A Certain Kind of Experience

Internships are about experience, unless you’re going on to a residency. Which most people aren’t or can’t anyway. Why would you want to get crap pay for experience you could (in most cases) get elsewhere along with better wages, benefits, and where you might even get treated like a real person?

Saying something like this is unpopular and frowned upon. But I still feel like it’s true. So long as you have good mentorship, does it really matter if you’re an intern or “just” a newbie associate? And don’t tell me that the ‘mentorship’ part is the difference. There are awesome mentors both in official internship slots and at private practices. There are also crappy places on either end.  And sometimes it’s not even that there are or are not good mentors so much as a problem meshing and working well together.

I just don’t get it. I could see myself specializing a couple of different ways, but none of them involve going into a random internship for general experience with no plans of residency.

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Haunted Signs

I pass by a Chevron station every morning on my way in to the hospital. I buy gas there too sometimes, but mostly I just pass by as I am trying to maintain consciousness and suck down my coffee. I think the electronic sign that displays the gas prices is haunted. Because most mornings, probably four out of five of then, the sign goes all wonky, stops displaying the price, and starts showing random shapes (or as random as is possible given the limited conformations of the digital readout)  for about one full second as I approach before reverting to pretending to be a normal, non-haunted, sign and telling me gas is $3.23 today. This happened the first few times without me thinking much beyond it being strange and perhaps wondering if there was a short. It does not happen in the evening or the afternoon if I pass by, only in the morning though.

After the first few times, catching it out of the corner of my eye and thinking it strange, I began to actually watch it. When it still did the weird creepy-movie-dream-sequence non-numbers flash I began to wonder if I was crazy. Was I seeing things? Imagining them? It’s been happening for several months and the rest of my life has continued without someone offering me the choice between any red and blue pills, so I have begun to accept that there is probably something odd going on. If I was crazy, I would hope that it would show in more ways than this one, very limited, less than spectacular way. If I’m gonna be nutso, I want to be batshit, white coat, rubber room crazy, thank you very much.

I can really only think of two possibilities beyond crazy though. The first, more ‘logical’ explaination is that there is a super-bored attendant sitting and waiting for me to pass by in the mornings so he can press a button and freak me out. This seems even less likely than something bizzarre or supernatural for the following reasons: 1. Seriously, how bored would you have to be? 2. It assumes an astounding level of narcissism- why would he select MY pickup to taunt? 3. He would have to watch like a hawk. I do not go by at a consistent time daily. All in all, I consider the actual likelyhood of this being possible to be less than the likeyhood of the supernatural.

Which leaves weirder options. Does my 1995 pickup truck emit some sort of crazy electromagnetic interference that fucks with the sign? If so, how? Or, as I mentioned, either the sign, my pickup, or both are haunted or inhabited by gremlins that think it is either funny to mess with me, or they like talking to each other as I pass by. I don’t know what it means that I have accepted that this may be the most likely possibility.

 

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Circles to Left of Me

Being a professional is an odd headspace for those of us new to it. I have been a student all my life. Yeah, I graduated to secondary school, then to college and learned what life as a college student was all about. It was and wasn’t different than that of a high schooler in different ways. My college promoted responsible drinking, which is to say, they didn’t punish you for being smart and going to the health center (or your roomie for hauling your drunk ass there) if you drank to much rather than secretly hiding in your room and dying of alcohol poisoning. That was different from high school. And the easy access to pot.

Then again, that was probably just because I was too determined to get into college and follow my medical dreams to take advantage of the fact that one of the high school teachers dealt pot to students for nearly twenty years before he was caught/retired my senior year. Many of my friends smoked pot though. I still hold that if I was ruler of the world, pot would be legal and cigarettes wouldn’t be. Not that even in college I smoked much weed. I am a terrible smoker- I cough and hack and it’s just not fun for anyone. The high is fine, but getting there may or may not be worth it depending on my mood. Pot brownies on the other hand, those are good clean fun for everyone. I have fond memories of driving a (very) stoned friend to the store for brownie mix. Because that was how we rolled- no one was allowed to pressure anyone else to drink or smoke, and you sure as hell better not let anyone of your friends find out you had even thought of driving under the influence when there are plenty of folks about who would happily give you a ride for a tasty treat after the fact, or just the moral superiority and hilarity of watching your buddies behave like buffoons.

Undergrad was a good time. I enjoyed it. Not as much as some others maybe, but enough to have accumulated fond memories. I think being a humanities person had something to do with it though. Late night discussions about the history of the ramen noodle and the embargo on cuban cigars were always par for the course. Then I go and get myself into a professional medical school. Where people have NO humanities skills, FEW social skills, and can’t read literature or write a simple opinion paper. It’s all sorts of fucked up. You tell me you need a 20 page paper? I may bitch and moan, but there is no question I can get it to you by Friday if need be. Some of my soon to be collegues might have a heart attack.

How did you people get to (almost) be doctors when you cannot write? I have read some papers by these people, on topics of their own choosing, that made me want to scoop my eyes out with a rusty spork. Yes, they can do multivariate calculus (so can I btw, it’s actually pretty fun) but they cannot communicate in writing, and some can’t even do it verbally. The social and coping skills are to match. So I look at this group of professionals I will be sharing breathing room with for the rest of my career and I wonder.

I can do all the things they can do. To some extent, anyway, we all have our strengths and weaknesses of course. But I can do these things, AND I can also do other things. I WANT this to be my career, but I could make a living a dozen other ways too if I had to. So while I feel I am a complete and almost certified member of this professional circle, I also feel like I am still part of another circle. Another circle who knows that there is Art to Medicine, not just science. I hope that more of the folks in the one circle learn to come share my second circle with me too, or it is going to get lonely in here.

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Post Exam Letdown

Exhaustion? Failure? Surrender?

It is now a full day after the most important test in my life. Unfortunately, I do not think I am exaggerating. This test was years in coming and I have spent the last three and a half year and tens of thousands of dollars preparing for it. Then I had the privilage of paying $550 dollars in order to spend seven and a half hours in front of a computer screen taking it. I have had the last three weeks ‘off.’ Meaning that none of my normal duties were required, but I studied. And studied. And then happened to study some more from a different resource. I find out if I passed sometime after the new year

The days immediately before the test were an oddly surreal time. The thing, the thing that had been the focus of so much time, energy and pain was nearly at hand. There were moments of odd surrender when I knew that there was no time left. What I did not know by now was not going to be learned in the feverishly panicked moments that I spent reading over and over and going through lists once more. But during those panicky moment I KNEW that if I failed by just a little, just a few points, I would know that I should have studied that one chart, that one packet, just that much more closely.

I ate terribly. I did not exercise. I had beer, wine, and spirits in occasional blowouts or blowups of stress. My stomach began to revolt and tried to dissolve itself in protest. I did not enjoy the last few days before this exam. I would pass people in the hallways of the hospital and shoot random questions at them. What drug do they think would be most effective for this disease? If you open a patient up with this condition, what organ will you see first? What would these symptoms mean to you if the patient was from this certain geographical region. And, most of all, which bacteria/virus/parasite/fungus/toxin/etc causes X, Y, or Z? It would be accurate to say that this test consumed my life for a while.

Then, I went and took it and if I had to guess, I’d say I failed. But that’s what everyone says they feel like. Often with very colorful language just before they go binge drinking to purge the memories. I am no different. Fortunately, something like 90% of applicants that are qualified to sit for the test do pass it. So on that end, at least, odds are good, and that really is some small comfort. The misery loves company sort of comfort.

Today was an odd day though. There is still much I have to do, most of it on a timeline and all of it requiring a significant outlay of effort, but I feel entirely disconnected. I feel like I am severely hung over. I am exhausted and feel slightly sick. I am sore, my stomach is still unhappy, and I can barely stay awake. I want nothing more than to melt away and have no responsibilities for a good while. The fear that has been driving me is gone, and apparently in it’s grasp, everything else has been worn away. I’d be surprised if I do not come down ill with something after this, just because so much stress for so long and not taking care of one’s health followed by a break seems to be the recipe for a cold. I got the flu vaccine just for this, so that I am less likely to be taken advantage of by that opportunistic viral demon.

Now that the fear has faded, I hope I can learn to be a real person again in the oncoming weeks.

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Mood Swings

What the hell is up with mood swings? Sometimes they make sense, if something particularly unpleasant or something awesome happens, it would make sense from you mood to become sad or happy. But I don’t really understand the random, for no reason blahs. Or worse, the sudden inexplicable onset of the desire to smash something into itty bitty pieces.

According to a quick google search, these swings mean that I may have manic-depressive tendencies, be deficient in B vitamins, or I may be smoking too much pot. That’s an interesting trifecta of possibilities, but I’m going to tend towards it being the combination of Boards happening soon, a paper and presentation happening soon, having to travel soon and the stress of feeling completely unprepared for all of them.

There are many things I could do to combat this. Go for a walk, meditate, medicate, prepare, plan, study. But actually enacting any of these possible plans would require a little thing called motivation which the anger has apparently eaten. Instead I am typing. Because it is a sideways activity, meaning it neither takes the energy fixing the issue would, nor does it aggravate it. Sideways it is.

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Philosophy Evolution on the Personal Scale

I recently realized that I have developed a personal philosophy. I’m not really sure when it arose, or at what rate. It definitely grew plantlike. A little seed settled in some corner and found a receptive environment. It settled and swelled and finally germinated. The the little roots began to sink in. Deeper and deeper they found purchase as only a nubbin rose up. The little leaves, the cotyledons, bore virtually no resemblance to what it would become with time and the right environment, but they were there. Easily overlooked and mistaken for every other plantlet it continued to grow amongst the weeds until such a height and distinctiveness of maturing leaves kindled a faint recognition. A thought that there was something familiar about this one.

Then, some event. A drought, a fire, a landslide revealed this growth for what it was. While all else was swept or burned away, this one, deeply rooted and grown strong remained and stood tall and was recognized.

I imaging this is how it goes for many people, though certainly not all. Folks strong of faith in their religion I imagine to have a strong awareness of philosophy from a much earlier age than I, just because it is taught and named rather than discovered. I am sure that produces its own struggles and challenges, but I am equally sure that they are somewhat different. I was never given a guiding light as a child. I built my own lantern out of construction paper and toothpicks to start with, and only now do I have something that feels clear and sturdy. And while mine may bear similarity to others, that is more a facet of analogous evolution for similar, basic human needs and motivations than by design.

And in my philosophy, serenity plays a huge role. Think of the monk on a distant mountain chanting to the winds. That is my ideal. Serenity, harmony, balance with the world. To that end, I appreciate the Serenity Prayer. I’d like it even better sans the whole ‘god’ bit, but it is well known, and when things are well known, it makes it easier to communicate meaning. You can say to someone, “You know about that thing there? It’s like that,” with some confidence you’ll actually be communicating your meaning to them. It’s like having the nature guide book- the one with all the plants and pictures in it over the different seasons and being able to point at the pictures and saying, “mine is like this one here.”

This is especially important when, like mine, yours is not, say, a maple tree, or a California redwood, but a somewhat less well known Madrone.

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Wherein Reality Becomes a Dream

At what point do reality and dreamland intersect? There are always those moments between wakefulness and sleep, but what about in the remembrance of the past?

I have had a few adventures. One included a long trek in a foreign country with many sights, challenges and people along the way, but sometimes I wonder what was real. I have memories, certainly. I have journal entries as well, though written half in English and half in Japanese as they are, I wonder how well I would decipher them today. But occasionally a memory will strike me. The smell of a cup of tea, when I am rolling a sleeping bag, or even wet socks will bring something drifting up to engulf me.

I remember hiding under the eves of an abandoned business, a car dealer, spreading wet bedrolls on the dusty ground to try to get them even slightly drier as the rain poured down a few feet away. I think I remember anyway. What if that part was actually something I had in a dream once? What if I my mind only categorized it as a memory of that time because the subject matter was consistent with what I saw then, while I was a world away? A sort of miss-filing of the memory. I wonder about this frequently, as with time and distance, true clear memories seem to become as hazy as any dream becomes after morning coffee.

In fact, I’ve had some dreams that still stick more vividly than some actual events. For example, I remember the sheer joy and elation of my first lucid dream better than yesterday’s breakfast. Emotional impact dictates clarity, not ‘reality’ in the sense of observable events. I wonder and think about how much of our past we dream up, either as we sleep, or through the distorted lens of recollection, or even moreso, nostalgia. It seems to me that the weight of things that we re-imagine is likely greater than the things we recollect accurately.

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