His story, Her story

Everyone has a story. Everyone has tales of woe and triumph about this abortive process called medical training. The stories are all about the trials and tribulations, the attendings, the rotations, the schools, the classmates, the exams, the sleep (or lack thereof), the process, the residencies, the hours, the longer hours, the memory (lapses). And we all seem to have the same response on any given day...one day at a time, moving closer to the goal, whatever that is for you. It's a daily slog.

And it's so great to find those of use who relish, thrive and look forward to the learning day. There are great mental triumphs and "oh wow" experiences of eureka, mind blowing understandings of new, or newly incorporated knowledge. And it's those that force people to answer the question, "how are you?" with "I'm EXCELLENT!" :) and really mean it.

The process can be a great challenge.

But, today, I'm EXCELLENT.

Thanks Ceriman, the waiter, for reminding me of that simple fact. It's not what happens to us, but how we respond to what happens.

Mortality

I've learned to equate "clinical trials" of medications on people with illness as a terminal event, one step closer to death. It's just the places I've hung around, people I've worked with and things I've seen, but the the two -- Clinical trials & terminal -- just seem to go hand in hand.

One of my friends from way back when I was too smart for my own good, just told me she's in a "clinical trial". I felt sick...for her, and her family. She's so upbeat, so positive, so able to move through the day with a huge smile on her face. That same smile way back when, won her awards. Now they hide the sad fact that disease is ravaging her body.

I'll pray, I'll hope, I'll stay positive for her when we speak. But I've become acquainted again with mortality.

One, more, STEP

Seems like I've been studying medicine my whole life. Oh wait, I have! And it seems that it really all comes down to this set of two exams...Step2 "clinical knowledge" CK, and Step2 "clinical skills" CS. The entire reason for being comes down to two day of exams, one live with patient actors (and I use that term very loosely), and one "dead" day with a computer for 9 hours. Then sometime this fall, two email messages, and attached PDF's announcing the fate...Yay, or nay, to have the opportunity to graduate, get the MD in hand and move forward into the next part of training, the residency.

Rotations have been great. I'm in my element. I love the patient, the clinic, the learning, the relationships with staff, the smells, sounds and activity around healthcare. Lots of people are disgruntled in the field of healthcare, but I largely ignore them. Rotations are signs of things to come, residency and practice beyond. This really is the essence of why I did this in the first place. I am encouraged.

I thought she said "your ass" when I first heard the description of "what next" from one of my classmates. Actually E-R-A-S (residency) application. It is truly time consuming, but a necessary evil and it too continues getting ready for the 2012 match with 35,000 close medical friends who will also apply. Letters, documentation, work history, blah, blah, blah. Seems like I've been filing paperwork my whole life too. Oh wait; I HAVE!

So I study, and study, and study some more. It's a race against time, knowledge attrition, creeping dementia, boredom, mind numbing fear and a touch of ADHD. It's a balance between sitting for long hours, exercise, sleep, eating right and knowing just how much caffeine I can bear without overdosing.  It's keeping an eye on the prize and doing what it takes, even if I should have found "another career" (- career counselor, 1977). This 2nd step isn't the last step, but it's the one that really counts and "bookends" the process of the past 4 years. It's exhilarating, and frightening in one well wrapped package. My date with destiny coming very soon. Emails forthcoming.