What comes next

​One of my patients had a major event, and very nearly died. It was very touch and go, and after several months, she is finally on the path to recovery, and I was a little surprised that she pulled through, because of all of my patients, she is the most accepting of death. She's been a widow for years, and we frequently have talked about how she is ready to go. So I was surprised to see her clinging to life with such tenacity. She is not going without a fight, the person I had thought to be the most eager to have her ticket punched. 

Life is funny sometimes like that. On the news sometimes, you see people ready to commit suicide, and at the very moment they are ready to leap, they grab onto the edge desperately. There's a line in "Crime & Punishment" by Dostoevsky where he says:

... where was it that I read of how a condemned man, just before he died, said, or thought, that if he had to live on some high crag, on a ledge so small that there was no more than room for his two feet, with all about him the abyss, the ocean, eternal night, eternal solitude, eternal storm, and there he must remain, on a hand's-breadth of ground, all his life, a thousand years, through all eternity - it would be better to live so, than die within the hour? Only to lie, to live!

I don't know what comes in the next life, but I don't have much expectation for what remains for me in this one. Maybe I will have a different perspective when I am in my eighties, but if I look at my life honestly, I am already coasting in neutral. I really wonder if when my time comes, will I also grab onto the edge?

The right thing

Recently, I had to go to a meeting where we reviewed our HCAPS scores and other quality metrics. If you don't know what these are, then you're lucky. And we've had industry experts come in and talk to us about "Here's how to get your HCAPS better!" or "Shaving down your length of stay" or some other talk, in order to game our numbers and earn ourselves a few extra nickels. Most of the time, I play on my phone the whole time, or zone out completely. I have open disdain for such talks, not because quality of care is important, because it is. Quality of care is extremely important. But average LOS and HCAPS and HEDIS and all these quality metrics are all surrogates. I can make those numbers better, but that doesn't mean that I'm a good doctor.

However, one of these speakers said something that reached me. "The most important thing," he started. "...is that we do what is right for our patients. That's job #1. Then, we should figure out how we can get paid better for it. But even if we can't get paid better, at least we know we did what is right."

I spend a lot of time doing what is right, rather than what is expedient or what gets me more money. And that sounds so estimable and noble, but in reality, that is hard work. That is spending time arguing with an insurance company over a refused prior authorization, or seeing that patient who came in so late to their appointment but with acute problems that can't wait till next week, or spending 5 extra minutes writing a good note that most likely no one will ever read.

I used to be a little bitter that here I was, doing the right thing, and getting no credit for it. As well, there were plenty of others doing a fairly terrible job, and no one was calling them out for it. And it took this line from this industry expert to remind me that the goal wasn't to get credit. The goal was to do the right thing. That's the reward. Getting credit is just a pleasant side effect, should it happen.

When I was in college, I was the proverbial "nice guy" who never got the date with the girl, and I was similarly bitter back then. Here I was, such a nice guy, but ignored by so many women. And I was reminded by a very wise old lady that goodness is its own reward. If you are being nice to women only for the expectation of a reward, then that's not chivalry. That's being a creep.

The toll of medical school

My New Year's resolution this year was to get back to healthy living. I spend countless hours talking to people about improving diet and exercise, and ways to change lifestyle to improve health. And it's good advice, and some of my patients are quite successful. However, it's advice that I should probably heed.

Before I started my third year of medical school, I ate healthy. I bought fresh produce. Turkey was my favorite meat. I ran a few times a week. I worked out a lot. I was probably in the best shape of my life. Then came clinicals.

Since that fateful July 1st, my health has gone into a tailspin, because after a 30 hour call, I just didn't have the energy to do anything else, muchless exercise. And every year, I've gotten fatter and more complacent. So I have finally decided that it's time to change. And so I am returning to healthy living.

And I think to myself that medical school has taken a considerable toll on my life. I was physically great. I was mentally stable. I was doing quite well. And as much as I enjoy being a doctor now, it's with the knowledge that I spent so much time taking care of medicine that I forgot to take care of me.

Prom was for losers anyway, speaks the voice of bitterness

For the first time in two years, a friend has achieved a level of correspondence deserving of a personal folder in my file cabinet. Only twelve others have achieved such a distinction, but paradoxically, I am out of contact with seven of those twelve. So, maybe this is a bad thing. I read through my favorite Christmas card ever, from a girl I used to know. She's got a special place in my heart because she was the only girl ever to actively pursue me. And for that, she gets all the props in the world.

I realized that I've never been invited to a white tie affair. Now, I've been invited to plenty of black tie events, but never white tie. Well, I've never actually been to a black tie event, but I've been invited. D was confused when I mentioned this. Y'know, formal events like the prom or other dances. I repeated my statement. I've never been to a black tie event.

I'm not sure if it's weird that I didn't go to prom. It was pretty much the most unappealing idea in high school. I hated my school. I hated all the popular kids in the school. I had no date. And going stag was akin to social suicide. And then, dancing? *shudder*.

Y'know, I spent so much of my life watching from the sidelines. I've watched other people get where they want in life, and I keep wondering when I get to start. Y'know, I'm not sure how many more weddings I can really attend and still care. I wish that for once, it was my turn. But it's not, and it won't be, especially since I've adopted my little laissez-faire policy on dating.

So whatever. I've conceded defeat in this stupid town. I've come upon the sad realization that I'm not going to find what I'm looking for in this city, or state, and I really should have pursued the coasts more vigorously. At least on the coasts, I've got a fighting chance. This whole Midwest thing, it's like living in a big tub of vanilla. And that's fine, if you're vanilla. But it's nothing but trouble if you're a praline.

There is a two year expiration date

I find myself in a very awkward position these days of wishing that I was in a relationship, but entirely unwilling to deal with potential rejection. I am, to put it in the vernacular, gun shy. And so, I'm not really sure what to make of all that. I mean, I'm sure there are positive steps that I can make, but right now, I'm not exactly the picture of confidence.

S is right to point out that I have exhausted my available options. I mean, I do know single women, but I've been relegated to Friendville, so it's not like I'm going anywhere. I find this quite ridiculous, but then again, I'm the one that's single. I'm supposed to find it ridiculous.

Of course, my mom is unusually eager about my prospects. For the past few years, she has been increasingly inquisitive about my romantic life. In college, my mom took the hard line opinion that I should not date because it would interfere with my studies. Well, it wasn't like I listened to her. Now that I've become a medical student, she seems convinced that I should be dating more. Well, I should be dating, period. 'More' would imply that I've been dating.

I had a funny discussion with my mom. I was showing her pictures on my computer. And whenever there was a girl in the picture, my mom would go, "Oh... is she married?" You can imagine the follow-ups that ensued. Anyway, I knew this was coming, but we eventually hit upon one friend of mine. I'll just quote the conversation.

mom: Oh, who is she?
me: That's ______, the friend of mine I told you about.
mom: [trying to ask casually, but this is like the fifth time she's asked this question] Is she seeing anyone?
me: I'm not sure. I don't think so.
mom: Oh, then you should ask her out.
me: I don't think that'd be a good idea.
mom: She sounds nice. And she's pretty. You should ask her out.
me: [laughing] well, I already did. That's why it's not a good idea.
mom: So what did-
me: The answer was no.
mom: Well, how long ago was that? [furrowed brow, analytical gaze]
me: Umm... a while? Like 2 years?
mom: Pfft, after 2 years, it's okay to ask again. It's so long ago, it's like you never asked.
me: ... Well, if she were interested, she'd have said something.
mom: Why would you think that? After two years, ask again.

I have come to realize three very important things. (1) I have absolutely no comprehension of the female mind. (2) My mom seems to have far more confidence in me than I do. (3) From now on, I should tell my mom that all my female friends are married or are nuns.

Less important, but also interesting, the following three items. (1) My mom seems to have this uncanny knack for picking up on girls that I have been interested in. It's not like I tell her anything, but she always manages to hit the mark. (2) My mom's questions have become interesting as well. At no time did she ask me if I knew any Korean girls. She didn't ask about the religion of any of the girls I know. She didn't come out and ask me about my romantic life, but tried to be subtle about it. Odd. (3) I didn't know that "No" had an expiration date.

Why I don't have a Christmas tree

Every year, I catch a lot of flack about Christmas, because I do not make a big fuss. I no longer buy a tree or wreath or any decorations. I don't even buy presents. This time I bought 5 presents. In 2002, I bought 3. I write my Christmas cards, but otherwise, that's pretty much it. People always seem surprised why I don't do more for Christmas. Well, what does any of it have to do with the birth of Jesus Christ? You know, it's tough to put up a tree and decorate it, knowing that it has no religious or spiritual significance whatsoever.

I just can't bring myself to do commercialized Christmas anymore. It's not what Christmas is about. To me, Christmas is a wonderful time of year, and it has nothing to do with presents or hot cocoa or a douglas fir or blinking lights. I think that the Charlie Brown Christmas special sums it up:

"And there were in the same country shepherds abiding in the field, keeping watch over their flock by night. And, lo, the angel of the Lord came upon them, and the glory of the Lord shone round about them: and they were sore afraid. And the angel said unto them, 'Fear not: for, behold, I bring you good tidings of great joy, which shall be to all people. For unto you is born this day in the city of David a Saviour, which is Christ the Lord.

"'And this shall be a sign unto you; Ye shall find the babe wrapped in swaddling clothes, lying in a manger.' And suddenly there was with the angel a multitude of the heavenly host praising God, and saying, 'Glory to God in the highest, and on earth peace, good will toward men.'"

"That's what Christmas is all about, Charlie Brown."
-Linus Van Pelt

Word, Linus. Word.

2003 in Review

First Quarter

After doing child psych, I was really conflicted. I loved working in the child and adolescent service, but it was so hard. Everyday, I'd come home emotionally drained. Eventually, I decided that I couldn't do child psych, because it got me so angry every day, so frustrated because most of the kids are the way they are because their parents abused them or mistreated them. It was emotionally too much, but I never wanted to be cold to that sort of human suffering. So in the end, child psych was not for me. But it was nothing but fun being on a rotation with M.

Then, OB/Gyn! It started off hellish, but after 4 weeks slaving through surgeries and countless pap and pelvics, I found out that I actually really like OB/Gyn. And I could never do it. Half the women told me to my face they'd never see a male OB/Gyn, and with malpractice costs it'd be a terrible idea. But if I was a woman, I'd do OB/Gyn in a minute.

Second Quarter

For Spring Break, I stayed in town and did nothing. I tried to upgrade my computer, but I ended up wasting a lot of money. Started surgery, and I really enjoyed working in the ER. I called a laundry list of people for the Baskin Robbins free scoop night and only managed to get two people. For free ice cream. How pitiful is that? Went to the museum with F to the museum, then Hooter's afterwards!

Started surgery with M! We were like ill-behaved children. It was the most fun I've had on a rotation in a long time. Then, vascular kicked my ass, and I have to say that no human should have to do that. Memorial Day came and went, and I did not have a date in the meantime. But at least I got to grill. I got drunk, again, in R's basement.

Third Quarter

I worked on my golf swing at the range, only to determine that I suck. Went on a canoe trip and ended up in the ER. My laundry sock streak ended. In the past 4 years, I've only lost 2 socks. The AC broke and we were very warm for a while. Went to the museum with I and R, and sushi! I started climbing again, after a 12 year hiatus. Bought gear, a Nalgene bottle, the works. Learned that I can apply a coat of Rain-X to a front windshield in about 3 minutes.

I went on several trips to look at knives, egged on by F. I finally broke down in December and bought a set of Henckels. I frequented the sauna for a month or two. I found out that my aunt has terminal cancer. I started getting into punk and emo music. I had the damnedest time writing my personal statement, which went through 3 revisions before coming out in its limp form. I had my standard Labor Day grillfest, with the standards in attendance. I spent two months trying to find a decent bowl of naeng-myun. I picked up a new laptop thanks to my old computer's uncanny ability to cease working. And I tried to quit smoking again, and I failed, again. I did go for 5 weeks without, but in the end, I broke down. And in September, I began my quest for apple cider. I changed my haircut, who's to say if that's for the better or worse, or if anyone even noticed. And I came upon the realization, as September came to a close, that I might have Seasonal Affective disorder.

Fourth Quarter

I went to a concert with D, I started cardiology, I bought canvas tote bags, because somewhere along the way, I picked up some eco-nerd into my persona. I discovered Starbucks, only to discover that I prefer a different local coffee house. It IS true then. Starbucks really is good for independent coffee houses by increasing the prospective market. I had my whole big deal about bill splitting, to the point where I treated about $400 worth of meals this year. I bought a new PDA because my old Handspring (wrought with all sorts of problems to begin with) shattered.

I tried to get drunk on Halloween to wash away my troubles, and I failed, and I ended up so depressed the following weekend that I formulated a plan to kill myself, and the only reason I didn't follow through was a pack of cigarettes and a holy day of obligation. In retrospect, I should've gone to the ER and had myself committed. I stopped eating for quite a while, and I lost around 15 lbs as a result. I found that I can actually starve myself down to 1000 kcal a day. I had to force myself to eat. My brake lines went out. Thankfully, I wasn't suicidal at the time. After several long talks with a few close friends, I managed to pull myself from the edge. I am pretty sure now that some component of this is seasonal affective disorder.

I took Step 2, and passed. I swore off drinking to get drunk. Never again. I made the switch from briefs to boxers. I went to visit my dying aunt. I came to the realization that when I climb with R, I always injure myself, and when I climb with I, I always strain something or work something till it's sore. I went with I and R to Thanksgiving at R's, which was the most educational Thanksgiving ever. Me and I had a slumber party. I was talking to some friends and telling them that according to her, I snore like a little boy. Then, silence. It took me 5 minutes to realize the obvious next question: why does she know how you snore? My aunt died. I feel happy about it, and I feel guilty for being happy. Happy that her suffering's over, but how could I feel right hoping that she would die sooner.

I started Neurology. I got to see so much of my college friends, they're such a welcome sight. I saw Handel's Messiah with D, which was an excellent performance. I ruined a sweater. I rediscovered the art of being a gentleman. I wrote a million Christmas cards. I got some touching cards in return. I went South for Christmas and that's pretty much a wrap on the year.

Rebuilding burnt bridges

I got a few cards today, and a piece of homemade fruitcake. Now, the cards are always welcome. Man, I love cards. And one card from S was especially sweet. But the fruitcake was entirely unexpected. I was glad, because it came from someone that I haven't talked to in so long, and we parted on such bad terms, and it was nice to hear from her again.

I am not the biggest fan of Christmas. As a holiday, it has more religious significance to me than anything else, but still, it always ends up being a wonderful time of year because I hear from some friends that I haven't heard from in a long time, or I'll get a card and it'll be the nicest thing that I've read. There is an untold amount of love that can be given in card form, and this year, I got so many wonderful cards. If any of you read this site, all your cards are very appreciated, and I want to thank all of you from the bottom of my heart.

Tooting my own horn

There's something funny about crushes, because they're completely nonsensical, but sometimes, something will pop up or remind you, and it's like nothing ever changed. I was thinking about one of my old crushes today as I flipped through my old letters and cards. And all I could think was what a tragedy.

I don't often toot my own horn (that sounds dirty...) but I think we would've been good together. We got along like peaches and cream. We were both so full of foibles and quirks and sharp edges to cut yourself on. We were both so flawed, but flawed like puzzle pieces. It's like, if you have two round spheres, they can never get that close. Only a little bit of their surfaces can ever really touch. But two puzzle pieces, with their odd sides and rough bits, they can interlock. We were like two funny shaped puzzle pieces, trying to find the places where we fit.

But we never locked together. We were like bookends, always being kept apart by one thing or another, and then when we got too close, one of us would put more stuff in between. And only looking back now do I see that we would've been a good fit, but it's a little late now. It's a little late to be digging up the past and trying to relive it. It's a little late to feel bad about it. I have far more immediate things that I can feel bad about.

In a foul mood

I am... temperamental right now. Perhaps that's too gentle a word. I am in a foul mood. I'm not depressed. I'm not sad. I am, for lack of a more descriptive term, angry. And you know what? You people don't deserve me cheery or happy. You haven't earned it. You got cheery me as a matter of course. You got cheery me because I was trying to be cheery me. You didn't have to suffer through moody and depressed me like my friends from high school and college. You didn't have to deal with smoking myself to death me. You never had to witness distraught me or sorrowful me. You didn't have to put up with me through all my shit. You don't deserve to see me cheery. You have no right to see me cheery when you contributed no part to all the work that went behind that.

I've spent so much time trying to be cheery and happy and pleasant, and you know, that's all bullshit, and I'm done with it. I'll be what I want to be and how I want to be and when and where I want to be, and I'm done with trying to please you and humor you and play to you. I have spent far too much of my lifetime acquiring a boatload of fair-weather friends.

I'm ready to move

I feel pretty good today, and I don't have any reason to be so happy. It was yucky outside. The neurology service looks to be... messy. And all in all, it was certainly not the best day I've had. Still, I feel pretty good right now, and maybe it's because I'm confronting things in my life that I've always viewed as internal problems. You know, I've always viewed everything wrong in my life as a deficit, a weakness, a failing. I've never really entertained the possibility that problems in my life may not be within my power to control. How's that for a shocker. And I have every right to be angry with life about that stuff, but as far as hating myself goes, there's not a lot of ammunition there.

I felt so good today that I didn't even entertain the idea of going to student health to see someone for depression. If in one week I can accept that I am a good person, I don't hate myself as much as I thought I did, and that I have every right to be frustrated with my life, and that certain things are beyond my control, then I'm in the fucking home stretch. I'm not trying to be cheerful anymore. I'm trying to be me. I'm trying to be outwardly true to my internal feelings. As I told S, positive steps. Moving in the proper direction. I may not be moving fast or far, but I'm pointed the right way, and that's more than I can say for the last 4 years of my life.

I really wish that I could meet someone to share my life with, not in some grandiose sense, but I wish that I had someone to open up my life to. And not having such a person in my life has been handicapping, because it makes the hard times harder, and it dulls the good times. Friendship is a boat that can only take you so far. I'm not expecting to be married in a year or any such nonsense. I'm simply saying that it would be nice to meet someone that I could trust with my heart. You know, I've spent so much time guarding it, protecting it, keeping it locked away from danger. I just would like the chance to love.

That's an absurd or outrageous desire. It's basic. It's what we all want. And if I can't find what I want here, then it's perfectly reasonable to find somewhere that can accommodate my desires. If no one within 50 miles of this city can appreciate who I am and find in me something special, then I want nothing to do with this city and I'm ready to move the fuck on, because I think it's not an absurd thing to say that I am special and that I have a myriad of good qualities, and that the only absurd thing is that it has been so hard in this damn city to find a woman that would even entertain the notion of dating me. What a load of shit. I'm ready to move today. I should've moved a long time ago.

"You are superior to mollusks in every way but looks." -Dogbert

I realized today that I'm the dating world's equivalent to oatmeal, or gruel, or rice cakes, or something devised with the auspices of being good for you, but with such a bland taste that it's practically unpalatable. From now on, I'm going to carry around a packet of brown sugar, and when I get turned down, I'll tear open the packet, sprinkle it on myself and say, "Wait, wait, I'm more appealing now!" Sadly, though, this will do little to combat the fact that I'm still Asian and still in the Midwest, still getting shot down left and right, and still entirely hopeless for finding a date in this city or within a 50 mile radius. I think S is right. I am in desperate need of a move to a state as far away from where I am as humanly possible. I'm like a winter coat in Arizona. Somewhere, someone is in desperate need of me, but certainly not here.

I also realized that Korean food is the best food in the world. I've managed to fill my belly with Korean food with weekend, and I'm very happy about it. I miss my mom's cooking. I miss coming home to a Korean meal, with soup and everything. I miss all the weird little things that my mom did that I cannot replicate. I tried cooking something, and my mom picked me to pieces. More soy sauce. Less sugar. Stir more. Leave it covered. Add more garlic. Arg! I cannot replicate any of my mom's recipes, so my only hope for a life full of nutritious and delicious Korean food is to find some Korean girl who is in desperate need of a green card. If you are such a girl, you should consider e-mailing me. When we meet, you should come bearing soup.

Today was not a good day

I feel like shit today. I guess I wasn't feeling all that great yesterday either, but I didn't think I was this bad. I couldn't eat today. I ate an apple, a granola bar, a cup of OJ, and a handful of chips (~900 kcal). My workout was sorry. But you can only do so much after not working out for 4 weeks.

I wish I could say that there was some precipitating event, something that set me off, but I just woke up feeling shitty today. My light therapy seems to not be doing the trick anymore. And all I can think is that I've still got 3 more weeks before the winter solstice. If this really is seasonal affective disorder, then it's certainly the worst I've had yet, and I still have all of winter to go. I wish at least these bouts of depression had some sort of predictability. I wish there was some rhyme or reason to it. I wish I could make sense of it.

So I think I'm just going to call it quits early tonight. Yes, I realize that 7PM is a pretty early hour to turn in, but maybe I'll feel a little better after some sleep. Maybe I'll get hungry and wake up and eat something. I really don't want to have to start forcing myself to eat again.

A bad time in November

[Editorial note - I am wading through a lot of depressed posts, and I've opted to consolidate them all into one entry, as this is overall quite depressing to read 12/27/10]

I am normally a pretty cheerful person to be around. And I like being cheerful. I like being a person that's fun to be around. And I don't want to be depressed. I don't want to show people all the stuff that I deal with. Who wants all that baggage, and that emotional turmoil, all the stuff that I write here, and then some. I hold back when I write here. I don't talk about a lot of things that trouble me, stuff that I could never write here because I have no idea who's reading this and it's private stuff. But I don't write much about the good stuff either, and it's not like good stuff doesn't happen.

I don't think people want to hear my shit. I don't think people want to see what's underneath. I don't think that anyone wants to hear about my problems. I think people are perfectly content with the cheerful happy version of me. And so that's what they get. Because I don't know what they would do with the moody, having trouble making it through the day, hopeless version. I mean seriously, who would even want to talk to that, or even be nearby? The truth of the matter is that in this universe, there are very few people that care either way whether I'm depressed or not.

I really don't display any of my emotions. I think in the end, people honestly do prefer me cheerful. People would far prefer to hear about how I accidentally grabbed a girl's butt yesterday than about how I broke down and smoked half a pack of cigarettes yesterday, because I finally got to a point over the last couple months where I just fucking needed a cigarette.

Cigarettes are my buffer. You know in chemistry, a buffer is a compound that you can add to a solution in order to prevent radical changes in pH. It has limits, and you can surpass a buffer's ability to maintain a pH, but for the most part, it just smooths everything out. No big highs, no big lows, just even keel. That's what cigarettes are for me. Life becomes much easier to deal with when you can reassure yourself of your impending mortality

So, I bought a pack of cigarettes at this morning, and wow, do I feel about a million times better. Thank you cigarettes, for shaving another few minutes off my life expectancy. If not for my belief in God, I would've killed myself a long time ago. I thought this 'salvation' was because I had a purpose in this lifetime, that God had a plan for me, and thus did not allow me to kill myself, as I would've liked. Perhaps this logical conclusion is entirely lacking. Who ever said God is logical?

And so, sitting in church today, I did what I practically do every time I go to church. I ask God, why exactly was my life worth saving. What is it about my existence that was worth the trouble of extending?

Every fiber in my body tells me that I should be happy. I should be content. I should be at a point in my life where shit slides off. I should be happy. But I'm not. I'm just not. And it eats me up inside. It makes me wonder how bad can Hell really be. And how easy it would be to just put an end to it all. You know, I keep going to church because I'm waiting. I'm waiting for God to tell me what it is that makes my life so worth living. I'm waiting to find out what exactly is the point of my continued existence. I don't know that it's worth waiting around to find out.

And you, what's the deal, huh? Why do you always have to be so fake with me? Or is that the real you and you're fake to the rest of the world? You've got all the pieces in front of you, but you refuse to put them together. And you're right. I'm one to talk. I'm full of shit too. But you know what, at least I stared my problems in the eye. You? I don't understand how you can get up in the morning and not cut open your jugular.

You must be medicated, you're so complacent. You sit back and let the train fly off the rails, like nothing is wrong at all, but both you and I know better. We know that everything is wrong, and sometimes, it gets so bad that when anything goes right, that's good enough. But you deserve better than that.

But you'll never look to me for a helping hand or a shoulder to lean on, so y'know what, I'll let this all slide. It's like in AA. You have to admit that you have a problem before anyone can help you. So have a good life, I guess.

My type of girl

I've spent a lot of time lately giving thought to something a friend of mine told me. She informed me, routinely, that not only do I have a type (of girl) but that this girl I was chasing after certainly wasn't my type. This sort of set off a series of thoughts, revolving around the question: what is my type? So, it's been years since that statement, and I think that only recently am I in any way grasping what my type is. And it's sort of a sad realization, because now that I know what my type is, it sort of points out all those women that I've known and that have summarily written me off. You know, sometimes knowing what you want is more painful because you are made acutely aware of the fact that you don't have it. Whereas if you don't know what you want, you don't know what you're missing.

Anyway, that's not to say I'm depressed or all 'pity me' or whatever. I just made the observation today. At least I've had plenty of time to think about what is not my type, and that list is pretty extensive. And it's funny, because I always find myself in a funny spot where I'm sure that I should want something, but I don't. It's just not a deal to me in the least. I guess there are perks to knowing what you want. You don't waste your time on what you don't want. Or if you do, you at least have the good sense to know you're being an idiot.

Fuck them too

So, 4 weeks ago, I had my last cigarette. This is something that most people would be proud of. I feel no pride in this whatsoever, because it was terribly easy. I'm not really addicted to nicotine. My deal with cigarettes is that it's how I dealt with a world that seemed to screw me over at just the right times. It was my means of shortening my life, a suicide that would take 40 years.

But I'm learning how to deal with life again. I'm figuring out that my life's been in neutral for so long that I've been rolling backwards. It's time to get things in gear again. I know this sounds incredibly stupid. I feel stupid for typing it, but here goes. Why am I so down on myself? Honestly, despite my tremendous string of failure, I'm a good guy. I'm pleasant, courteous, kind-hearted. I'm honest, eager, driven. I'm not ugly or freakish. I take good care of myself. I am, all in all, a pretty decent guy. Why should I worry so much about dating and women and all that jazz? Honestly, if no women in this city or this state can see their way to dating me, fuck them. If no women in this city or this state can see themselves dating some Asian guy, fuck them too.

Why should I get all worked up about the hangups of other people? Why should I torture myself over what is essentially someone else's problem? Heck, I'm not going to lose another second of sleep over this shit. You know, if no one can appreciate me, I shouldn't have to change myself or lower my standards. That's bullshit. And if it takes another 26 years of my life to find someone that appreciates me for who I am, then so be it.

It's amazing how much more empowered one can be when one concedes reproduction.

San Diego must be nice this time of year

I'm finally submitting my ERAS application. It took me long enough. I'm applying to an obscene number of programs, especially since I'm very much leaning towards staying right where I am. It was funny today. I had two different attendings tell me that they didn't even need to see my app. One attending asked when I was interviewing. I told him that I hadn't even submitted my application yet. He kind of laughed and said for me, it wasn't necessary.

I would like to stay here for residency. There are all sorts of reasons I shouldn't stay here. It's always a good idea to train at a different location so that you can see a variety of conditions and managements. It'd be nice to go to a program where I can get a nice fellowship and a good faculty position. It'd be nice to work at an institution that runs more efficiently. But what it boils down to for me is that if I stay here, I know it's going to be another 3 years where my romantic future will go bbbpllbffplt.

I'd like to believe that it wouldn't make a difference where I am. I'd like to believe in fate and destiny and finding that perfect person for you. Except I know that fate and destiny and all that stuff is bullshit. I know that if I plan on procreating, I have to go to the East or West Coast. But I can't stand the idea. I can't stand the thought that my ability to attract another human being is entirely dependent on geography.

You know, it's amazing just how low you can set your sights in life. I used to think that what I wanted was someone who was perfect for me, who could understand me, who loved me, who I could share my life with. At this point in my life, my romantic aspirations total to this: I'm looking for a girl who will let me feel her up occasionally.

The finer points of apple cider

You know that perhaps you take apple cider a little too seriously when you convince yourself that you can taste the difference between regular apple cider and UV irradiated apple cider. I purchased some good old fashioned apple cider and was pleasantly rewarded. It should go without saying that you're drinking unpasteurized apple cider. The pasteurization process essentially kills the natural taste and body of apple cider. I'm talking fresh out of the press. The lack of pasteurization is a bit of a roll of the dice. It comes with the knowledge that there are risks involved. However, I have yet to meet someone that orders filet mignon well done. If you're going to play everything safe, you might as well do nothing at all.

I also managed to eat some Korean food. It's been forever. It felt so good to be eating Korean again, it's like something that I put aside and now rediscovered. I wish I cold eat Korean food every day, but I can't. My stomach and my budget can't take it. Well, actually, I guess when I'm a doctor, there's nothing stopping me from eating out every night, which I may as well do, since my social life is on such a roll. And by roll, I mean roll down a steep hill with a cliff at the end. Especially since I have entirely given up. I mean, before, I at least had some hope. You know, the kind of 'Oh maybe someday' sort of stuff. I'm just out of it now. I've conceded. I'm trying to decide if it's a valid idea to waste all your money on frivolous things if you don't have a wife or kids. I mean, what would I be saving up for, other than retirement? Nothing. So, let's blow it all. As soon as I'm out of residency, I'm going to live like a king.

I really want a cigarette, but I'm being good. I'm telling myself that a cigarette won't make my life any better. It won't bring meaning or fulfillment. It won't solve my problems. However, there's always a little voice in my head arguing the point: it'll make my life shorter though. And well, that little voice has got some pretty good logic. People congratulate me on quitting smoking. What congratulations? I quit because I thought maybe it would make a difference in my life. And it has. Now, my life expectancy is inching upwards, while my life goals get pitched one by one out the window.

In the end, I get the feeling that I took a wrong turn somewhere, and it's far too late to turn around and double back. And I'm not doing such a hot job finding my way back on track. So maybe this is going to be one hell of a long and boring drive ahead of me.

The hot nurse

Every hospital has one hot nurse, a nurse that is attractive and catches all the stares. She's got residents wrapped around her finger. This is, by and large, a product of the system. But it's true. My hospital is no different. We have such a nurse in the ICU that draws a surprising amount of attention. People kept telling me about her, so when I finally met her, I had a good laugh. I had two patients that were under her care, so I had ample opportunity to talk to her, but really, I didn't make much of it, because I wasn't trying.

I know, you're thinking to yourself that if you have to sit through another rant, you'll beat yourself to death with a squeaky hammer. But really, it's not that. I mean, who's to say if that didn't factor into her (or more likely my) thinking, but the truth of the matter is that I had about as much chance with this girl as a Ford Festiva in the Paris-Dakar rally.

I learned long ago that I attract about as much attention as a bowl of oatmeal (and have a similar consistency). I joke (almost incessantly) that all I need is some girl, a couple bottles of tequila, and a state where you can get married drunk. I'm not going to win any beauty contests. I would be very afraid of how I'd do on sites like hotornot.com and the like. So, over time, I've learned that I've got to put out extra stuff, kick my game up a notch just to get noticed. That is faaaaaar more inspired than I actually am.

I would think that after almost 5 years of pitiful failure, I'd have tried just about everything I was willing to try in order to trick convince a girl to go out with me. Well, not everything, but just about enough. I've finally decided enough is enough! Holy crap, I'm done. Let the ladies come to me. Haven't I done enough pursuing for a lifetime? Is it entirely unreasonable to sit back and say it's time people started chasing after me? Probably, but who knows. At this point, I'll take what I can get. And when they brush me off as a loser, I'll point my finger at them and say, "That's DOCTOR loser to you!"