5 years. Is anyone still reading this?

Holy shit, I've been doing this for 5 years.  Look at my first post, that was over 5 years ago and before I was even in med school.  I was applying to med school; a doe-eyed premed, full of hopes and dreams, and fresh out of college.  And look at me now, applying to residency, a weary-eyed soon-to-be doctor, filled with realities and not enough sleep for dreams, or fully coherent thoughts, still fresh out of college (right? right?!?! I can still party right? I'm cool, right? Say it!  Say it!!).  So let's highlight the differences between me now and me 5 years ago.

1) Let's start with the most pressing for any hopeful premeds.  Primary care blows.  I sort of figured I wanted to have a long-term relationship with my patients, doing primary care in an underserved area, stomping out diseases with a tongue depressor and deep thought.  I'm going to listen to my patient. Fucking listen to her. That's what I'm going to do, fuck yeah!

Primary care sucks.  I don't mean people who do primary care sucks, I mean the way primary care physicians are treated sucks.  Every specialty has it's own brand of suck, but something about primary care, particularly outpatient, feels like you are standing there in your white coat, trying to listen to your patient, acting dignified and thoughtful, like a good doctor should, while monkeys surround you and fling poop at your face and laugh at you.  Fifteen minute visits, gatekeeper status, hyper-specialized docs keeping you out of the loop are the poop on your face.  The insurance companies are doing the flinging.

All of the underserved, long-term relationship, sword of justice stuff is superfluous to my new found love of hyperspecialization.  Everyone with a brain tumor is under-served.  I still like all that stuff, it is just mostly irrelevant in my world, and takes a back seat until I can breathe on the other end of residency.

2) I have confidence.  As you can tell by my first post and the subsequent ones about interviews  that I wasn't really sure how this whole thing would go.  Med school has a 58% rejection rate the last time I checked.  Residency is virtually guaranteed.  I didn't know how I would do in med school, on my board exams, with extra-curriculars, etc.  I now trust in the system.  They let me in because they thought that I would be fine, and I was.  "Med school is the narrowest hoop, and once through that, you will do just fine and get a residency" that's the basic idea and it is pretty much true.

3) I have chest hair.

4) I am jaded. Not jaded, that's not quite right, hardened, calloused.  I try very hard not to be jaded, but hardened for sure.  I've watched people die, I've pumped on their chest while they die, I've had my patients die.  That's never great, but the weird thing is just how used to it you get.  Not to mention all of the gross shit I've done or seen or been asked to do and just been like, "yeah ok whatever".  As in "Stick my finger in that guy's butt? Yeah ok whatever."

Ways I am the same:
1) I still want to be a doctor.  I want to  be a totally different kind of doctor, but I love this profession so much.  We love to bitch about it and prove how much more hardcore we are than all the other professionals, but truthfully, we get paid a more than decent salary to go around thinking about how the body goes wrong and fixing people.  We can get jaded and bitch about the paperwork and the insurance companies (for good reason), but there are so many opportunities to more or less switch careers to teaching, or admin, or writing or even a different kind of doctor if it gets bad.  Worst comes to worst, it becomes like every other job, we do it for pay and can't wait to get home to our real passion.  Boo hoo for us.

2) I want a cat.  I wanted a cat then, I want a cat now, I still don't have a cat and probably will never get one.  Seems like a lot of work.  A tattoo is in the same boat.  The same boat as the cat.  Which makes it some sort of strange boat with a cat and a tattoo and wanted by me, but only, like, sorta.

I am NSFW

A bunch of my classmates were asked to write blogs about their experience at my med school.  I have no idea why I was not asked to do such a thing.  I mean, I already have a blog; I feel like I'm an obvious choice.  What could possibly make them not want me to do it?  Pricks.

I was once asked to start a twitter account for the school where they would live feed my tweets to the admissions page.  They pulled me down in a month.  Apparently, the word "fuck" is not exactly the message they wanted to send.  But that's a totally normal, med school reaction to finding out you have another write-up to do. "You have an incomplete write-up" "fuuuuuccckkk".  See?  Natural. "You are not allowed to write an official blog" "fuuuuuucccckkkk you".  Just trying to express thoughts in real time.

display('programming sucks')

I'm learning to program (again), which is a lot like trying to learn to live in a world with a different set of physical laws, holding nothing but wikipedia.  It's like appearing in a world, wearing normal clothes, and the sun is shining, and people are walking around looking normal, so you try to take a step. Error.  Area (muscle) non-real index.

So your leg doesn't move. So you look up muscle.  Then you realize you need to know more than muscle, so you go looking for other stuff that is often cool, but you have no idea if you need it or not.  So you look up cell, nerve, desire, will-power, gravity, lactic acid, exhaustion, coordination, balance, track and field, world records, and walk-a-thon.  You try again. Your leg picks up and you try to extend your leg to land the step. Error. Undefined function or method 'step' for input arguments of "walk".

I respect the shit out of people who spend they're lives recreating the world through a made up series of logical operators, while listening to techno and monstering red bull.

This is what I think about when I'm on a research month

You will be locked in the same place for the rest of your life.  If you leave, even for a short time, you will be accompanied by a guard and in shackles.  You will get around 15 minutes of outdoors time per day, most days, weather permitting.  Exactly twice per day, you will be fed the same food you are always fed with no variation.  You may have water when you need it.  You will receive special goods and services, but only upon witnessed and continued good behavior.  You will speak only when spoken to, and never too loudly.  You will be castrated.

FREE DOGS!!!

You can take my freedom, but you can't take the word Dong.

I was taking this test where we see standardized patients*, take a history and physical on them, then write the whole thing up, come up with a differential diagnosis, and order some fake tests.  It's a timed test for both the interview and the write-up, so you tend to rush through and not care much about spelling and whatnot.  Still, I finished one patient and had a bit of time to review my write up, at which point I found this:

"64 year old female complaining of left sided chest pain following exertion.  Patient was taking her dong for a walk when she began feeling chest pain."

Hahahahahahahahaha, dong, hahahahahah, no but seriously, delete.

*note: Standardized patients are actors paid to pretend to have certain diseases and to give us information only when we ask the right questions.  It's a bit like a LARPing in terms of realness, skill at acting, and awkwardness.