I never thought I'd hear such a complement on my interview trail, especially not at my home institution. Today was my sixth interview, the one I was least excited about. I am definitely done with this state, and feel like you have to have had really positive medical school experience to want to stay at your home institution for residency. That's right all, I'm a fourth year. And it is kicking ass, now that I'm in the middle of it. I haven't blogged in awhile, but lets just say that things haven't been getting much easier from all the rants I've posted so many time before. I had a horrible sub-I experience that left me feeling like the worst student in the history of medicine, and very close to dropping out of school. Yes I say that in almost every blog, but here I was, finally decided on peds, excited to get started,ready to prove myself, and instead proving that I'm just an idiot with no talent and no ability to be a doctor. The sub-internship is a difficult place to struggle. You feel like you should be good at something and when you aren't, you wonder about your career choice and the rest of your life. And when you are in a state with only one option for a pediatric residency, you don't realize that just because one program doesn't work for you doesn't mean you aren't going to find one that does.
I spent a good portion of the end of my third year and beginning of my fourth year thinking that residency was going to be this hellish experience that I was just going to have to get through and hope that real life practice was better. Considering I've spent the past three years hoping everything was going to get better it was kind of a depressing thought to resign myself to more years of horror in the hopes of things getting better. Luckily, I figured out that part of the problem with the program at my school was that it was just to big,and I didn't like big. I wanted to go back to small. So I started looking for smaller programs, and I've found some amazing programs to apply to.
during the interview process I've found that I could conceviably be happy in any of the schools I've interviewed at so far. Really, honestly, happy and enjoying residency. I've even found a program that I think is perfect for me, even if the location is less than ideal. Who knows though, maybe I'll love the town once I get there.
But what really surprised me throughout this experience is that I'm a really good residency candidate. Yes, me, failed boards, bad attitude, and inability to learn. Why? I'm not quite sure. Apparently all the other stuff I've done in medical school has turned out to really work in my benefit. Maybe I'm just applying to places that want something more than a boards score. Or maybe, just maybe, failing the boards and struggling through medical school has actually made me a stronger, more in tune with myself person. Maybe the fact that I have to explain over and over again why I failed the boards and what I learned from it is actually working to my benefit. And I'm finding that saying "failing the boards sucked, but was actually a blessing in disguise" isn't just some line I'm spouting, it really is true. I mean, I'd rather not have failed the boards, but what if I had just barely passed? Where would I be now? Still thinking I'm the dumbest, most unteachable person in the world? Because now I can see that maybe I'm not as smart as everyone else, but I'm sure not dumb, I just learn differently. Would I have learned that I learn differently if I had never been forced to face that fact? Interesting...
When I started picking school to apply to for my residency, I wanted school that wouldn't care quite as much about my failure as they did about the fact that I do have some things to contribute to a program. However, being a student allowed me an interview at a top ranked program. A wonderful, courtesy, you go to the medical school we are affiliated with but have no chance of actually getting into here interview. And to be honest, for as much as they probably don't want me, I didn't want to go there either. I don't think they have ever accepted a boards failure before, and while I'm more than willing to be some program's token Muslim, being the token board failure didn't seem like something to be bragging about. So when I got to my interview today, I was expecting the worse. I was all geared up for a fight. I seriously, genuinely thought that they were going to sit me down in my interviews and say "why in the heck should we even consider you? Because right now as it stands, you don't have a chance in hell. You know that right? You would never get in here." Or some variation of that theme. And I was nervous about it, but also kinda ok with it, because it's a mutual understanding that I don't belong there.
Well, as in most times when I've geared myself up for a fight, everything actually went really smoothly. And strangely, though nothing I heard today made me think this progam would be a good fit for me (even though it is a FANTASTIC program, with some of the best facilities and learning opportunities a student could ask for), I left glad that I had gone. I remembered my bad experiences there, but I also saw it through the eyes of other applicants, and really wanted to want to go there. That makes really great sense in my head. I loved the state of the art facilities, I remembered how much I felt like if I had sick kids I'd want them treated there, and I appreciated what the program had to offer. But most of all, I had two amazing interviews with physicians who made me feel valued. My interviews were the opposite of what I'd been expecting. Two amazing physicians from an amazing, highly ranked program with all the applicants they could possibly dream of, telling ME, little old me, that I was an amazing applicant with great experiences and insights. And at the end of the my second interview, the doctor said any program would be lucky to have me.
When it comes right down to it, I still don't think they are going to rank me very highly on their list. I mean, come on today we had students from Duke interviewing. I can't compete with shit like that. But I left there feeling like someone who, with hte right amount of training, can go out into the world and do something special that others might not get to do. And that was one of the best feelings I've had in a long time.
So, for those of you who read my blog (which I'm sorry I haven't updated in awhile) and feel like I do, that everything is falling apart and there are just so many more years of hell in front of you, remember that everything that is happening now is worth something, making you stronger, and helping you to become the best doctor you can be. And that isn't just smoke I'm blowing up your ass. I really am starting to think it is all going to work out.
Thursday, December 22, 2011
My freakin' awesome pediatrics personal statement:be jealous
I never realized how important it is to dream until I discovered I’d lost my ability to do so. Ask a child what they want to be when they grow up, and they have such large, vivid dreams that no one can take away from them. When I was a child I wanted to be a princess, and a ballerina, a fashion designer, travel the world, and be a doctor. All I had to do was dream. None of my dreams conflicted with each other, there was always time for all of them, you could be a fire-fighting princess teacher if you wanted to be. All you had to do was grow up. Growing up was the key to fulfilling all dreams.
During the process of growing up, I realized that my dreams did conflict with each other, and my vision became more concentrated and focused. Medical school narrowed down my focus to the business of becoming a physician. Focusing on the moment and succeeding in each of my classes was essential to fulfill my dream of being a doctor, which seemed like such a huge accomplishment in and of itself that I forgot that I could be so much more, and that being a doctor meant so much more than just earning my degree. And when I failed the boards, I felt like becoming a doctor was just that, a dream that was slowly passing me by. But I picked myself up, recognized the weaknesses that had kept me from passing the first time, and worked hard to pass it the second time around. As I continued through my clinical rotations, I was working to reach an endpoint, a fixed goal, instead of remembering all the dreams I’d had for what I would do when I “grew up.”
I started noticing a difference during my pediatric rotations. At first it was unclear to me exactly what had changed. I assumed it was just the magic of being around children all the time; however, I soon realized I was starting to get my dreams back again. And by dreaming big, like a child does, my enthusiasm for my future was renewed. I was excited to see what each day had to bring, what new cases there were to see, and how I could be part of a child’s care. When children shared their dreams with me, I was able to share my dreams with them, and show them that dreaming never has to stop. Now I want to show them that they can fulfill those dreams, maybe with just a few adjustments.
I came to see that during the process of growing up, children’s dreams are slowly stifled. In very young children, we encourage large, intense, somewhat ridiculous dreaming. As kids grow older, parents and society start having expectations of kids that can sometimes restrict their dreams. It’s all part of the process of growing up. But I feel that through medicine I can work with children to keep them healthy so they can continue to dream. Additionally, by living my own dreams, I can provide opportunities for kids to live their dreams.
So while I have accepted that I may never be a fire-fighting princess fashion designing super hero solving mysteries and saving lives, I’m realizing I’ll never “just” be a doctor either. Children believe they can do many things all at once, and by being around children I’m able to hold on to those dreams of being many things at once: a doctor and a teacher; a mother and a therapist and a world traveler. And most importantly, I’ll be saving the world, one child at a time, just like I always knew I was destined to do. Children gave me back my ability to dream, and I now will dedicate my life to giving them everything I can dream of.
During the process of growing up, I realized that my dreams did conflict with each other, and my vision became more concentrated and focused. Medical school narrowed down my focus to the business of becoming a physician. Focusing on the moment and succeeding in each of my classes was essential to fulfill my dream of being a doctor, which seemed like such a huge accomplishment in and of itself that I forgot that I could be so much more, and that being a doctor meant so much more than just earning my degree. And when I failed the boards, I felt like becoming a doctor was just that, a dream that was slowly passing me by. But I picked myself up, recognized the weaknesses that had kept me from passing the first time, and worked hard to pass it the second time around. As I continued through my clinical rotations, I was working to reach an endpoint, a fixed goal, instead of remembering all the dreams I’d had for what I would do when I “grew up.”
I started noticing a difference during my pediatric rotations. At first it was unclear to me exactly what had changed. I assumed it was just the magic of being around children all the time; however, I soon realized I was starting to get my dreams back again. And by dreaming big, like a child does, my enthusiasm for my future was renewed. I was excited to see what each day had to bring, what new cases there were to see, and how I could be part of a child’s care. When children shared their dreams with me, I was able to share my dreams with them, and show them that dreaming never has to stop. Now I want to show them that they can fulfill those dreams, maybe with just a few adjustments.
I came to see that during the process of growing up, children’s dreams are slowly stifled. In very young children, we encourage large, intense, somewhat ridiculous dreaming. As kids grow older, parents and society start having expectations of kids that can sometimes restrict their dreams. It’s all part of the process of growing up. But I feel that through medicine I can work with children to keep them healthy so they can continue to dream. Additionally, by living my own dreams, I can provide opportunities for kids to live their dreams.
So while I have accepted that I may never be a fire-fighting princess fashion designing super hero solving mysteries and saving lives, I’m realizing I’ll never “just” be a doctor either. Children believe they can do many things all at once, and by being around children I’m able to hold on to those dreams of being many things at once: a doctor and a teacher; a mother and a therapist and a world traveler. And most importantly, I’ll be saving the world, one child at a time, just like I always knew I was destined to do. Children gave me back my ability to dream, and I now will dedicate my life to giving them everything I can dream of.
Thursday, June 9, 2011
The third year tremor
I happen to have a slight tremor in my hands, which is making my surgery rotation quite difficult. However, I recently heard of this "third year tremor" and it made me wonder, where does it come from? Is it from the late nights, lack of sleep, increased coffee that comes with third year? The stress of trying to impress residents, attendings, patients, classmates, residency directors, the whole wide world? The fear of making a mistake? Or is it from holding so many damned instruments for long periods of time during your surgery rotation? Either way, after third year you are never the same.
I often wonder what other medical conundrums you get from third year. Is there a return in incidence of nightmares or sleep terrors? Or is that just me. Has anyone else noticed a fake plastic smile stapled to their face? Is that going to eventually cause some twitching in my cheeks? Is there an adverse effect from trying to hold back tears and hold your face perfectly still so that your attending doesn't realize that he is getting to you? How about GI upset from all the coffee, stress, fast eating, hours of not eating, dehydration etc etc and so forth? I know I've got narcolepsy that is definitely enhanced by third year. Has anyone else noticed a total lack in concentration? I've got ADHD up the wazoo, I think it is from too many hours of rounding on patients. The more I try to pay attention the more trouble I have. I'm starting to think I have absence seizures. How about the neurological signs like like word finding difficulty? Not only do I have trouble figuring out what I'm trying to say when I'm presenting a patient, but I've also noticed that in general conversation I now lack the ability to express myself, because I can never remember the word, and I can't figure out how to use another word to describe what I need to say. I also stop abruptly in the middle of sentences, probably because my brain is busy trying to multitask.
What other symptoms have come along with third year? Of course hanging out around sick people all the time can make anyone start to think they are sick as well, but there are certain things most medical students notice about themselves as they go through the year. Many of us become more hardened and apathetic. Our trust in what a patient (or anyone) is telling us decreases as we go through a year of lying and manipulating patients. Our social awkwardness increases secondary to a lack of normal social interactions. Things stop surprising us, because we've heard and seen worse. And the strangest, little things horrify us while large things that would horrify others no longer affect us. How many other medical students have heard a story about someone getting hit by a car and been more worried about the person's dog that wsa also hit than about the patient. "Oh the guy died? What about the puppy? Oh thank goodness he is fine! He lost a leg?! That is the saddest thing I've ever heard. Poor puppy." What is that about? Priorities definitely change.
The worst thing third year brings about is also the one that most people won't talk about, and that is the increased depression. Third year is fucking hard. I still prefer it to the other two years,and find myself a bit happier than I was second year. I'd rather go through my toughest days of third year over again than any day of second year. But third year comes with its own bag of insecurities and sadness. An overwhelming feeling of insignificance and incompetence surrounds me daily, even when I'm doing well on a rotation. I have noticed a complete lack of interest in anything not related to pediatrics, to the point where I'd skip out on surgeries if I could, and I have to muster up all my energy just to go to rotations every day. I find that things that excite other students do nothing for me. I couldn't care less about procedures. I'd rather not be responsible for doing them. I don't want to scrub into a surgery. I don't want to round on my patients. Especially now that I'm at the end of my third year, I don't want to do any of this stuff anymore. Where did this apathy come from? What happened to my passion? All I want to do all day is go home. And once home, I don't have anything to do, nor is there anything I really want to do. I could look forward to a bike ride all day but then get home and decide not to go out on my bike. And I keep telling myself that it is just because I am not interested in anything but pediatrics, and everything will be better once fourth year starts, but what if it isn't? What if medical school has taken my passion away completely? All of my interests are gone, partially because I don't have time for anything. And some times are better than others, but this rotation has been especially hard. And I'm worried it isn't going to go away. What if, even though I love pediatrics, I'm forever this uninterested, bored, tired, and lonely. I sure hope not.
I hope that when I get into something I enjoy a little more, or finally find my niche in life, my passion and interest and love of life will return. Until then, I'm just trying to muck through these ridiculous assignments and rotations, jump through the flaming hoops and land on my feet at the end of all of this. Now I just have to figure out when "the end of all this" is going to be. Because these third year symptoms my never go away...
I often wonder what other medical conundrums you get from third year. Is there a return in incidence of nightmares or sleep terrors? Or is that just me. Has anyone else noticed a fake plastic smile stapled to their face? Is that going to eventually cause some twitching in my cheeks? Is there an adverse effect from trying to hold back tears and hold your face perfectly still so that your attending doesn't realize that he is getting to you? How about GI upset from all the coffee, stress, fast eating, hours of not eating, dehydration etc etc and so forth? I know I've got narcolepsy that is definitely enhanced by third year. Has anyone else noticed a total lack in concentration? I've got ADHD up the wazoo, I think it is from too many hours of rounding on patients. The more I try to pay attention the more trouble I have. I'm starting to think I have absence seizures. How about the neurological signs like like word finding difficulty? Not only do I have trouble figuring out what I'm trying to say when I'm presenting a patient, but I've also noticed that in general conversation I now lack the ability to express myself, because I can never remember the word, and I can't figure out how to use another word to describe what I need to say. I also stop abruptly in the middle of sentences, probably because my brain is busy trying to multitask.
What other symptoms have come along with third year? Of course hanging out around sick people all the time can make anyone start to think they are sick as well, but there are certain things most medical students notice about themselves as they go through the year. Many of us become more hardened and apathetic. Our trust in what a patient (or anyone) is telling us decreases as we go through a year of lying and manipulating patients. Our social awkwardness increases secondary to a lack of normal social interactions. Things stop surprising us, because we've heard and seen worse. And the strangest, little things horrify us while large things that would horrify others no longer affect us. How many other medical students have heard a story about someone getting hit by a car and been more worried about the person's dog that wsa also hit than about the patient. "Oh the guy died? What about the puppy? Oh thank goodness he is fine! He lost a leg?! That is the saddest thing I've ever heard. Poor puppy." What is that about? Priorities definitely change.
The worst thing third year brings about is also the one that most people won't talk about, and that is the increased depression. Third year is fucking hard. I still prefer it to the other two years,and find myself a bit happier than I was second year. I'd rather go through my toughest days of third year over again than any day of second year. But third year comes with its own bag of insecurities and sadness. An overwhelming feeling of insignificance and incompetence surrounds me daily, even when I'm doing well on a rotation. I have noticed a complete lack of interest in anything not related to pediatrics, to the point where I'd skip out on surgeries if I could, and I have to muster up all my energy just to go to rotations every day. I find that things that excite other students do nothing for me. I couldn't care less about procedures. I'd rather not be responsible for doing them. I don't want to scrub into a surgery. I don't want to round on my patients. Especially now that I'm at the end of my third year, I don't want to do any of this stuff anymore. Where did this apathy come from? What happened to my passion? All I want to do all day is go home. And once home, I don't have anything to do, nor is there anything I really want to do. I could look forward to a bike ride all day but then get home and decide not to go out on my bike. And I keep telling myself that it is just because I am not interested in anything but pediatrics, and everything will be better once fourth year starts, but what if it isn't? What if medical school has taken my passion away completely? All of my interests are gone, partially because I don't have time for anything. And some times are better than others, but this rotation has been especially hard. And I'm worried it isn't going to go away. What if, even though I love pediatrics, I'm forever this uninterested, bored, tired, and lonely. I sure hope not.
I hope that when I get into something I enjoy a little more, or finally find my niche in life, my passion and interest and love of life will return. Until then, I'm just trying to muck through these ridiculous assignments and rotations, jump through the flaming hoops and land on my feet at the end of all of this. Now I just have to figure out when "the end of all this" is going to be. Because these third year symptoms my never go away...
Monday, May 23, 2011
I can't have another evaluation saying I show no interest, so I better learn to fake it
There are a lot of things that are difficult about third year. The hours, the stress, the lack of knowledge, the trying to figure out what you want to do for the rest of your life. But by far the hardest thing to do is pretend and show that you are interested in EVERYTHING. The beginning of the year you ARE interested in everything. Or at least you think you are going to be. You start the third year thinking that even if you don't want to go into surgery, or neurology or whatever, you are still really going to enjoy the rotation, and you'll learn something great in each one. And while it is true that you will learn something in every rotation, I have found it very difficult to keep up a level of interest in things I couldn't possibly care less about. Unfortunately, this is an integral part of the game. A game I suck at.
Somehow I grew up thinking that I masked all of my emotions very well and no one could ever tell what I was thinking. I'm still convinced of this, even though repeated it has been pointed out to me that I am wrong. My mother, for instance, has always said she can tell when I'm upset about something because it is written all over my face. And classmates constantly tell me they love watching my facial expressions during classes/lectures when I am not happy about what is going on. Apparently I am their source of entertainment in really boring moments. And at least three times this year I've been told that I lack enthusiasm and don't appear interested. One resident told me she could always tell when I'm bored. This is no good, because quite honestly, I'm bored a lot of the time. My attention span just doesn't last very long. And I don't know how to fix that.
This is my great challenge of third year, which is now almost over. Trying to figure out how to convince people that I'm interested. Because even when I am interested apparently I look bored. Much of it is my lack of ability to play the damn game. The bring in articles, ask a million questions, show off my knowledge randomly, suck up entirely and always be working hard, or appearing to work hard. I can't play that game, I'm tired and burnt out. If I don't know something one day, I'll look it up that evening, but I'm rarely able to then track down my attending and tell him everything I learned about the topic I didn't know anything about before. Not because they aren't around, but because I literally cannot bring myself to be such a suck up. But that apparently makes me look uninterested and unwilling to learn. So sometimes I bring in an article, but that doesn't seem to impress anyone either.
And sometimes I'm just a quiet learner. I don't like to ask questions during a surgery. I like to watch and concentrate on holding what I'm holding or retracting what I'm retracting. I don't want to spew out bits of information about the surgery unless asked. And I don't want to find "interesting" surgeries to go to, because those are long, and I can't handle long. Last week I saw an open heart surgery. Coolest thing I've ever seen IN MY LIFE and I was still bored in the middle of it, wanting it to end, and unable to concentrate on the whole thing. And super glad I wasn't scrubbed in, because I could not have stood for that long. But I was totally fascinated and enthralled by the surgery. I doubt the surgeon could tell though, because I wasn't asking a million questions and pointing out all the stuff I know. I was just watching in awe of his magnificance and the fact that you can stop a beating heart and keep a person alive.
So now I've had three evaluations that say I don't seem interested. And this surgery one will probably be the same. So how do I counter this attack? I've tried a couple of things. I've tried being that annoying student who brings in a bunch of articles and STILL one of the residents wrote I didn't appear interested. It's because I phase out when someone is talking to me for too long. I just can't deal.
Does this make me a bad doctor? I sure as hell hope not. And I don't think so. Is anyone really interested in everything that happens around them during the day at all times? Does that make them bad people? I care about my patients, how come that doesn't come up in my evaluations often enough? Sure I'm bored with neurology, but I sat with a patient for ten minutes comforting her over her diagnosis. Yeah, maybe I don't ask questions while in surgery, but I sure as hell make sure when he comes out of surgery that patient gets a warm blanket right away, and that he isn't in pain. And maybe I don't look up articles about some seizure disease a baby has, but I'll sit there with the parents holding their baby while they cry and pray with the pastor after finding out that their baby might not live. And I don't do any of that for the fucking show of it. I do that because that is why I went into medical school. I didn't go into medicalschool to be a suck up, to be fake, or to prove anything to anyone. I went into medical school to become a fucking doctor, someone who cares about others and helps them through hard times.
Maybe I'm not like the other students and doctors. Maybe all of them really are legitimately interested and excited about everything. Maybe they all just love learning so damned much that they never take a second off from learning to be a real person. Maybe I'm not cut out for all this crap that it takes to become a doctor. Maybe I won't be as great of a doctor because I don't have a lot of interest in everything. But I get the job done. I learn. I care. I try. I know I'm going to work hard for hte rest of my life and I'm okay with that, excited for the challenge even. But I have no attention span and I look uninterested. So I may not make it through this year. And I guess that is just the way it is. My original goal for third year was to pass everything, just pass, and hopefully high pass or honor a couple of blocks. And I've managed that thus far. But my new goal is to not get any more evaluations that said "student looked like she was uninterested." Unfortunately, I am just that, uninterested.
Is this over yet? I just want to be a doctor...
Somehow I grew up thinking that I masked all of my emotions very well and no one could ever tell what I was thinking. I'm still convinced of this, even though repeated it has been pointed out to me that I am wrong. My mother, for instance, has always said she can tell when I'm upset about something because it is written all over my face. And classmates constantly tell me they love watching my facial expressions during classes/lectures when I am not happy about what is going on. Apparently I am their source of entertainment in really boring moments. And at least three times this year I've been told that I lack enthusiasm and don't appear interested. One resident told me she could always tell when I'm bored. This is no good, because quite honestly, I'm bored a lot of the time. My attention span just doesn't last very long. And I don't know how to fix that.
This is my great challenge of third year, which is now almost over. Trying to figure out how to convince people that I'm interested. Because even when I am interested apparently I look bored. Much of it is my lack of ability to play the damn game. The bring in articles, ask a million questions, show off my knowledge randomly, suck up entirely and always be working hard, or appearing to work hard. I can't play that game, I'm tired and burnt out. If I don't know something one day, I'll look it up that evening, but I'm rarely able to then track down my attending and tell him everything I learned about the topic I didn't know anything about before. Not because they aren't around, but because I literally cannot bring myself to be such a suck up. But that apparently makes me look uninterested and unwilling to learn. So sometimes I bring in an article, but that doesn't seem to impress anyone either.
And sometimes I'm just a quiet learner. I don't like to ask questions during a surgery. I like to watch and concentrate on holding what I'm holding or retracting what I'm retracting. I don't want to spew out bits of information about the surgery unless asked. And I don't want to find "interesting" surgeries to go to, because those are long, and I can't handle long. Last week I saw an open heart surgery. Coolest thing I've ever seen IN MY LIFE and I was still bored in the middle of it, wanting it to end, and unable to concentrate on the whole thing. And super glad I wasn't scrubbed in, because I could not have stood for that long. But I was totally fascinated and enthralled by the surgery. I doubt the surgeon could tell though, because I wasn't asking a million questions and pointing out all the stuff I know. I was just watching in awe of his magnificance and the fact that you can stop a beating heart and keep a person alive.
So now I've had three evaluations that say I don't seem interested. And this surgery one will probably be the same. So how do I counter this attack? I've tried a couple of things. I've tried being that annoying student who brings in a bunch of articles and STILL one of the residents wrote I didn't appear interested. It's because I phase out when someone is talking to me for too long. I just can't deal.
Does this make me a bad doctor? I sure as hell hope not. And I don't think so. Is anyone really interested in everything that happens around them during the day at all times? Does that make them bad people? I care about my patients, how come that doesn't come up in my evaluations often enough? Sure I'm bored with neurology, but I sat with a patient for ten minutes comforting her over her diagnosis. Yeah, maybe I don't ask questions while in surgery, but I sure as hell make sure when he comes out of surgery that patient gets a warm blanket right away, and that he isn't in pain. And maybe I don't look up articles about some seizure disease a baby has, but I'll sit there with the parents holding their baby while they cry and pray with the pastor after finding out that their baby might not live. And I don't do any of that for the fucking show of it. I do that because that is why I went into medical school. I didn't go into medicalschool to be a suck up, to be fake, or to prove anything to anyone. I went into medical school to become a fucking doctor, someone who cares about others and helps them through hard times.
Maybe I'm not like the other students and doctors. Maybe all of them really are legitimately interested and excited about everything. Maybe they all just love learning so damned much that they never take a second off from learning to be a real person. Maybe I'm not cut out for all this crap that it takes to become a doctor. Maybe I won't be as great of a doctor because I don't have a lot of interest in everything. But I get the job done. I learn. I care. I try. I know I'm going to work hard for hte rest of my life and I'm okay with that, excited for the challenge even. But I have no attention span and I look uninterested. So I may not make it through this year. And I guess that is just the way it is. My original goal for third year was to pass everything, just pass, and hopefully high pass or honor a couple of blocks. And I've managed that thus far. But my new goal is to not get any more evaluations that said "student looked like she was uninterested." Unfortunately, I am just that, uninterested.
Is this over yet? I just want to be a doctor...
Thursday, February 17, 2011
Am I really smart enough to be a doctor?
Some days-okay every day, but some days more than others- I really wonder if I am actually capable of being a physician. Mostly it's when I'm around other students. Or being asked questions. Or in any clinical situation whatsoever. My first two years of school it was easy to blow things off, and tell myself that I'd figure it all out and knowing all these tiny details wouldn't make me a better doctor. I told myself that test grades didn't determine my ability to be a good doctor. It was all about the clinical skills and knowledge that I'd gain over my third and fourth year. But as I reach the end of my third year, I feel like I don't actually know anything, still. My faith in my ability to be a doctor is severely decreasing every day. I can't answer questions that are asked of me, but I feel like all the other medical students are able to. I've heard that I don't really learn anything about medicine until I'm an intern and a resident, but somedays I feel that is just another way of allowing myself to live in denial about my inability to think well enough to be a doctor.
The first day of a new rotation is always the worst, but sometimes it doesn't get any better than that first day. Sometimes I just continue feeling like an idiot. I can't do anything right. I don't know anything. I'm terrified of everyone because I don't think I can make them better. I've already ruled out any profession where on a daily basis I am directly responsible for numerous life and death decisions (ie Emergency Medicine or Surgery) because I know I can't think on my feet the way I would need to in those situations. Maybe that is why I enjoyed outpatient pediatrics. I didn't have to save any lifes. Everyone was relatively healthy, even those who were sick. I didn't feel responsible for life or death decisions. But even in the outpatient world, there was plenty I had no clue about, so many things I didn't understand or know how to deal with, but I feel like I saw them a million times over and still can't figure them out.
So here I sit, three shifts into an emergency medicine rotation, watching physicians run codes and remember what they are supposed to do, and I can't even remember how to do a full neuro exam on a patient, or remember why I might need to. I can't answer a patient's questions about PAD or PID or UTIs or anything. I'm grossed out by half of the patients I see in the ED. I can't stand the noise, the smell, the shear number of people. It is too much for me. I don't like doing procedures. And it all stems from a feeling of inferiority and stupidity.
A doctor once told me that third year isn't really about learning how to be a doctor. It's about figuring out what you want to do and what you like, and learning how to learn. I don't think I've learned how to learn yet. I don't remember things I've already learned. I don't enjoy researching new things. I can't keep all the information in my head.
Another doctor told me the three things you need to be a good doctor are 1. a good personality so people will want to come see you (done), 2. efficiency (gots that) and 3. enough knowledge to function as a docto. That's the one I'm worried about. I liked him, because he said I didn't have to know everything about everything. I didn't have to have all the answers all the time. I didn't have to be a specialist in my field or any sort of genius. I just needed to know enough to deal with things as they came up, and know where to look when I didn't know the answers. That's the worry for me.
I used to want to be a specialist in some field. The fore-most knowledgeable person in whatever it is I choose to do. Now I just want to survive. I don't have enough faith in myself to think I'm going to be anything better than a mediocre doctor. I definitely will be depending more on my personailty than on my actual clinical knowledge. So I'd better work in a place where I don't need to know all that much, or I'm totally screwed.
Will I ever actually be a good doctor? The fact that I don't know much right now isn't an indication of my inability to ever know things right? I'll eventually learn won't I? Experience, practice makes perfect, all that good stuff? Seeing, doing, teaching, eventually knowing? I have to hold on to that hope or I won't be able to function any longer. I can barely function now as it is...
The first day of a new rotation is always the worst, but sometimes it doesn't get any better than that first day. Sometimes I just continue feeling like an idiot. I can't do anything right. I don't know anything. I'm terrified of everyone because I don't think I can make them better. I've already ruled out any profession where on a daily basis I am directly responsible for numerous life and death decisions (ie Emergency Medicine or Surgery) because I know I can't think on my feet the way I would need to in those situations. Maybe that is why I enjoyed outpatient pediatrics. I didn't have to save any lifes. Everyone was relatively healthy, even those who were sick. I didn't feel responsible for life or death decisions. But even in the outpatient world, there was plenty I had no clue about, so many things I didn't understand or know how to deal with, but I feel like I saw them a million times over and still can't figure them out.
So here I sit, three shifts into an emergency medicine rotation, watching physicians run codes and remember what they are supposed to do, and I can't even remember how to do a full neuro exam on a patient, or remember why I might need to. I can't answer a patient's questions about PAD or PID or UTIs or anything. I'm grossed out by half of the patients I see in the ED. I can't stand the noise, the smell, the shear number of people. It is too much for me. I don't like doing procedures. And it all stems from a feeling of inferiority and stupidity.
A doctor once told me that third year isn't really about learning how to be a doctor. It's about figuring out what you want to do and what you like, and learning how to learn. I don't think I've learned how to learn yet. I don't remember things I've already learned. I don't enjoy researching new things. I can't keep all the information in my head.
Another doctor told me the three things you need to be a good doctor are 1. a good personality so people will want to come see you (done), 2. efficiency (gots that) and 3. enough knowledge to function as a docto. That's the one I'm worried about. I liked him, because he said I didn't have to know everything about everything. I didn't have to have all the answers all the time. I didn't have to be a specialist in my field or any sort of genius. I just needed to know enough to deal with things as they came up, and know where to look when I didn't know the answers. That's the worry for me.
I used to want to be a specialist in some field. The fore-most knowledgeable person in whatever it is I choose to do. Now I just want to survive. I don't have enough faith in myself to think I'm going to be anything better than a mediocre doctor. I definitely will be depending more on my personailty than on my actual clinical knowledge. So I'd better work in a place where I don't need to know all that much, or I'm totally screwed.
Will I ever actually be a good doctor? The fact that I don't know much right now isn't an indication of my inability to ever know things right? I'll eventually learn won't I? Experience, practice makes perfect, all that good stuff? Seeing, doing, teaching, eventually knowing? I have to hold on to that hope or I won't be able to function any longer. I can barely function now as it is...
Saturday, February 12, 2011
If you are not evaluating me I feel no need to impress you
Lately I have found that I only have so much energy to give. I cannot be "on" all the time. So I have found that if I don't think you are going to directly evaluating me, I won't find any reason to suck up to you. In fact, I may not even be willing to talk to you. You mean nothing to me. Maybe I'll be nice to you at least, but probably not. I can't expend energy on people who aren't going to have some kind of say in my future. I have to do way too much sucking up in my time as a student. I can't care all the time, I'm sorry. So if I find myself in a situation where I am with someone who is not going to evaluate me, I find myself not giving any effort. Not just giving less of an effort. No effort whatsoever. I will walk out of clinic early because I know you aren't going to say anything to anyone because you don't know who to tell that I'm not doing my work. It is awesome. Fairly liberating. I should care a little bit, but I just don't.
Thursday, February 3, 2011
Aparently everyone can tell when I'm bored. Which is always
Something I am slowly learning about myself: I don't actually care about anything anymore. Medical school has sucked the curiosity right out of me. My attention span is about the size of a peanut. Rounds: boring as hell. A "good learning opportunity." Yeah, if I could pay attention all the way through rounds maybe I would in fact learn something. But my ADHD (self-diagnosed) will not allow for that. I can pay attention to maybe two patients that aren't mine. And if your presentation is more than one minute long, you can bet good money that I won't be listening anymore. I don't find "self directed learning" time to be useful, it turns into nap time for me. I'm not willing to spend any more time looking something up than it takes to read an up to date article. By the time I get home I couldn't care less about anything I saw during the day. And if you ask a question at the end of a long clinic day, I'm going to punch you in the face. I honestly don't care about the answers enough to spend another ten minutes hearing the answer.
Does this mean I'm going to be a bad doctor? I sure hope not. I really don't feel any need to add extra work to my schedule. I don't look for extra stuff to do. Either you keep me constantly stimulated or I'm going to be asleep in the corner. I don't give myself assignments, I don't go searching for someone to see, I don't ask questions so attendings notice me.
All of this is bad. Very very bad. Because people are starting to notice. People who write my evaluations. Those people. Apparently I wear my emotions on my sleeve and everyone can tell when I'm bored or annoyed, which tends to be all the time. Sometimes even with patients I'm bored. Depends on the day. Usually I'm not. Usually if I'm with a patient I'm the happiest person in the world. Unless it is getting close to the end of the day, and this one patient blathering on is keeping me from going home (where, in case you are wondering, I am also bored) then I get a smidgen annoyed. And if clinic has gone late, I sure as heck am not going to ask my attending any questions, even if I really want to know.
Why? Because then things like today happen. I asked a simple question (what is the difference in prognosis between two diseases) and got a ten minute answer. Then, the other student felt the need to also ask a question so he wouldn't be shown up, and then the attending ended up on a half hour soap box about God knows what (I literally have no idea what he was talking about). Meanwhile, my eyes are slowly glazing over. I have to start telling myself ot pay attention, but then I'm only paying attention to me telling myself to pay attention. I really did at the time want to know the answer to my question. I have to really really want to know the answer to a question to ask one at the end of the day. But I can tell you, it wasn't worth it. Especially since that guy is not evaluating me in any way shape or form. I could have asked my aunt later, she's a Rheumatologist. That would have been more simple. And I could just tell her straight to her face when I no longer cared about the answer.
Five second answers, that is waht I need. That's about all the time I can spare anymore.
Mostly, I can't win for losing anymore. You can't make me happy. One minute I'm bored out of my mind, sitting and doing nothing, but then the second work appears I'm hoping I don't have to do it.
My poor friends who aren't in medical school but are reading this. You must be terrified of going to the doctor after you read my posts. Don't worry, not everyone is as jaded and cynical as I am. And, when I'm with patients I'm fantastic, they all love me, and I find the answers, so don't worry. But medical school is this annoying game that I am not good at, because I don't have the attention span to follow the rules. If you give me the afternoon off I'm going to take it. I'm not going to try and find myself extra work to do around the hospital. If the choice is between seeing another patient or going home, I'll probably go home. Does this make me a bad student? I sure hope not.
I've found that there are a group of us like me. Students who don't play the game, because we don't have teh energy. Sometimes we worry that we aren't going to be good doctors because we don't play thet game. But friends, I really think we are going to be okay. Because when it comes down to it, I don't need to be the leading expert in any field. I don't need to be a super star. There is nothing at the end of the road I need to compete for. All I want is to be a doctor, and to do that I just need enough knowledge to either know the answers or know where to find the answers. I can do that. And, I've got great people skills, so I know patients will want to come see me. Right? I'm going to keep telling myself that.
Why do I want to be a doctor? Sometimes I don't remember. And people I'm sure often wonder why I want to be a doctor when I seem to lack any interest or enthusiasm in what I do. But the truth of it is, I kinda know what it is I want to do, and that interests me, and I know I can do it without having to be a douchebag about it. I'm not willing to fake interst in things I'm not interested in. But unfortunately, I need to learn how to.
Usually I'm all about the journey, but in this case, I just want to get to the end point. I want to be a doctor. I don't want to answer to a bunch of people. I don't want to have to pretend to be excited about things. I don't want to have to work hard just at maintaining a front. I want to do my work, help my patients, and go about my life. I don't want to be graded and evaluated against my peers. I just want to be a freaking doctor already! Gah.
Anyway, to all of you out there who really are interested in everything, good for you. But could you tone it down a little for those of us who are struggling to stay awake and get through the work they already have to do? And for those of you like me, who really couldn't care less, hang in there. We're all going to be good doctors one day. And to the gunners: bring it down a level, no one likes a douche
Does this mean I'm going to be a bad doctor? I sure hope not. I really don't feel any need to add extra work to my schedule. I don't look for extra stuff to do. Either you keep me constantly stimulated or I'm going to be asleep in the corner. I don't give myself assignments, I don't go searching for someone to see, I don't ask questions so attendings notice me.
All of this is bad. Very very bad. Because people are starting to notice. People who write my evaluations. Those people. Apparently I wear my emotions on my sleeve and everyone can tell when I'm bored or annoyed, which tends to be all the time. Sometimes even with patients I'm bored. Depends on the day. Usually I'm not. Usually if I'm with a patient I'm the happiest person in the world. Unless it is getting close to the end of the day, and this one patient blathering on is keeping me from going home (where, in case you are wondering, I am also bored) then I get a smidgen annoyed. And if clinic has gone late, I sure as heck am not going to ask my attending any questions, even if I really want to know.
Why? Because then things like today happen. I asked a simple question (what is the difference in prognosis between two diseases) and got a ten minute answer. Then, the other student felt the need to also ask a question so he wouldn't be shown up, and then the attending ended up on a half hour soap box about God knows what (I literally have no idea what he was talking about). Meanwhile, my eyes are slowly glazing over. I have to start telling myself ot pay attention, but then I'm only paying attention to me telling myself to pay attention. I really did at the time want to know the answer to my question. I have to really really want to know the answer to a question to ask one at the end of the day. But I can tell you, it wasn't worth it. Especially since that guy is not evaluating me in any way shape or form. I could have asked my aunt later, she's a Rheumatologist. That would have been more simple. And I could just tell her straight to her face when I no longer cared about the answer.
Five second answers, that is waht I need. That's about all the time I can spare anymore.
Mostly, I can't win for losing anymore. You can't make me happy. One minute I'm bored out of my mind, sitting and doing nothing, but then the second work appears I'm hoping I don't have to do it.
My poor friends who aren't in medical school but are reading this. You must be terrified of going to the doctor after you read my posts. Don't worry, not everyone is as jaded and cynical as I am. And, when I'm with patients I'm fantastic, they all love me, and I find the answers, so don't worry. But medical school is this annoying game that I am not good at, because I don't have the attention span to follow the rules. If you give me the afternoon off I'm going to take it. I'm not going to try and find myself extra work to do around the hospital. If the choice is between seeing another patient or going home, I'll probably go home. Does this make me a bad student? I sure hope not.
I've found that there are a group of us like me. Students who don't play the game, because we don't have teh energy. Sometimes we worry that we aren't going to be good doctors because we don't play thet game. But friends, I really think we are going to be okay. Because when it comes down to it, I don't need to be the leading expert in any field. I don't need to be a super star. There is nothing at the end of the road I need to compete for. All I want is to be a doctor, and to do that I just need enough knowledge to either know the answers or know where to find the answers. I can do that. And, I've got great people skills, so I know patients will want to come see me. Right? I'm going to keep telling myself that.
Why do I want to be a doctor? Sometimes I don't remember. And people I'm sure often wonder why I want to be a doctor when I seem to lack any interest or enthusiasm in what I do. But the truth of it is, I kinda know what it is I want to do, and that interests me, and I know I can do it without having to be a douchebag about it. I'm not willing to fake interst in things I'm not interested in. But unfortunately, I need to learn how to.
Usually I'm all about the journey, but in this case, I just want to get to the end point. I want to be a doctor. I don't want to answer to a bunch of people. I don't want to have to pretend to be excited about things. I don't want to have to work hard just at maintaining a front. I want to do my work, help my patients, and go about my life. I don't want to be graded and evaluated against my peers. I just want to be a freaking doctor already! Gah.
Anyway, to all of you out there who really are interested in everything, good for you. But could you tone it down a little for those of us who are struggling to stay awake and get through the work they already have to do? And for those of you like me, who really couldn't care less, hang in there. We're all going to be good doctors one day. And to the gunners: bring it down a level, no one likes a douche
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