Are We There Yet?

Am I still a medical student? I am legitimately no longer sure.

In the last four weeks, I’ve flown to five different cities, taken a two-week family vacation to Japan, stayed in enough hotel rooms to bankrupt a minor consulting firm, and worn a suit enough to notice that I am clearly fatter than when I had it first tailored in 2012.

If you’re not a regular reader of this blog (hi, Grandma), I’m also trying to match into emergency medicine. I mention this fact because I have not actually seen a patient in the emergency room since September. I no longer know what the HEARTS score is, or what goes into a syncope workup, or the five causes of shortness of breath.

This is because fourth year is simultaneously the greatest year and a largely wasted one. My school does better than most in trying to make the fourth year a meaningful clinical experience, but they made the mistake of admitting me – a trueborn expert in the art of squeezing every inch of freedom possible from the curriculum. To be fair, I frontloaded the hell out of my third year for this payoff.

To illustrate my point, here is my 4th year schedule, in order:

  • 2 away rotations, where I admittedly worked hard;
  • 1 month abroad, where I also worked hard, in the sense that I was present a lot, got to play with ultrasound machines all the time, and once had to figure out how to mix up a dopamine drip by hand while someone was about to die;
  • 1 month on the pulmonary consult service, which was the greatest elective class of all time from a Netflix perspective;
  • 3 months reserved for “interviewing,” during which time I am becoming especially proficient at analyzing various Westworld fan theories and at sleeping a great deal;
  • 1 ICU month, which is upcoming and will be very hard;
  • 1 class on radiology and anatomy, which is supposed to be hard. I have already emailed the course director saying that I am interested in learning things but not in trying, so don’t expect much from me. She preemptively understands I am a lost cause.

Counting from November – the kickoff of interview season – I have two actual hospital months left, one of which is a nice learning experience but is, for all practical purposes, a throwaway.

…A $46,000 throwaway. I’m basically paying for the privilege of buying plane tickets and trying to be nongrouchy to people who hold my future in their hands.

Not that I’m complaining about the funds – money for a medical student is a mostly abstract concept to be contemplated, not used. There are so many fixed and sunk costs in medical school that we all pretty much just ignore the concept of money and pretend we are still using the barter system and Hammurabi’s Code.

The alternative is to try and add up all the numbers, which invariably ends with a full-blown nervous breakdown: the med student sounding like a Scarecrow victim, muttering “compound loan interest” over and over again and having all their meals pureed by an orderly. Not that I’ve thought of that particular scenario before or anything.

batman-begins-scarecrow-screencaps-dr-jonathan-crane-scarecrow-13222096-1022-420

So back to my question. Am I still a medical student?

I don’t really feel like one. Perhaps this is because I am not in the hospital and thus out of practice with the Med Student Daily Apologia, which entails being informed or shown that I am a stupendously incompetent boob, a walking liability bomb, and by far the dumbest person in the hospital, if not the zip code.

(That said, this emotion still surfaces on occasion on the interview trail when I discover that an applicant singlehandedly invented ketamine or something equally spectacular. This is because my lifetime achievement to date, bar none, is my 2005 second-place finish in our high school football team’s chipotle burrito eating contest.)

Perhaps it is because for the first time in a very, very long time, those higher up on the food chain are selling their programs to us instead of the other way around.

(kind of)

Or perhaps this is because besides the occasional interview or travel day I don’t actually have anything to do, a circumstance that has driven some of my fellow med students unaccustomed to free time (especially those who do not know of the Real World, wherein work actually ends at 5 pm and does not resume until 8 am the following weekday) to the brink of insanity.

Remember, medical students are the single most high-stress, driven group of people you will ever encounter – yes, lawyers and finance friends, even more than you – and some of us are cognitively incapable of giving it a rest.

These friends will go to extreme lengths to make themselves busy. It’s terrifying to watch.

Regardless of the reason, I’m not sure what my status is right now. I never know how to answer the taxi/Uber driver when he says, “are you traveling for business or pleasure?”

“Neither,” I usually reply. Once I tried telling the truth – “I’m actually traveling to satisfy my own neuroticism and to relieve both the crushing psychological weight of being alive and the anxieties of my mentors, without whom I would probably apply to three places, throw up my hands, and yell ‘jesus take the wheel’ on stage at Match Day” but all I got was a confused look and a hand turning up the volume on the radio. Now I reply with neither.

jesus-take-the-63hr78

I’m ready for this to be over now.

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