Agraphia Medical Tragicomedy



Well, it's struck again, the dreaded apathy.

It's interesting, as I look back through my med school career. At first I remember being totally excited to learn, to understand, to really study our coursework. Anatomy, neurology, physiology... that was the stuff I loved in college, and being able to study it and apply it to other people? What an honor, what a privilege!

The grind slowly caught up with me. I studied too much, took the "work hard, play hard" mantra too much to heart. I would sit on the couch with a beer, a sleeping pill, the TV blaring, and my computer fired up simultaneously just to relax. I started making jokes that I used coffee as an upper in the morning and beer as a downer at night... but I wasn't joking.

I finished Boards - god knows how - and thought to myself finally the long hours, the stress, the constant feeling that I should be doing something productive would stop.

3rd year rolls around and you realize that for all the studying you may have done during years 1 and 2, you still don't know shit. Attendings pimp you on arcane knowledge from their specialty they've been practicing for 40 years and are shocked when you don't know it. End-of-rotation exams are brutally hard and require you to diagnose, treat, and manage 100 patients in about 120 minutes.

On top of it all is the knowledge that everyone you work with... interns, residents, attendings... are all going to grade you subjectively on how well they thought you did. So you put on your smiley face, pretend like ophthalmology is the most awesome field EVER and go to work every morning, starting on average at 6AM and finishing around 5PM.

It is brutal, and exhausting, and sometimes honestly I wonder if it wasn't a huge mistake to go to medical school. I'm not asking for sympathy here, by the way, but instead hoping that some of you nod to yourselves while reading this and go "yeah, I know where he's coming from. I've thought the same thing to myself from time to time".

Listen, sometimes you get that patient who comes along and just makes it all worthwhile. But sometimes you punish your body, mind, and soul for some asshole who treats you like crap and expects you to FIX EVERYTHING WRONG WITH ME even though he's not fixable.

I'm a person too, folks. I like sleep, and food, and friends, and family. I've lost a lot of that these past 3 years... and sometimes the field of medicine just isn't rewarding enough to make the sacrifice worthwhile.

I suppose the reason I write this now is that I have really, really been enjoying internal medicine- I like the diagnosis, the management, the primary care aspect. But I see my interns and residents getting no sleep every 5th day (and if you aren't a meddie, imagine that for just one second. No sleep every 5th day for the next 4 years of your life... plus little sleep the rest of the time) and frankly, I don't know if I want to do it.

So, here I am again, thinking about the decision between doing what I love and doing something where the lifestyle doesn't suck. There's a damn good reason people go into pathology, anesthesia, radiology, and dermatology. You work real people hours, and you get paid a decent salary.

After all this time and energy, don't you think we deserve that?

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  1. Feeling your pain. The worst part about my clinical rotations thus far is a) I do very little “real” work, and b) what I get graded on is totally subjective. Nobody sees me talk to patients, nobody works through a differential with me, all anyone ever sees is the asinine question I get wrong when being pimped, and whether I remain silent during surgeries yet somehow manage to act enthusiastic anyway. Oh, and the write-up you sent me to do which will only get into the chart if you bother to go over it with me.

    Health policy is sure looking good right now. All I have to say is THANK GOD I’m not going into debt for this crap. And THANK GOD I’m getting the PhD too.

  2. First of all, yes, you deserve whatever you desire and if that is normalcy, go for it. You have worked hard to reach your goal.

    Secondly, I understand that this is a very difficult time in your life but a simple project I did in a Human Development class put everything in perspective for me.

    We were asked to make a time line of our lives. Ok you are thinking.. I am not dead yet, how do I complete it? Well, we had to decide when we were going to die. We listed our birth and all the other significant events in our lives, siblings births, graduation from high school, close relatives deaths (ie grandparents), hire dates for big career changes/jobs, etc. Right up until the current moment. Then the projections started… date of college graduation, marriage, birth of children, death of parents (very hard to write down), children’s marriages, birth of grandchildren, etc… and our own eventual death.

    My time line ended up taking three 8×11 pieces of paper laid length wise. I chose to live to the ripe age of 88.

    But what did I learn? I learned that in that moment when I felt like the road ahead of me was so long (pre-req’s and nursing school) and in looking at that portion of the time line in comparison with my life as a whole it was SHORT, very very short.

    So, maybe you need to look at that longer portion of your time line, the portion that represents your career as an MD and how that hopefully long and prosperous time will be spent.

  3. I’m only a second year, but so far I haven’t found it all that bad. As far as postgraduate training, well, I figure I’ll do it somehow.

  4. you wrote:”yeah, I know where he’s coming from. I’ve thought the same thing to myself from time to time”

    I was thinking exactly the same things not so long ago.
    Here the first years is all about physics, chemistry, math.
    Just on the third year of med school you actually study something that remotely resembles medicine.
    If you’re not badly motivated you’ll succumb to the temptation of give up at the first opportunity.

    On my first day my prof told us that med school is a hard game where often the only thing required is stubborness.
    never words were truest.
    but yesterday I had the chance of visit my first patient!
    realy nothing thrilling, just a little pneumonia, but when I was there talking with the interns making the diagnosis I had this epiphany and I knew that this is what I was made for.

    No lack of sleep will change that.
    Yes, a easier life will be appreciated but would you truly bargain the satisfaction of make the life easier for somebody else who need it more of you for the pleasures of your youth?
    Hell no! ^.^

  5. This is my first blog comment in almost 2 months because this is an important issue. My few thoughts are these, even though I am not yet at your crossroads:

    1) the next 3+ years will pass regardless what you do; don’t be at the end of them thinking, “woulda, coulda, shoulda”

    2) Your health–including mental–comes first. Doctors aren’t made of any different “stuff” than anyone else. Your use as a physician is directly proportional to your overall well-being, regardless of what some crusty old fuck department chair says about his glory days as a resident in ’58.

    3) Internship and residency predictably is a sacrifice, hopefully getting less sucky as it goes along. Some payback upon being out of training–early practice struggles aside–is the whole payback mantra of all this “delayed gratification” we live with. When you see seasoned attendings/private docs in a given field, their lifestyle, and think, “Screw that noise,” trust yourself and choose otherwise.

    4) Being a physician in any capacity is an honor and privilege. Be of much of one as you can.

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