To Sir, With Love

One aspect of medicine which is so pervasive, yet infrequently discussed, is the role of teaching. By this, I mean the day to day, person to person teaching that happens on every rotation that one goes through as a student or resident. I've always enjoyed this part, because it makes me feel like learning is a tangible discussion, rather than a formal and stiff lesson. There's something thrilling about walking away from a lively spontaneous discussion on sickle cell anemia or primary amenorrhea, that makes you feel like you gained so much just by staying tuned in for an extra five minutes.

What's not so easy, I'm discovering, is leading that teaching process. I've always loved sharing information with others, and reinforcing what I think I know with a group of people who inevitably remember better than I do. As medical students, we are continuously expected to teach and help each other, as well as to give more formal talks on disease processes and case presentation. But I'm realizing now that this type of teaching, which is simply informational, is the easy part. What's not so easy is to teach someone how to be a medical student, how to get through doing physical exams and admissions and learning to formally present a patient at rounds. I remember helping third year students with this last year, and I never found it as difficult, perhaps because the responsibility ultimately didn't fall with me.

But perhaps I was also lucky, and didn't have too many encounters with that Thorn In Your Side, the lazy medical student. Most medical students I knew, often my friends, were incredibly smart but also terribly hard working. They didn't mind coming a little earlier or staying a little late to get things done, especially if it meant learning how to do something new that would later be an expected responsibility, like drawing blood or placing IV lines. I myself enjoyed staying late to learn how to do central lines or surgery consults, because I wanted to be sure that I at least had an idea of how they were done before I was expected to do them regularly. This is, of course, most likely a ridiculously rosy picture of myself, and I know that on many occasions I have been an inadequate or incompetent student. But I can say with 100% certainty that I always tried hard.

Somehow, it never occurred to me that there are some people who make it past the first two years of school and are still trying to make it through with as little work as humanly possible. These are the people who don't want to see the complicated cases, even if they are classically tested on the board exams. These are the people who don't want to learn how to properly present a case, and refuse to recognize the value in an efficient exchange of patient information between colleagues. These are the people who consistently disappear to the cafeteria or library if you don't keep your eyes on them, and always have a complaint about something or another. Every conversation is about which specialty gets you the most money for the least work, and every assignment is met with a complaint (and even talking-back). And, of course, these are the people who are most persistent in asking about how to game the system and get the best recommendation letters.

A lot of residents I know are of the mentality that if a person wants to screw him or herself over, let it happen. We are all adults, this isn't daycare, if someone doesn't want to learn how to work hard, that's their problem. I wish I had more of a hands-off attitude like that sometimes, because I feel like I am letting myself get more stressed about this type of situation than I need to be. But I feel that if all doctors are also teachers, we have a responsibility to help our students find the motivation to work hard, and form good habits. I also feel that I have a responsibility to all the students who do work very hard on rotations, even if it isn't a specialty they want, and it isn't fair that other students slack off and there are no consequences. I know that I had a lot of bad habits as a student, many of which I still struggle with, and it's only with the consistent help of people who cared that I've been able to make any improvement at all in my SOAP note writing or patient presentation. So, I don't want to give up.

I wonder how my parents did it.

Mad Skool Gradumacation

I never really consider myself to be superstitious, but I am one of those people who tends to view bad events in a particular way. I tend to have famously bad and good luck, by which I mean that a bad event will happen in a spectacularly melodramatic way, and then resolve itself in a similarly spectacular way that nobody else could reasonably expect. (Examples include $500 cash stolen from me at the Citibank and then retrieved and returned by NYPD in less than 48 hours, as well as losing all my keys on Wall Street in a giant crowd, and then having a Planet Fitness Jamaica employee message me on Facebook to say he'd found them.) This sort of reliable cycle of bad luck has now forced me into believing that sometimes, you have to make a little sacrifice to the gods to let things go smoothly. Thus, I am ok when I get into a car accident on the way to an exam and still get my 2 highest Shelf Exam scores. Or when I get rear-ended on the Belt Parkway, on the way to Graduation Weekend.

Yeah, that happened. Fortunately nobody was hurt, but now there's a ton of hassle that goes with it, which starts with my trunk door no longer opening. And graduation went without a hitch, no last minute notices from administration stating that I had failed Band-Aid Class and therefore would not be graduating. So, I am officially, a DOCTOR.

~commence applause~

Otherwise, the 2 day event was surprisingly pleasant. There were no major hitches on behalf of my school, and the event was overall well organized and meaningful to my parents, and followed by a nice brunch afterwards. I'd like to pretend that it wasn't meaningful to stout old me, but in reality, I definitely got teary-eyed more than a few times. The kicker for me was when several of my classmates were hooded by their physician parents, and I realized how much this meant to all the parents out in the audience who had supported their kids all the way. (Ok, I'm getting teary now just thinking about it.) I mentally contrasted things a little bit to the dinner dance our school held for the graduates a few nights before, in which they closed the open bar at 10:15 pm and then kicked us out at 11:15 pm (invitation said 7 - 12), a shenanigan they had also pulled at our Match Party a few months earlier. But nevermind that, it was still nice.

For some reason, I didn't really think that much about gifts for this graduation, and yet people really pulled out all the stops. In addition to the bobble-head doll, I also got quite a bit of money, some Indian dresses, and Operation.



As it turns out, Operation has been upgraded since yester-year and now there are multiple games to be played with increasing levels of difficulty. (I opened mine up yesterday to play with 2 girls I was babysitting, and they accused me of cheating because I'M A SURGEON. Ha.) My aunt, a nephrologist with a doctor husband and md-phd son, wrote a super nice note about how I was the first doctor in the family for my generation. And it was all so meaningful to have my family friends and boyfriend around with me for the ceremony. They made us announce our own names on the stage, and apparently everyone lost it when I said my full name, because my middle name honors my deceased grandmother, and they all felt how excited she would have been for me. My dad hugged me for like an hour and I had to hint at him that we needed to get moving or we'd be trampled in the aisles. And my mom kept telling people over the phone how nice the ceremony was, and I could hear in her voice how proud she felt.

~sniff~

So here I am, a doctor. Bit odd, really. And scary, because now I can't say the phrase "I don't know, I'm just the student". Wow.

Queens Command

I'm not sure if I'm the only one who feels this way, but I hate searching for apartments. I mean, HATE. HAAAAATE. (hate.) It's such a hassle, and I can never understand why people posting their apartments don't include basic details of space, features or even photos. It's 2010, people. Everyone has either a digital camera or a cell phone, or knows someone who has either.

It wouldn't be so bad except that my parents have their spoons in the soup, too, and their idea of a decent apartment often conflicts with my own. This is often complicated by the fact that they used to live in NYC, and my dad commonly makes proclamations about how well he knows the area. (Mind, the last time they lived there, it was the late 1970's.) They have ideas on convenience and comfort, I have ideas on proximity to civilization (aka Manhattan), and unfortunately the market just is not cooperating.

On top of it all, I have been doing the apartment scramble for a long time now. 4th year for me meant moving almost every month to a different location and hospital, and I pretty much lived off of Craigslist and the sublet listings. For the most part, things worked out really well. I generally had proximity to hospital, proximity to life (or something like it), and proximity to home. For my hospital, it seems like Queens is the best option, and I had a number of good tips on neighborhoods that are slightly less chic but still do the job.

I actually had narrowed things down to a few decent apartments, and my dad and I drove out yesterday to check out a few. The one I liked the best was one that was newly renovated in a nice neighborhood, but was a bit far and lacking in street parking for my dad's taste. Nevertheless, I insisted that he see it because it was miles better than any of the apartments I had been able to schedule in the closer neighborhoods. Also, I had seen this apartment and another similar one and gotten a shady vibe from the second place's owners, and so felt confident that this place was The One True Place. Alas, it was not meant to be, as the owner turned out to be EVEN MORE SHADY, trying to nickel and dime us even to the last second, and questioning all of my credentials while offering none of her own. (For example, I showed her a copy of my hospital contract, my driver's license, my passport and my impeccable credit report. She still insisted that she couldn't be sure that I was reliable, or that I had verified employment, and asked my dad to sign a document ensuring he'd financially back me.)

The long and short of it was that it did NOT work out, and we wound up making a hasty exit with some tastefully chosen words for her lack of professional demeanor. Of course, it's better that I found this out now than later, etc etc, but I was just so disappointed that the whole business was THISCLOSE to being done and now I had to start from scratch. Of course, I do still have lots of time before July and blah blah blah, but I have to say that I am just so tired of living with uncertainty. I should be able to handle not yet knowing where I will be living 6 weeks in advance, but after moving all the time and worrying about the match all year long, I just need a break.

.... anybody know of a nice apt in a house in Queens I could stay in?? I don't do drugs!!