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Twenty 75+ hour weeks into clerkship, and I think I finally figured out what I want to be when I grow up.

20, 75+ hour weeks into clerkship, and I think I finally figured out what I want to be when I grow up.

A doctor, right?

Ha, ha.  That one doesn’t get old.

This year, or more specifically the last five months, has been by far the most intense, work wise, of my life.  Some weeks have involved more than a hundred hours of work.  I’ve taken my terrible “call karma” into dozens of overnight emergency surgeries, codes and other crises well beyond the capacity of an intern to contribute to, much less handle.  (Some people are afraid to be on call with me – I say, even if individuals tend to spontaneously combust on an alarmingly frequent basis when I’m in house, I also carry a fairly high success rate in terms of how many of these cases actually have quite good outcomes.  Nothing says science like a little superstition, am I right?)

Life is goooood……

Not unlike the “Medicine vs. Surgery” debate between Turk and JD that pops up every now and again on Scrubs, my brain waged a similar battle over the last five months.  Most people by my stage of training have at least figured out this simple question, if they have not yet tackled the intricacies of the categories within that category.  For me, about one week after I really should have been sorting out my electives (which in itself requires that essential question to be answered), I finally realized that it was definitely medicine, and that surgery, while extremely cool, was not how I wanted to fill the rest of my life.

Why?  The big tip off was that when I was trying to look at electives, I was having trouble fitting in all the really cool things I wanted to do into the small amount of time we get for medicine (ICU, Infectious Disease, Rheumatology!), while I actually had to struggle to think of something I would really like to do for surgery (should have been more obvious than it was, but you know – 20/20 hindsight).

Also: more interesting cases, less rigidly structured, less high stress, better hours, more amenable to women and (shudder) ultimately families, jobs are less thin on the ground and I can set up a practice in the middle of nowhere and still have a ton of patients.

The next barrier is getting past the whole it would be so much faster to just do family medicine… thing.  I recognize that Family Medicine is a very challenging specialty in many ways – I just mean that there is something thrilling about the concept of a two year residency.  I only have a year left of holding my hand above the “easy” button, trying hard not to let it fall.

Free Writing

On Thursday, I went to a meeting of the Creative Writing group I belong to.  We did two ten minute free-writing exercises, and this was what I came up with.  Remember, ten minutes.
Cookies (yes, it is called cookies).  The topic was “eating habits”.

Two years ago, you taught me that cookies aren’t a breakfast food.
Two years ago, your ankle started to hurt.
You showed me where to get organic food.
Your foot continued to hurt.
Time went on and our cooking adventures became more and more elaborate.
You went to the doctor.
She told you the pain would last forever.
She told you it would spread, to your hands, to your back.
Slowly we stopped eating the foods we loved.
The medication, you said, was making you sick.
One day you asked me what was the point of eating well, when inactivity had stolen your muscle.
Slowly, you stopped eating at all.
Now it is you who eats cookies for breakfast.
I wish I could teach you what you taught me.

The next topic was “write a letter”.

Dear Sirs,

I am writing to inform you that the current year is 2011.  This may seem to be a superfluous letter, but it has come to our attention that this may have escaped yours, and that you may still be under the impression that it is 1957.  As such, we would like to make the following suggestions in order to facilitate your entry into the 21st century.

1. It is okay to hire women.  They are able to work as well, and as efficiently, as men.  It may surprise you to learn, in fact, that women vary in ability in the same way as men.

2. Individuals are now no longer judged based on ethnicity.  We recognize that this may be a shock in someone with the chronologic deficiency you are exhibiting, so this is a friendly if official reminder.  Denigrating comments are not to be made to any individual on the basis of race.  In fact, lets be safe and say no comments of the sort at all.

3. Many of your patients are experiencing life changing situations while under your care.  It is not inconceivable that they may want to speak to the person responsible for their health.  Please feel free to interact with them.

Thank you for considering this advice.

Yours Sincerely,

Common Sense.

Keeping Track of What the Hell I’ve Been Up To

I got here on Sunday, after my selfless sister and homo-friend drove me up here and drove themselves back all in one day. Seriously. (It was 8.5 hours either way.)

I got introduced to the crazy ways of the bro-pad after I let myself in dumped my shit off, went for a bike ride and chilled on the hammock for a bit. Bro #1 came home, turned on a like 1994 video game and LAUGHED MANIACALLY the entire time he played it. It was terrifying – until they told me that this dude is on Disability, hasn’t worked a day in his life (maybe?), and stays home and smokes pot all day. Then I understood a bit. Confirmed later by his moderate-to-bad trip on shrooms later in the week.

The rest of the week at the bro-pad was filled with waking up to an average of three new people sitting on the couch next to my groggy self every morning, which was interesting, but seriously – what do these people do during the week? Bro #2 and Bro #3 were really nice, and kind of seemed tired of the bro-paddy-ness of the place, and really, it was a fine place to be, but I was glad to be able to move into my new place on Thursday night (after poker night with the scrubbiest men I have ever met), which by the way is beautiful.

Work/school/whatever has been fantastic. The first day I met my preceptor at the hospital, we checked on one patient and then spent a half day in the clinic. I have my own office and exam room (uh oh, I just realized I forgot to put back the oversized cuff and now they’regoingtothinki’munprofessionalohno okay relax, breathe…) This isn’t actually as stressful as I thought it would be. I’ve done two days in the ER so far, and they have been amazing. I’ve done two sets of sutures, a couple of pelvic exams, observed conscious sedation, tons and tons of histories and physicals…. I wish ER wasn’t so competitive.

Still no baby deliveries. Bah!

Anyway for some reason I had the long weekend off. Apparently everything here shuts down on a weekend, which is kind of a bummer. Liz and Danny came through yesterday so we spent some pretty awesome relaxation time around town and on the beach (and in the glacier-fed lake, which was actually amazing), and today I’m trying to get as much of my work done as possible.

Clinic tomorrow. Three weeks left!

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