Bettering myself

When I started medical school, I decided that I was going to reinvent myself, become a new me. I set some goals for myself, and I implemented a very ambitious plan to meet those goals. When setting goals, I always believed that it was best to set them high, so that even failure is really just a partial success. Easily achieved goals are worthless.

My goals were (1) to become popular, (2) to be engaged before graduation, (3) to have no fewer than 10 people with whom I would interact on a regular basis, (4) to have weekly social activities and no free weekends.

These were goals that I thought were quite reasonable and enjoyable. I was decidedly NOT popular in high school or college. I hadn't been on a date in a long time. My circle of friends had contracted from dozens to a handful. I spent most of my weekends doing laundry or cooking. I was disconnected from the rest of the world.

So, I seet my plan in motion. Over the course of medical school, I went to nearly every party. In the first month of medical school, I went to more parties than I'd attended in all of college. In the first two years of med school, I'd been drunk more times than my entire life before med school. I lost weight, a lot of weight, like 50 lbs. I worked out all the time. I was in the best shape of my life. I had scores of friends. I was invited to everything. I would meet with friends on nearly every day of the week.

I asked out so many women that for a while, I was utterly fearless. I had a big circle of friends. Other than the engaged thing, I achieved every goal I'd set out. My mission was a tremendous success, and I was utterly miserable.

And what I realized since then is that I went about trying to solve the problems in my life in the completely wrong way. I thought that by changing my trappings, I could change the person. I tried to be someone else, to change without growing. This is what the ancient Greeks would refer to as hubris.

Once I'd finished med school, I was able to look back and see some of the realities of my life. At first, I thought that it was just stuff about my love life, but after a while, I realized that the lessons I learned were more than just about love. I came upon some truths to life. And I thought I'd share what I've learned about life.

• Happiness comes from within, not from anything external. Something or someone can't make me happy.
  
• I must always be true to myself and accept who I am. I can't be happy unless I'm willing to be me.
  
• I cannot love others if I don't love myself.
  
• No one will love me if I'm not willing to love.
  
• I can't dictate the actions, perceptions, or emotions of others. I can't choose who will love me or hate me.
  
• There is no point in agonizing over that which I can't control.
  
• I cannot change who I am without growth.
  
• I cannot change other people unless they want to be changed.
  
• Doing something is NOT necessarily better than doing nothing.
  
• Life is measured in emotional content: not money or popularity or trips or parties or being social.
  
• I deserve love and happiness and everything good, as long as I'm willing to work for it.
  

This list required a lot of personal growth, but see? Growth is the only real way to change. And I needed to change, because that guy in med school, he may have been quite a guy, but he wasn't me, and I've left him behind.

Don't become a doctor #9 - it's all your fault

If you look in any medical chart, you'll see signatures and initials everywhere. Every test is initialed. Every study checked off. Every call to the doctor noted. This is all done for one reason: liability.

Somewhere along the line, we decided as a society that the buck would stop at MD, and so it is the doctor's responsibility to ensure that care is appropriate, and if malpractice does occur, the doctor is the one who is responsible.

This all sounds very reasonable until you consider a few circumstances. The doc is liable if a test is done and the report not sent, but the test is markedly abnormal. The doctor ordered the test, and should have followed up on the result.

The doc is liable if he orders a medication that is not administered over the course of a hospitalization. He ordered it, and should have ensured that it was given.

My point here is that there is only one person to blame for all these mistakes that happen, and that person, if you have MD after your name, is you.

Ouagadougou

VSEPR: Valence Shell Electron something something. Position? Pairing? I spent over an hour today trying to remember what VSEPR stood for, and I was a little embarrassed to come up so blank on something that I'd spent practically an entire semester of college studying. All that time, and now I can't tell you a thing about it, muchless what the letters stand for.

I have books full of medical information that is entirely lost to me. I was looking through a neuroanatomy text, thinking to myself that only a few years ago, I probably knew as much about the rubrospinal tract as any neuroscience grad student. Now, I don't know what it connects, and even less of a clue about what it does.

There are 16th century Chinese painters, eons of Japanese history, quantum mechanics and thermodynamics, linear algebra, linguistics, all these myriad pieces of information that are entirely lost to me, things I once knew so well. And even more frustrating is having to be reminded of things constantly. I need to cheat all the time with katakana. I keep a Korean dictionary on my coffee table. I need to be reminded every single time about what is the infield fly rule.

And what I've retained is entirely trivial sometimes. I remember that the capital of Burkina Faso (a small, land-locked West African nation), is Ouagadougou. I remember that the Battle of Antietam is the single bloodiest day in the history of the United States. I remember that it is known as the Battle of Sharpsburg in the South because the South liked to name battles after local towns and cities, while the North usually named battles for local creeks, rivers, and bodies of water.

There are times that I mourn all this lost information. I think about how sad it is that it's gone. There are things that have pushed this knowledge out, but it's not a replacement. It's not equivalent. Calculating PORT scores doesn't equal Kano Masanobu's paintings for the Ashikaga shoguns. Knowing the etiology of Diabetes Mellitus type 2 isn't the same as the Schrödinger equation.

But it's nice to realize that there are some precious things that I've held onto, like being able to escort a lady or a very basic waltz. I actually know the difference between a teaspoon and a dessert spoon. There are little things like this that bring a smile to my face, more so than VSEPR (I got it! Valence Shell Electron Pair Repulsion! It's a theory for predicting the geometry of bonding configurations for non-metals by estimating the repulsive forces of the valence shell electrons.) ever did.

Where were you?

There are certain things that are defining for a generation, defining for a whole society. One of my teachers in grade school told us about when he first heard about the Pearl Harbor attack, and where he was and what he was doing. Another of my teachers from England told us about VE Day.

When the Berlin Wall fell, I was sitting down to dinner with my mom and brother, and we'd watch the news during dinner. I was in the same spot during the LA riots. I was in gym class in high school when Michael Jordan retired. I was in school, like so many other kids, when I heard that the Challenger had exploded.

So now, five years later, I can tell you with deadly accuracy exactly where I was on September 11, 2001. I was sitting around in the student lounge of my medical school after a particularly annoying quiz. We'd finished early and were waiting for lectures to start. A few of us were playing euchre. My friends had been playing ping pong. One of the maintenance people ran in and told us to turn the TV on, and a few minutes after the fact, I learned about the first plane crash into the North tower. We watched just enough television to see the second crash, and then lectures started.

My professor made some offhand comment that we would need to learn to deal with adversity and that classes wouldn't be canceled. I was glad I invested in a cell phone, and I started calling everyone I knew who'd be around the WTC area.

After the lecture, I find out that one of the towers has collapsed. After another hour of lecture, another collapse. I call a med student friend of mine and she's been enlisted into the ER of a local hospital in NYC. But she has plenty of time to talk to me. No one's coming in. The ER is silent. I can hear over the phone, no buzz at all.

Instead of lunch, we all gather in front of the TV and watch the coverage. Several of us are darting in and out of the lounge trying to get better cell phone reception. Our afternoon lectures are canceled. There's no point in trying to teach us more. We're numb.

By the time I get home, they have footage of the exact moments the planes each crash into the towers. They have shots of people jumping to their deaths, preferring to die from suicide rather than burn to death. And they first realize that somewhere in the neighborhood of 400 firefighters are missing or dead. I watch as much CNN as I can stomach for the next 2-3 days, and then I can't watch anymore. I can barely watch cable news even today.

Turns out that everyone I knew in and around the WTC area were all okay. A friend who worked in the WTC didn't work in the towers, and my family was all far away. I visited Ground Zero about a year afterwards, and it was just a hole, and I felt numb. I still feel pretty numb, like it couldn't have happened.

And I still cry when I see those planes crashing into those beautiful buildings, that stood there for just a little longer than Ive been alive. It seems like they were there forever, and I can still remember going to the top three times in my life, and it's sad to know that I'll never see that view again.

Things that go bump in the night

Calvin: Help me (hic) get (hic) rid of (hic) these darn (hic) hic (hic) hiccups!
Hobbes: How?
Calvin: (hic) Scare me.
Hobbes: Our oceans are filled with garbage, we've created a hole in the ozone layer that's frying the planet, nuclear waste is piling up without any safe way to get rid of it...
Calvin: (hic) I mean surprise me (hic).
Hobbes: That doesn't?! Boy, you're cynical...

Last night, I had by far my worst nightmare in years. I wish that I could say that it was trolls or falling to my doom or something otherwise frightening, but it was me sitting in a big room taking the Boards. And I was doing bad. REAL bad. And I didn't finish. And I got my results instantly. And of course, I failed.

And then I lost my position. And then my girlfriend dumped me (waitaminute, I had a gf?), and everything was horrible.

Y'know, lately, whenever I have nightmares, they're not ghosts or things like that It's all stuff that is stuff that I wake up in the morning, and I'm not any less scared. The whole point of a nightmare should be that you wake up and feel safe. You shouldn't wake up in the morning and feel worse than you did in the dream!