Thursday, October 30, 2008

Listen to Your Heart

let me listen to your heart;
bare your chest to me,
bare your soul to me.
tell me about this scar on your chest but
hide that scar you carry deep inside,
hide it away from me if you must.

take a deep breath for me;
in and out, nice and steady.
i know it's hard.
i can hear the work, you know-
but go ahead and pretend.
there is little you can hide from me.

i'm going to press here;
here on your stomach but please
tell me if i cause you pain.
my hands are cold but my heart is warm
and i know it hurts but you would
feel so much better if you would tell me the truth.

but instead, you lie and
let me listen to your heart,
let me hear you as you breathe,
let my cold hands wander along your stomach
even as i question your scars and hurts
and you quietly return to places you never wanted to revisit.

so share with me your worries and fears;
that's why you are here, after all.
your heart is heavy, not dead-
i know because
that's what i heard when you
let me listen to your heart.

Thursday, October 16, 2008

Musings after Interview #1

I have just finished my first residency interview. I guess the season has officially started.


1. Being stuck in the middle of Queens in the dark near some sketchy Wal-Greens store on my first night in the city; the cab I called apparently didn't feel like picking me up and my hotel had NO idea where I was. I don't recommend spending 60 minutes like this. Hilarity did NOT ensue. On the "bright side," I'll never again forget to bring pantyhose with me to interviews.

2. Wandering around Queens in the dark because I am directionally challenged and got lost upon exiting the subway station. Somehow, I turned a 5 minute walk into a 90 minute walk. [Note to Queens borough: you have an abnormally large population of weird men that hang out together in clumps after nightfall. You should fix that.] Hilarity did not ensue here, either - however, I did have an anxiety attack in the middle of the Flushing Meadows Park. Another first for me.

3. Spending 3 hours with the good (and, on occasion, scarily interesting) people on the NYC subway. It was supposed to take me 40 minutes but I kept getting on the wrong trains.

4. Having to settle for a visit to the Natural History Museum instead of the Met because I was just so tired of getting on the wrong train and the NHM happened to be right in front of me. Even I can't get lost when it's right in front of me....generally....

The program was good, for sure. But I just don't know about living in New York City, when it comes right down to it. Manhattan is nice, but too expensive...and from what I saw of both Queens and the Bronx, I can't live in either place. I guess we'll see how this all turns out.

Monday, October 6, 2008

Rip Van Winklette

Rip Van Winklette
Current mood: angsty

When I sat through the first lecture of my medical school career a few years (?!) ago I thought to myself, "Man. This is seriously awesome. I can't believe I'm actually in medical school!"

When I came close to failing my first biochem exam as a freshman I thought to myself, "Man. This is seriously bad. What have I gotten myself into?"

When I was struggling, trying my best to understand pathophysiology during sophomore year I thought to myself, "Man. Dr. Werner just seriously schooled me. This blows."

When I finished taking the USMLE Step 1 after my sophomore year I thought to myself, "Man, that was heavy. I am seriously ready to be a third year student now."

When I became a 3rd year medical student I thought to myself, "Man, what was I thinking? I seriously want this misery to be OVER with. When will it end?"

And now, as a bonafide senior medical student I am thinking to myself, "Man, where has the time gone? There are some serious choices to be made in the next few months."

It's funny to me how the events that you never think will happen eventually come to pass. Sometimes I feel like Rip Van Winkle, that poor gentleman who took a nap under a tree one day and woke up only to find that somehow, he had inexplicably slept through nearly 100 years of his life. To me, it seems like just yesterday that I was a freshman in college struggling to adjust to life 2,000 miles away from the only home I'd ever known. Then, in the blink of an eye, today has dawned and with it, I realize that I am just a mere 7 months away from having two letters after my name that will actually mean something to a lot of people. It leaves me scratching my head and wondering just where the time went...and how I've magically gone from being plain old Chelsea Tooke to (very nearly) Chelsea Tooke, M.D.

If I think about it really hard, it gives me minor panic attacks. You never realize just how much responsibility will be thrust upon you after you walk across that graduation stage. Today, I sit in the pathology department and read slides with attendings. I don't always have a clue exactly what it is that I'm looking at (especially when we're talking dermatopathology) but that's ok, because I'm a student and I'm learning. I don't have to deal with calls from the blood bank about possible transfusion reactions, and I don't have to stress about immunohistochemical stains and whether they are nuclear or cytoplasmic and what the relative staining patterns actually mean. But tomorrow is a different day. Tomorrow, I will be an attending. I will look at a slide and help decide someone's fate. I will help the ENT surgeons decide whether or not they need to remove the entire voicebox or dissect through half of a patient's face. I will help decide whether the general surgeon needs to remove most of someone's colon. I will help the dermatologist decide whether a skin lesion is a small basal cell carcinoma or a malignant melanoma. I will help the Internal Medicine service diagnose metastatic cancers. I will help clincians decide exactly how much time a person has left on this planet when I give them my diagnosis. I will oversee the labtoratory functions that every clinician takes for granted: blood banking, microbiology/immunology, drug testing, CBCs/CMPs/LFTs...I will have a hand in it all. I will be expected to have answers. For today, I am safe...but I am scared for tomorrow. And tomorrow is coming quickly.

In the next few months, I will be exhausted as I criss-cross this country. I will spend thousands of dollars on plane flights, hotels, and rental cars. I will answer the same interview questions over and over again until I think I will vomit if I hear "So tell me about yourself" ever again. I will most likely spend more time sleeping on hotel beds in unfamiliar cities than I will at home. I will pay monthly rent to live in a place that, for a few months, will seem more of a myth than a reality to me. I will lose sleep over my Rank Order List and will probably need to start taking anti-depressants in February, a full month before Match results post. I will pack my belongings and move to a new city to start a new chapter in my life. Tomorrow is indeed a frightening prospect.

So I sit here and reflect on yesterday instead, and remark to myself just how quickly these four years have flown by. I've dreamed of this moment...residency interviewing and graduating for years, and if it didn't hurt and wouldn't leave a mark, I'd pinch myself very hard to ensure that this is not just some dream. Soon, there will be no more patient care. There will be no more 5:00am alarm bells sounding me to my pre-rounding duties in the hospital. My stethescope will lay forgotten in my car, hearing the sounds of wheels on pavement much more than beating hearts in human chests. I'll never again pick up an ophthalmoscope and try to discern cup-to-disc ratios (not a big loss, frankly). I'll probably never ask another person about their bowel habits or whether they have had any "funny discharge" (again, this is really not a crushing loss). I won't be delivering babies at 3:00 am, admitting patients when my shift is technically over, or performing Ortolani-Barlow maneuvers on infants.  However, I won't receive Christmas cards from long-time patients and I will probably never hear a "Thank you, Doctor" fall from a thankful patient's lips. I will work behind the scenes with the knowledge I've acquired these past years, heard although largely unseen. It is by turns a bittersweet symphony, this life, these choices.

But if life, as Shakespeare so poetically stated, is a play with everyone having their own parts, I can think of no better role for me than the one I have been chosen to play. I have acquired this knowledge and made my choices. As I reflect on these past four years and their relative brevity I feel a multitude of emotions. I am happy at times that this experience, this new chapter is upon me. I am sad, I am worried, I am terrified, I am ecstatic. I am learned with much still to learn. I am older and occasionally wiser. I am more than I was four years ago and yet not who I will become. This time has moved so slowly, yet is gone in the blink of an eye. These four years have been such a long road for this weary traveler. I feel as though I am standing on a precipice with arms outstretched over a grand mystery, scared to fall into the abyss yet afraid to remain rooted where I stand. I suppose that I must simply take it on faith that all the knots in my mind will right themselves and that this modern day Rip Van Winklette will manage to happen upon a small, silent eddy in this racing, tumbling river of time