, I'm clinging on to the good month or so I have of being a relaxed, cheery M4, awaiting graduation in May.
*********************
Thursday, February 12, 2009
From Hollywood to the Hospital: Redefining Glamour
For the naive, happy, carefree outsider, the world of medicine often carries an oddly "glamorous" mystique. For proof, we look at Popular Media, where the glory of doctordom is handily presented in broad strokes: 5-second miracle brain transplants, routine chest-cracking/bare-hand heart massage and placenta-less, assembly-line pregnancies. In this world, general anesthesia is essentially a formality, replaced by the swoon-inducing, sheer hotness wattage of budding Patrick Dempseys and Katherine Heigls.
The media mystique is pervasive:
- You've got doctor soap operas featuring chiseled, Botoxed doctors barking "Nurse, scalpel, STAT!" as they powerfully steer gleaming gurneys through endless hallways, while scandals fester in deceptively innocent supply closets.
- You've got cheesy doctor documentaries with the token James-Earl-Jones-esque baritone gravely narrating things like, "The young boy's heart had stopped beating and all hope seemed lost - when finally, Dr. Smith decided to take a chance on a miracle", accompanied by some kind of backwards-ticking digital clock and a beeping red heart rhythm pulsing ominously on the screen.
- You've got doctor beach-lit featuring a tortured young doctor-protagonist questing after a tainted stethoscope which has been implanted with a timed-release, deadly diarrhea-inducing virus and is now spreading the runs among patients with each auscultation. (This, sadly, could actually be real life. Reader, meet C difficile.
- You've got beanie babies inspired by loveable, charismatic interns such as yours truly. (Come on! The Obama girls are too glamorous to be anything but doctors when they grow up.)
In 2008, 31,000 people applied to jump on the medicine glamour bandwagon in 2008 - and that's 31,000 people who are clearly not reading this blog. (Perhaps, by listing this statistic, I could be part of the search results for "number of applicants to medical school", which Google reports has been searched for 5,833,000 times. Talk about instant increase in blog readership!) At least some of them (or their parents) must have been motivated by the seeming panacea of glamour offered by the M-bomb. After all, what better way to quickly sum up the biodata of "steady-income-earning potential with requisite intelligence, strong likelihood of compassion, PLUS a lifetime of free medical consultation bypassing hours of flipping idly through backdated issues of Golf Digest in a cramped doctor's office" than simply attaching the "M.D." after your name?
Ah, glamour. In former, naive, pre-internship times, I thought the term referred to things like strappy patent leather high heels, Paris, Fred Leighton drop earrings, spelling glamour with a "u". Back then, I also used an eyelash curler, sometimes read Dostoevsky and Sedaris by a crackling fire, served as an upstanding member of the DSW Frequent Shopper Rewards club, lovingly tended to a clothing collection which conspicuously lacked drawstrings, reversibility, and the color group "sickly pale green".
Then, I entered the world of medicine.
Some people think the hardest part of medicine is getting used to the "blood and guts". Tales abound of the 6'2, broad-shouldered football player who faints at the sight of an IV line or the neophyte intern who trembles with nausea after smelling the yeast growing under her patient's pannus. Sure, there's weeping ulcers, bile-stained dressings, toenail fungus, prolapsed hemorrhoids, inflamed follicles, oozing pustules, frothy sputum, ecchymoses, furuncles, liver spots, blood-streaked stool, tarry stool, fatty stool (sorry, there's a lot of stool). But forget all that. The hardest part of medicine in a nutshell? Quite simply: the sacrifice of the wardrobe.
At first, my natural instincts protested against the scrubification of my soul. You see, in those pre-medicine days, I was an ardent follower of the venerable art of wardrobe sciences, the reigning neighborhood shopping marathon endurance champion. I was the kind of shopper who obsesses over the subtleties of onyx vs jet black, who tries on two (seemingly!) identical pairs of the SAME SIZE trouser jean to evaluate subtle, sub-size/style variations in fit or wash, who navigates to fitting rooms using only smell, memory and touch due to the tower of clothes in her arms obscuring her vision. I curated my closet with the same fervency and dedication of a Smithsonian expert, organizing clothes by color, texture, season, temperament/mood, number of compliments (or odd stares) received.
And then, one fine day while journeying along the path to medicine, I suddenly found myself facing the prospect of obtaining my outfit from a vending machine.
I stared into the bowels of the behemoth, Darth-Vader-like automaton ScrubVendor TM, where rows of puke-green 70% polyester cylindrical bundles appeared to mock me, daring me to select them. The prospect of donning a pair of drawstring pants in my early 20s - not just any drawstring pants, but a pair of bunchy, tapered, thigh-enhancing, leg-shortening, crotch-disfiguring pants - flooded over me; feeling suddenly faint, I grabbed onto a chair for support. I briefly contemplated quitting medical school, then decided to furtively drive 30 miles to a specialty store to pick up a tailored pair of boot-cut, low-rise scrubs.
For a while, I continued to stubbornly resist enculturation into the world of medical fashion, determined not to be taken in by the temptations of tackiness marauding as socially acceptable norms. I boycotted clogs, refused to pair scrub tops with jeans/ khakis/mismatched scrub bottoms, never wore a scrub top without at least one "safety shirt" underneath, and of course, never, EVER did things like wear scrubs to the grocery store or the gym. Even as the anemic green rags snickered with a tempting, mindless, just-choose-me-I'm-so-convenient appeal at the fashion-challenged hours of 4am, I resolutely marched to my closet, determined to exercise my brain cells in choosing a real outfit that reflected my mood (needless to say, there were several outfits consisting of black, metal chains and spiked cuffs). While every other (sane) individual soft-shoed around the tiled hospital floors in ergonomic harmony, I was the one clack-clacking away in 3-inch heels, inciting intrigued/annoyed glances from nurses and unit assistants shopping for Louboutins on eBay/trying to reconcile medications.
But of course, like so much else, things change. Maybe it was the time I was sitting on a swivel chair, clad in a flowy A-line skirt and cognac pointy-toed heels, grasping a pair of heavy-duty pliers with one hand and the callused, toenail-fungus-ridden diabetic foot of a schizophrenic patient in the other, trying to complete the assigned task of removing said toenails with said pliers. Or perhaps it was the time the intoxicated college student in whose arm I was trying to place an IV decided to wake up and retch all over my camel-wool trousers and tie-neck blouse (at least the boots were spared!) Or maybe, it was waking up at an ungodly hour one morning and realizing that by wearing scrubs I could snag an extra fifteen minutes of beautiful sleep!!. That was it. The shapeless, tapered duds went on. A thunderclap was heard, and somewhere the evil denizens of de-fashionization cackled and rubbed their hands in glee.
Clearly, the glamour of medicine does not emanate from its wardrobe. It's also not likely to stem from the routine tasks of internship (see: Bowels, Idiosyncracies of; Missing Studies/Tests/Labs, follow-up of and endless waiting for; Google/Wikipedia, worship of; Agitated Patient, calming of; Mysterious Dizziness in 32-kg, 125-year old gentleman, lengthy workup of; Chicken With Head Cut Off, constantly running around like.) To be honest, it's probably more glamorous to be a resident of Albert, Texas - just think: if you had twins, you could almost double the population!
But even if it's not glamour in, say, the we-are-all-devastatingly-attractive-and-scandalous Grey's Anatomy sense, there is still something extraordinary about being part of the fold - about being one of the scrub-clad army of neophyte physicians. It's funny, the way it works. When the thin catheter you're inserting in a patient's chest suddenly slides in perfectly and the cloudy fluid drowning his lungs finally starts to drain; when you suddenly connect textbook facts in the context of your patient to arrive at a diagnosis; when you update a patient's family member and realize that they actually seem to trust and respect your opinion - that heady rush of "specialness" sort of hits, as close as I've gotten to sensing the M.D. glamour. But invariably, it's at these very moments that my undereye circles are their most cavernous, my stomach is likely staging a vocal, Graham-Crackers-Are-Not-Enough-themed protest, my scrubs seem especially ill-fitting, or my stethoscope is once again yoking me unceremoniously and un-glamorously to the doorjamb. Go figure.
So pshaw, TLC. You don't want no scrub? Pass 'em to me. They may get no love from you, but I know how to work it.
The media mystique is pervasive:
- You've got doctor soap operas featuring chiseled, Botoxed doctors barking "Nurse, scalpel, STAT!" as they powerfully steer gleaming gurneys through endless hallways, while scandals fester in deceptively innocent supply closets.
- You've got cheesy doctor documentaries with the token James-Earl-Jones-esque baritone gravely narrating things like, "The young boy's heart had stopped beating and all hope seemed lost - when finally, Dr. Smith decided to take a chance on a miracle", accompanied by some kind of backwards-ticking digital clock and a beeping red heart rhythm pulsing ominously on the screen.
- You've got doctor beach-lit featuring a tortured young doctor-protagonist questing after a tainted stethoscope which has been implanted with a timed-release, deadly diarrhea-inducing virus and is now spreading the runs among patients with each auscultation. (This, sadly, could actually be real life. Reader, meet C difficile.
- You've got beanie babies inspired by loveable, charismatic interns such as yours truly. (Come on! The Obama girls are too glamorous to be anything but doctors when they grow up.)
In 2008, 31,000 people applied to jump on the medicine glamour bandwagon in 2008 - and that's 31,000 people who are clearly not reading this blog. (Perhaps, by listing this statistic, I could be part of the search results for "number of applicants to medical school", which Google reports has been searched for 5,833,000 times. Talk about instant increase in blog readership!) At least some of them (or their parents) must have been motivated by the seeming panacea of glamour offered by the M-bomb. After all, what better way to quickly sum up the biodata of "steady-income-earning potential with requisite intelligence, strong likelihood of compassion, PLUS a lifetime of free medical consultation bypassing hours of flipping idly through backdated issues of Golf Digest in a cramped doctor's office" than simply attaching the "M.D." after your name?
Ah, glamour. In former, naive, pre-internship times, I thought the term referred to things like strappy patent leather high heels, Paris, Fred Leighton drop earrings, spelling glamour with a "u". Back then, I also used an eyelash curler, sometimes read Dostoevsky and Sedaris by a crackling fire, served as an upstanding member of the DSW Frequent Shopper Rewards club, lovingly tended to a clothing collection which conspicuously lacked drawstrings, reversibility, and the color group "sickly pale green".
Then, I entered the world of medicine.
Some people think the hardest part of medicine is getting used to the "blood and guts". Tales abound of the 6'2, broad-shouldered football player who faints at the sight of an IV line or the neophyte intern who trembles with nausea after smelling the yeast growing under her patient's pannus. Sure, there's weeping ulcers, bile-stained dressings, toenail fungus, prolapsed hemorrhoids, inflamed follicles, oozing pustules, frothy sputum, ecchymoses, furuncles, liver spots, blood-streaked stool, tarry stool, fatty stool (sorry, there's a lot of stool). But forget all that. The hardest part of medicine in a nutshell? Quite simply: the sacrifice of the wardrobe.
At first, my natural instincts protested against the scrubification of my soul. You see, in those pre-medicine days, I was an ardent follower of the venerable art of wardrobe sciences, the reigning neighborhood shopping marathon endurance champion. I was the kind of shopper who obsesses over the subtleties of onyx vs jet black, who tries on two (seemingly!) identical pairs of the SAME SIZE trouser jean to evaluate subtle, sub-size/style variations in fit or wash, who navigates to fitting rooms using only smell, memory and touch due to the tower of clothes in her arms obscuring her vision. I curated my closet with the same fervency and dedication of a Smithsonian expert, organizing clothes by color, texture, season, temperament/mood, number of compliments (or odd stares) received.
And then, one fine day while journeying along the path to medicine, I suddenly found myself facing the prospect of obtaining my outfit from a vending machine.
I stared into the bowels of the behemoth, Darth-Vader-like automaton ScrubVendor TM, where rows of puke-green 70% polyester cylindrical bundles appeared to mock me, daring me to select them. The prospect of donning a pair of drawstring pants in my early 20s - not just any drawstring pants, but a pair of bunchy, tapered, thigh-enhancing, leg-shortening, crotch-disfiguring pants - flooded over me; feeling suddenly faint, I grabbed onto a chair for support. I briefly contemplated quitting medical school, then decided to furtively drive 30 miles to a specialty store to pick up a tailored pair of boot-cut, low-rise scrubs.
For a while, I continued to stubbornly resist enculturation into the world of medical fashion, determined not to be taken in by the temptations of tackiness marauding as socially acceptable norms. I boycotted clogs, refused to pair scrub tops with jeans/ khakis/mismatched scrub bottoms, never wore a scrub top without at least one "safety shirt" underneath, and of course, never, EVER did things like wear scrubs to the grocery store or the gym. Even as the anemic green rags snickered with a tempting, mindless, just-choose-me-I'm-so-convenient appeal at the fashion-challenged hours of 4am, I resolutely marched to my closet, determined to exercise my brain cells in choosing a real outfit that reflected my mood (needless to say, there were several outfits consisting of black, metal chains and spiked cuffs). While every other (sane) individual soft-shoed around the tiled hospital floors in ergonomic harmony, I was the one clack-clacking away in 3-inch heels, inciting intrigued/annoyed glances from nurses and unit assistants shopping for Louboutins on eBay/trying to reconcile medications.
But of course, like so much else, things change. Maybe it was the time I was sitting on a swivel chair, clad in a flowy A-line skirt and cognac pointy-toed heels, grasping a pair of heavy-duty pliers with one hand and the callused, toenail-fungus-ridden diabetic foot of a schizophrenic patient in the other, trying to complete the assigned task of removing said toenails with said pliers. Or perhaps it was the time the intoxicated college student in whose arm I was trying to place an IV decided to wake up and retch all over my camel-wool trousers and tie-neck blouse (at least the boots were spared!) Or maybe, it was waking up at an ungodly hour one morning and realizing that by wearing scrubs I could snag an extra fifteen minutes of beautiful sleep!!. That was it. The shapeless, tapered duds went on. A thunderclap was heard, and somewhere the evil denizens of de-fashionization cackled and rubbed their hands in glee.
Clearly, the glamour of medicine does not emanate from its wardrobe. It's also not likely to stem from the routine tasks of internship (see: Bowels, Idiosyncracies of; Missing Studies/Tests/Labs, follow-up of and endless waiting for; Google/Wikipedia, worship of; Agitated Patient, calming of; Mysterious Dizziness in 32-kg, 125-year old gentleman, lengthy workup of; Chicken With Head Cut Off, constantly running around like.) To be honest, it's probably more glamorous to be a resident of Albert, Texas - just think: if you had twins, you could almost double the population!
But even if it's not glamour in, say, the we-are-all-devastatingly-attractive-and-scandalous Grey's Anatomy sense, there is still something extraordinary about being part of the fold - about being one of the scrub-clad army of neophyte physicians. It's funny, the way it works. When the thin catheter you're inserting in a patient's chest suddenly slides in perfectly and the cloudy fluid drowning his lungs finally starts to drain; when you suddenly connect textbook facts in the context of your patient to arrive at a diagnosis; when you update a patient's family member and realize that they actually seem to trust and respect your opinion - that heady rush of "specialness" sort of hits, as close as I've gotten to sensing the M.D. glamour. But invariably, it's at these very moments that my undereye circles are their most cavernous, my stomach is likely staging a vocal, Graham-Crackers-Are-Not-Enough-themed protest, my scrubs seem especially ill-fitting, or my stethoscope is once again yoking me unceremoniously and un-glamorously to the doorjamb. Go figure.
So pshaw, TLC. You don't want no scrub? Pass 'em to me. They may get no love from you, but I know how to work it.
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