First day fun

So ... as luck would have it, I may well have chosen the right career after all. Hm. Today was pretty damned awesome.

Some favorite bits of my 12-hour first day of surgery clerkship:

• Hearing a little girl who was running out of the elevator say, "I love the moving stairs! THEY ARE AWESOME!"
• Being reminded of how different the patient's perspective is when I heard patients try to describe their surgical, imaging, and medical histories. "CT scan" means nothing to a large portion of the population, but describing being stuck into a giant tube gets a good response.
• Time passes strangely without bathroom or lunch breaks.
  
• Taking my first real history with a real patient for a real doctor's visit and then discussing what we thought was going on with this very real patient. In reality. For real. WOW. IT WAS REAL.
  
• Finally feeling a part of a team - this sounds stupid, but I really like working with people to achieve good things for other people. It makes all the happy bits of me happier because I can go home knowing that life improved for someone else, and I got to be at least a teeny-tiny part of that. And someday, my part will be much larger.

Medicine is arguably the coolest job ever. Even though many aspects of med school suck. At least, that's my first-day impression.

So ... yeah! Hi! I am alive again! How are you?

Phew.

Well. Now I have time again. And what do I find myself doing, now that my exams are over?

I sleep in as much as I'd like. I eat when I'd like, whatever I'd like. I am reading a book for pleasure, although I'm having a hard time remembering that I can do that. Once you fall out of the habit of reading books and into the habit of reading blog posts, it's hard to remember that you can do both sometimes.

Or maybe that's just me.

I am slowly recovering ... my brain still feels like it's made of jell-o and I've been klutzier than usual lately, but I am getting better each day. And now I have chocolate chip cookies to eat! I baked them yesterday and didn't burn myself once. That that is an accomplishment is a testament to my incredible klutziness lately. Really. I have been a threat to myself.

Thank goodness the first two years of med school are over. Even if I failed USMLE and have to retake it, I 0nly have to do that. I don't have to go back and redo the two years of class. That was (hopefully) my least favorite part of med school, and now IT IS OVER.

PHEW.

The bigger picture

The last time they saw moving, the Ex packed up and left as a surprise to all of us. The last time they saw this, one of their people never came back again. While they've never liked moving, it is worse for them this time. They are anxious, milling around me, begging for attention with renewed intensity. They need to rub my hand NOW. They need to play fetch NOW.

I think about the impact the Ex's departure had on me, but it doesn't occur to me to think of the cats as grievers. But when they beg and whine and look up at me with those big eyes, it's clear that they worry there might not be a tomorrow. They need to be petted NOW in case I don't come back.

Overall, we're all happier now, but we all have the hurt of being left behind. All three cats and me.

Sometimes

When the day has been a struggle for entirely different reasons, I sometimes begin to doubt myself for having had a failed marriage. Never mind that I understand why it failed, why I entered it, and what I've learned from it. Never mind that I couldn't be who I am today without having had that experience, and for that, I really am grateful.

On days like today, when I judge myself harshly, this is one of the things on my list. This is one of the things for which I fault myself. I ask myself why the next relationship will be different, why I think I could one day succeed at a marriage. I doubt my ability to be in a successful marriage.

It's not fair to myself, I know. It's not fair to my experience, my strength, or my insight. It's not logical and it doesn't make me pretty.

But ultimately, deep down, it is something which calls into question who I am as a person. The kinds of judgment calls that led to that marriage and the divorce are calls which lead me to doubt myself.

It's not fair, and I know that I've grown a lot since then, but still: I did that.

On days like today, that is hard to live with, even though I know tomorrow I will feel better about it. Tomorrow, I know it will be less of a struggle. Tomorrow is always better on days like today.

Tonight I will go to bed early so tomorrow can come sooner.

It's the imperfections that make us perfect

I am at the bottom of my class in med school. Going through the marriage I did when I did made everything ten times harder for me. Additionally, I'm not as smart as some of my classmates. As much as that pains me to think (because I'd rather be the smartest! The best! I want to be super-awesome!), it really is true. I have classmates who outperform me regularly by studying a quarter as much as I do.

Most patients would probably never want to hear about my academic record before seeing me. They would probably hear about the classes I barely passed and cringe, thinking me inadequate as a result. Or at least thinking that I wouldn't know my craft as well as someone who'd gotten all As.

And honestly, in the old medical system, they would be right. It used to be that doctors were paternalistic know-it-alls. Doctors had all the answers, and if they didn't, they were bad doctors.

But there's a lot we don't know, and the role doctors have with their patients has changed a lot. Doctors are still well-educated and required to continue their education (after all, we get the MDs and the patients don't), but we are moving closer and closer to having a society wherein doctors are more like advocates for their patients than medical overlords to be obeyed. Patient autonomy is something we are learning more and more to respect whenever possible, and we're trained to encourage patients to make their own decisions.

This past year has been especially hard for me. I've had to confront a lot of personal weaknesses head-on. Despite my lower grades, I think this will ultimately make me a really great doctor. I know a lot of the real-life stuff my patients will be going through. I understand imperfection intimately. I've been a caretaker; I'm intimately familiar with the stress of being responsible for someone else, especially when that someone else is assumed by everyone around you to be a functioning adult.

In short, I've been there. A lot of "there". I've done a lot of "that". I will have a deeper understanding when my patients can't explain their pain to me - my classmates who are smarter and less experienced will miss that. There are sighs and ways your shoulders get bent that just don't mean anything if you haven't been there and done that.

So while my academics leave a lot to be desired, I keep telling myself that they're not the full story. The same way I know I'll see patients who won't be able to verbalize all that they are going through, my academics are only part of the story. I know the tendency is to want a doctor with the best academic record, and by the same token, we all want a patient to walk in and say, "Doc! I seem to have a pheochromocytoma, not a heart attack or panic attack! Please treat me correctly!"

I'll work hard to learn the things I don't know already. I'll study my ass off. But in this very human world with very human difficulties, the doctor we need is the one who will understand us, be respectful, and help when we can't help ourselves. I hope to be that doctor.

Love Thursday

Love Thursday is a tradition I've seen a lot over at Woulda Coulda Shoulda. I've decided to pick it up, at least for this week. We could all use a little more love in our lives.

My Love Thursday is dedicated to the Boyfriend, who very patiently waited through the divorce proceedings until things were legal and who has been very supportive ever since I met him (which was after the Ex had left and my life was pretty thoroughly chaotic).

BF has been the victim of one of my biggest character flaws: I have a complete inability in some moments to see the bigger picture. I am a detail-oriented person, and this can be a great strength when it comes to studying medicine and understanding the intricacies of how things work. I use this ability to focus on tiny things to maintain concentration when I study. I use it to understand how ingredients will cook and be able to predict how they will interact with each other. I use it to find ways of comforting people.

But then there are the days when it becomes a curse. Like a few days ago, when BF ate out of one of my non-stick pots with a metal spoon. For the five millionth time. And of course, the only thing I could see was my frustration with this (really very insignificant) transgression. The cost of the pots! It is so high! And I have told him to use a bowl when he cooks at my place! There were clean bowls! And the pot is mine, not his, so I'll have to pay to replace it if he breaks it! And the metal spoon could scrape off the teflon and give me cancer! Or Alzheimer's! Or a bad day!

It was truly the end of the world, I will have you know. Obviously.

The thing is, that's about the only bad thing I can say about BF: he can't remember he's eating from a non-stick pot. That's it. It's truly terrible, I know. Probably the worst fault a person could have.

Just last night, after a night of horrible sleep the night before, I fell asleep on his shoulder. He let me sleep and did absolutely nothing (didn't want to disturb me) for 30 minutes. I woke up again all of a sudden, convinced I hadn't been sleeping because I couldn't remember it, and then promptly fell back asleep for another 15 minutes.

In other words, he sat still as a human pillow for 45 minutes with no book, TV, or internet to occupy him. And then I didn't thank him, because I am really sweet like that. When he finally had to go to work, he commanded me to stay in bed and then tidied up the living room before leaving. Again, not much thanks from the semi-conscious Emily. I stumbled around the apartment a little bit because I had to clean out the kitty litter boxes and I insist on not letting BF do that for me (he can wipe down my stove but scooping cat poop? THAT is where I draw the line! We aren't living together, you know!)

My point is that he gets the big things right. He takes care of me when I need him and respects my token bits of independence. He keeps my best interests in mind. He's literally the shoulder I can lean on.

And that's really worth a few pots.

Happy Love Thursday, everyone.

Bouncing all around

Yesterday I was feeling discouraged, today I'm feeling happy. I think a lot of it is tied to how many hours of class I have. Yesterday was a really long day, and today is a much shorter, more doable day. I can use today to help get caught up. That always makes me feel better.

Emotions are funny things, aren't they?