Filed under: Uncategorized
Friday night, after becoming obsessive and anxious about why I haven’t gotten any interview yet (it’s only been 4 days since my app was complete), I decided (against my best, best mental advice) to re-read my app for possible typos. Bad idea. WORSE idea at night, all by myself. I got Poopy on the phone, as per usual, to hold my hand through it…and was there when I found two killer typos: “Opthalmology” and “optimze”. I almost shat my pants.
I thoght back…when I submitted the stupid app, those typos kept coming up and I went back to correct them and would save, review completed app, and there they were again! So I would go back, see that they had been corrected, and eventually figured it was some kind of computer glitch. So off the app went and I felt that it would be all alright….Clearly, that wasn’t the case.
True to form, it didn’t hit me last night. I shot the shit with Poopy for two hours, talked about some girl he met and how he should talk to her, etc., etc…I went to sleep then woke up in the middle of the night, crazy and anxious and freaking out. Today all I did is lay in bed and mope. I sent a mail to one of the deans to see what could be done, and she wrote back saying “Hm…how many programs did you apply to again…?”.
Yeah. Needless to say, I be fucked. I called mom and dad and fessed up and they both got on the horn to set me straight. “Man, in this country EVERYONE makes typos!”, my dad says. “I KNOW things will work out for you. I KNOW it.”. I almost cried, out of comfort and happiness. But, not feeling so comforted or happy anymore. Am actually thinking about what I should do with my year off. “At least I don’t have to buy a new suit”, I thought while watching Bravo re-runs. Big fucking comfort.
Anyways, I decided that instead of doing my usual “Let me just hide from things so they odn’t bother me”, I might as well fess up to ALL the tragedies in my life, not just that I won’t be going to residency next year.
Pathetic Confessions about My Life:
1) I organize my underwear drawer on Saturday nights. Needless to say, I haven’t been OUT out since…well, it’s been about 4 years.
2) Still a virgin. Wonder-fucking-ful. Perhaps that relates to the above point.
3) Since I live alone, my bathroom door never closes. Sometimes I worry that I’ll forget if I ever have company and start peeing free as a bird.
4) I troll CL “Missed Connections” MORE than ’secretly’ hoping that I’ll be mentioned.
5) Sometimes, lately, I want to be touched by another human so much that I’m not beyond rubbing up against some of my friends. I’m like one of those little monkey babies who had a soda-pop-bottle mom while growing up.
6) I didn’t shower the last two days because I felt too fat and ugly to face my naked body in the bathroom.
7) My vibrator broke and it’s making me upset. Also, along with #2, this is the closest I’ve gotten to real live sex in my LIFE and the most action I’ve gotten in the last 7 years.
In my typo thing…I have finally stumbled.
9) I FaceBook my old high school and college friends (to whom I no longer talk to) and look through all their pics to see: where they are, who they hang out with, if they’re in a relatinoship, if they’re fat now like me.
10) When I get bored with my life (often) I post random things on CL seeing if people will respond (personal ads, requests for concert buddies, rants, etc.) One of the most entertaining things I got out of this was when I posted a rant about how this whole personal ad thing is fucked up. Someone wrote back to me, spilling his very touching life story and saying how he agrees…doesn’t sound like much, but it was nice to know that I’m not the only frustrated one out there.
11) Along with #10, I also sometimes reply to the replies, but always end things before they get too serious. The furthest it went, I spent hours googling around to find a picture of the guy who I’d been emailing back and forth with for about a week. The same night I found the picture, I later saw the GUY at the cafe. Once I saw him in person, the hunt was over. I was done with him.
… Should I move on to My Dark Secrets?:
1) I still beleive in fairy tales. I’m not (just) talking about stupid Sleeping Beauty bullshit. I’m talking about possibilities of heros and dragons and faries and…I’ll just stop there.
2) As “lonley” as I feel, I don’t want a relationship. Too much work. Too much talking. I have *baggage* now. I don’t want to subject anyone to that. This is why I will not be in a relationship in the near future. Questions like “So…tell me about yourself” will end with “There’s nothing to tell. Can we just have sex?”. That’s good enough for me.
3) Baggage #1: My grandma died. She was the woman that raised me, my personal cheerleader, the only one who I’d listen to without arguing. It sounds so trivial, but for someone who was never really close with her family or even friends, it means a damn lot. She was everything to me; always was. I have a journal entry from elementary school where I write “It’s like there’s no space in my heart for anyone, except for Ba.”. And it was true. And when she died it would have killed me, if I wasn’t already dying. Instead, I’m left with Residual Sadness, where I start crying in my sleep on random days or when I see some old people. No one wants to sleep next to that shit.
4) Baggage #2: I was anorexic (much written about this in previous entries). I don’t even like to say it because it makes me think of stupid middle school girls (not unlike some of my friends) starving themselves. No, this was the real deal. I was way old enough to know better and still didn’t. Now that I’m fat(er), I can’t say I’m anorexic anymore but I’m still afraid of food. I don’t know how to eat. I don’t know when I’m hungry or full and sometimes can’t stop. I hate my body pretty much every day and don’t know what to do about it. I try to focus on the positives (“These huge thighs are what you stand on in the OR.”), but it doesn’t work. It’s starting to, I think. But not enough. And if there’s something that guys hate with a vengance, it’s a girl who’s insecure about her body (but I dare you to find one who isn’t.).
…okay, I have no more secrets. And this didn’t help. Now I just feel worse, covered in shit and will crawl into bed.
I have ~ 10 minutes to write out my frustrations. I don’t think it’s enough. I don’t think the industrial sized punching bag at the fucking gym is enough.
Jesus, SUCH a foul foul mood for the past few days. Feeling (and being) very fat, and not knowing what to do about it…and other, arguably more important stuff, like scrambling to get my last LORs in, studying for Step2, etc., etc…fucking. Fuck.
Stomach hurts. Because I eat too much. Fiber. I eat too much, and a lot of that is fiber lately. Mother fuck. I’d say that in terms of contribution to my bad mental state, the body image thing is about 80%.
20% is one of the following:
1) Dr. Chepeha hasn’t gotten my letter in, programs are treatening not to review my app, and I want to freak out MORE but just can’t muster the … the whatever it is that I need to give an additional fuck. Nevermind the fact that I kinda want to punch him in the face. Maybe I’m trying avoidance and by just not thinking about it, I won’t get stressed about it, etc. Riiiiight.
Maybe he needs to have gotten my fucking letter in half a month ago. Mother fuck.
2) Stupid fucking radiology rotation sucks my balls. Spent from 8:00-4:00 yesterday sitting in a dark room looking at stomach CTs. I want to poke my eyes out. First, all that sitting isn’t helping my fat ass, and second, I could be studying. Which right now I’m kind of enjoying, but I can see how it will quickly become a burdan.
3) Speaking of the above, I think I have to take “Radiology call” tonight, from like 3:00-9:00. THAT will definately suck my balls. Maybe (hopefully, oh, fingers crossed!) they’ll let me leave early. Ha.
4) This body thing is KILLING me. I just can’t let my self be hungry, can I. It’s like I’ll have a good day and eat normally and feel fine and then I’ll be like “AH, that can’t be ALL you eat! MUST EAT MORE TO PREVENT STARVATION!” … and then I go at it again! It’s SO fucked up and I hate having to wake up and find “fat” clothes, and I hate having dreams like last night where dada told me that I was too fat, and I hate how mom was looking at my monsterous thighs on Sunday in the car. I know what she was thinking, and if I hadn’t had any history she would have said something along the lines of “Oh my god, look at your thighs. How did they get so big!”. … but you know what? She was probably still thinking it.
5) I’m actually annoyed at HOW annoyed I am at mom lately. I’m a terrible terrible child and a total smart ass to her and…she doesn’t deserve it. Or she shouldn’t, anyway. Fuck. I need to get over that.
6) Am I annoyed that I have to take step 2? Yeah…but moreso that I want to study and have to look at fucking abdominal CTs instead. I just want to concentrate on putting myself back together so I can move on with this horrible chapter of my life, instead of having to jump through more hoops and do more paperwork. But it’s good to have something to keep me busy, even if it’s just studying. It’s kind of comforting to revisit these subjects and have a better sense of what’s going on (i.e “Oh yeah…you have to treat PARTNERS of women with Gonorrhea!”…ha)
7) Right now, am annoyed at Sahar for some stupid and insignifcant thing she asked about on a poverty survey I made. More like, I’m annoyed at MYSELF for being so insecure. I feel like I’m faking this poverty stuff. I feel like I don’t know a third of the facts or have a third of the drive that some of these other girls (Sahar, kelly, jason) have. … yeah. I hate being a faker.
8.) Hm, what else can I be pissed about? The fact that I’ll probably be late, that I won’t be home till 9:00 tonight, that it took me three tries to get my shirt on this morning, that I’m sleeeeepy and have to go sit in a dark room now?
…all are legit at this point.
Whatever. I really just hope that…I don’t have to do too much running around for the apps today.
I keep checking it: morning, evening, at work, at home, on rounds…
What do I even hope to see? There’s some common courtesy, isn’t there, that if you go out with a girl (who drives and pays for your tickets!!) then maybe you should write/say thank you?
…let me explain…
So a few months back I was lonely (surprise) and in the mood to see a band play (also common). Turns out a great band was coming here in September, which would be a perfect concert except for the fact that I have like 5 friends, none of whom care about this kind of stuff. Right, so I did what i thought was the next best thing: I put an ad online (in the w4m section, no less) asking if someone wanted to go with me…not as a long-term relationshipy kind of thing but just…because. Because I wanted to go out, with good company and…yeah.
I probably should have thought it out better. One guy responded asking if I’m Asian (no), another was in his mid-40s and assured me that he ‘wasn’t a freak’. Finally, almost two months after I’d posted and forgotten the ad I get a mail from what sounds like a normal looking guy who asks “Hey, I love this band, saw them when they were still fledgling guitarists and I’d love to go”. So I said ‘You’re the best response I’ve gotten so far.”…and there we were.
A few emails and logistics later (him flying in a few days before to start school and me being on my cardiology rotation), we finally set a date, a time and I got the $75.00 worth of tickets. I honestly wasn’t thinking about it at all, not even nervous that I was going on a ::gasp:: BLIND DATE with some guy to a concert! I guess Poopy made me nervous, suggesting that this kid would like kidnap me or something but, given the nerdy tone of his emails, I highly doubted it.
That said, I still wanted to look good so spent the 4 hours before the set meeting time running to the mall, buying three pairs of shoes and a hair dryer and preening myself into someone that didn’t look post-call. In the middle of getting ready it hit me: I was expecting something. And it wasn’t going to be what I expected. And what it WAS going to be was a concert with some nerdy lonerish buy (apparently my fucking specialty), who’d probably bore me with his social worship. By the end of the night I’d feel mature enough to be his mom and I’d never really want to talk to him again. Fan-fucking-tastic.
I pick him up and barely look as I lethally swerve the car into his driveway and unlock the doors. I’m remembering a glimpse of blue eyes but can’t really remember much more past that…honestly, even during the entire night I don’t think I got a good look at his facce. I’m wondering now, did he have brown hair or black? I DO remember the following: brown, baggy cords with thick rows in them, a messy t-shirt overwhich went a wrinkled blue checkered “dress” shirt, brownish/black hair all a mess on top of a pale white head with very very blue eyes…on, and a right wrist with various indie-esque bracelets and elastics. Tragic that that’s all I remember. While I was driving he probably got a fair look at me…hrmph.
On the way we get super lost and I’m freaking out, more because I don’t want him to hate me because I made him miss the band. We make it with time to spare though and catch the opening act, which wasn’t too bad. Surprise surprise, he makes excellent conversation though we did have our silent bits. I think we were doing well throughout the concert, especially cause once the band came on we didn’t have to talk anyway.
(P.S: The concert was really good. Not the BEST concert I’ve been to but still rocked. Not sure I would have paid for my ticket AND his ticket, but definately would have paid for my $30.)
On the way out I’m fucking sleepy and tired and I think I blabbed a big too much on the way home. Either way, he asked if I wanted to grab a drink with his new roommates and I truthfully replied that I had to be back at the hospital in 5 hours. So he gets out of the car, thanks me for the concert, I thank him for the company and…he’s gone.
On the way home I had one thought: Fucker didn’t pay for his ticket! What is this, a free ride!? What it all comes down to though is that, am I really willing to go to these lengths just to feel ‘taken out’? I spent time (at least 4 hours in prep and worry), money ($70+ for tickets gas), sleep (uh, 4 hours of sleep before a call night…), etc…and for what? I just…I just wanted to be taken out. To go somewhere with a guy, see a good band, and call it a night. Do something fun, meet someone new.
Apparently that’s how bad it WAS. I spent so long these past few years being SICK that I forgot how doing all of these things feel. Now I have to resort to desperate measures just to entertain myself. The entire time I was getting ready to meet the kid I kept telling myself that I NEEDED this, just for the practice and the experience to get OUT for once. And I think I was very, very right. For the past few months I actually HAVE been making (a few) friends, and doing things and remembering what it feels like to be my normal self. I’m surprised at how much I smile and laugh and crack jokes, and then I remember that that WAS me. That person is still inside me and is finally, FINALLY coming back to life.
Or something like that. Bottom line is, I like being social again. And even if this awkward concert experience had to happen, at least I know that it happened for kind of a reason. I can add it to my list of things I’ve done: modeled nude, eaten an entire watermellon, gone on a blind date.
The ‘date’ part of it is done and over with…so why do I keep checking my inbox? Probably for the same reasons that I posted the ad in the first place: bored with my life, lonely, wanting something to happen. Also, maybe moreso, I kinda want half of my $70 bucks back. Seriously, it’s only fair.
I need to fix this lonliness thing. If THIS is what I have to do to counteract it I’ll end up going broke or dying of a nerve-induced heart attack. Or shame.
Sigh.
Is it wrong to have sex dreams about your attendings?
It seems utterly inconceieveable. After the first day I spent with this man, Dr. K, in the OR I couldn’t even find the words to later relate his behavior on the phone to my parents. He walked in, asking if any of the scrub nurses had gotten any over the weekend, then sat at the computer looking at porn while waiting for the case to start. Once we were all scrubbed in we spent the next three hours bent over some poor woman’s filletted-open body while Dr. K entertained us with stories of erotic horror books, his dislike for muslims and his wife’s depression.
This went on the next day…and the next. One of the residents eventually asked if I was offended and I honestly said no. Dr. K, despite his crassness, made the long cases entertaining. I kinda appreciated his nonchalant attitude towards porn, sex, etc. And besides, once I saw him in clinic with his patients and…they love him. He’s a good doctor, end of story.
Either way, the sex dreams started about a week after I left the rotation. That’s right; it’s plural. I’ve never had sex dreams in my life and from what I remember I don’t think these qualify as “sex” dreams in the traditional sense…i.e I don’t remember if we were actually having SEX. But…we were doing something and there was this weird feeling in my head when I woke up like I’d just been…ravished?
Ha…I can’t beleive I’m writing this shit.
Am I attracted to older dirty men? Not that Dr. K is dirty per say…but he’s definately more, uh, sexually charged than most. I can’t possibly be the only girl around that this has happened to.
Seriously though, it’s happened 2 or 3 times now. And if THAT wasn’t enough, I seem to be getting turned on by everything. The other day I was watching a surgery video and they put glue around a pole-shaped implant and I got all hot and bothered. Maybe I can blame it on the birth control pills. They may have actually started making my boobs bigger…does this mean my libido’s back too?
More importantly, I’m worried that I may like older men. All of a sudden all the 30-40 year old guys I see are looking kinda attractive. Yeah, I’ve been through some shit,and maybe I think it’ll take an older guy to deal with it.
Jesus, I’m like a babboon with a flaming red ass. I bet one could see my red ass through my clothes. I should double-bag tomorrow. This is out of control. I’m too young for this whole mating thing to be happening to me
In response to the responses to this article: http://well.blogs.nytimes.com/2008/06/25/what-your-doctor-really-thinks/
The field of medicine has changed in ways I couldn’t imagine. Not only are legal and financial strains making it harder and harder for us to practice, but patients are becoming increasingly more distrusting of the care we provide. To quote #55 “I’m really glad I stay away from Doctors!”. Is this the environment I’ll be graduating into?
Medical school isn’t a magical place where people suddenly become tolerant, unbelievably patient and able to broach subjects ranging from obesity to safe sex. We’re human and have normal frustrations and drawbacks. If you were expecting more, then you should expect the same of yourself. Are there bad doctors? You bet. There are bad teachers, mechanics, hairdressers, etc. True, none of them is as intimately involved in your life as your physician, but patient-doctor communication isn’t easily learned. We have conversations with you, though we may barely know you, about subjects that you may not even discuss with your most personal self. Learning how to do this has been incorporated into curriculums across the country for us graduating students and we’ll see some improvement. However, patients and doctors have to be honest with each other. Physicians should be able to express their frustrations (“I’m sorry I keep bringing this up, but I’m not sure how else I can help you with your diet plan”) without being attacked and patients should be encouraged to be open as well (“I feel like your suggestions don’t help me. Is there someone else I can see?”) without feeling blamed.
There are some things people have to know about doctors: We came to med school because we loved it. The money, prestige or status doesn’t exist in today’s practice environment. We’re committed to new and creative solutions to problems and we all want our patients to do as well as they can. Our practice can be tough. We get calls every day from insurance clerks refusing a patient’s blood test or imaging study. We all get sued, at least once if not more. Our patients increasingly turn against us, favoring the internet, anecdotal advice from friends or just no treatment at all.
But you know what? We STILL do it, every day, forgoing higher paying and easier jobs to talk to our patients about their aches and pains, figuring out HOW we can convince them to take or not take a medication, fighting for tests for hours on the phone and putting up with 4 years of graduate schooling, 3 – 10 years of residency (at an average salary of $45,000), and a lifetime of 2AM emergencies and low reimbursement. If this isn’t a labor of love then I don’t know what is.
My point is: We care. We care a damn lot. And when we get frustrated (i.e “I’m tired of being your mother.”), it’s because we’ve invested so much into caring for you that it literally hurts when we can’t help you help yourself. It’s hard to convince people (ourselves included) to do things that are good for them, including surgery, pills, diet, or exercise. When we say these things it’s not because we’re so self-righteous. It’s because we know these things work and spent about 15 years learning about it and it’s our job to tell you this.
Don’t generalize after a few bad experiences. Don’t have preconceptions about treatments and medications without discussing them with a doctor you trust. Realize that we’re human and we’re trying. Above all, please please please don’t lose faith in us. Ahead of me are 15 hour days, 5 years of spending every 4th night at the hospital and hours of reading and research to be as right as I can be. After that are thousands of dollars in loans to pay, piles of paperwork, insurance hassles and medical emergencies. And at the end of all this, apparently all I have to look forward to is a patient who already has their mind set against me before I walk into the room. So why am I basically giving up ages 25 – 35? Because you deserve it. I promise you, this is a sacrifice well worth it when it works, but the rest of the population has to remain open to the role of doctors. I never once regretted my decision to come to medical school but it’s becoming harder and harder every day to practice medicine. We’re trying to do our part by committing to a life time of medicine and learning how to best approach our patients. Don’t make it any harder by hating us before we’ve met.
Easy day today. I got out at 9:00 (am!), and hit the gym, then read for a few hours. Went to get blood drawn, went to lecture. I sat there in a daze, sort of hungry and light headed, wondering if this is what I wanted to do with my life.
Was freaking out too much about the whole situation so took myself shopping and bought new gym shorts and some groceries. Also got a fucked up iPod car thing that I spent $14 on just so I could hear a staticy version of Death Cab blast through the worn speakers of my ghetto mobile. Honestly, there’s a certain joy that comes from driving around on 50-degree days, windows down and heat blasting while you play your favorite music. It must be a midwest thing.
Came home, ate, ate some more, wondered what the hell was wrong with me. Tried to research away rotations then realized that all the dates were off at the programs I wanted to go to and that I better get SOME applications in or I really would be a total failure. I worry (a lot) that this whole residency application thing is gonna pass me by and I’m gonna be like “Psht, whatever” and just…like…forget to apply! The whole not-wanting-to-get-out-of-bed thing this morning isn’t like me…neither is academic apathy. I can’t handle this.
Changed into PJs and thought I’d check my blood labs before I went to sleep. Mistake of the world. Saw my liver enzymes are bumped and the word ‘hepatitis’ popped into my head. Called Poopy.
“Hey, what’s up”, I said when he picked up, my voice tired after resting all day.
“What’s wrong??” It’s the first thing he says, picking up on the subtle change in my voice.
“Ha…no-thing..”
“Oh my god, seriously, what’s wrong”
I laugh. “I know, I’m a shitty liar today” I finish pouring water into the coffee pot and walk back to the computer. I explained how I got labs done and how my liver enzymes are up and how I’m worried about heptatitis now and beyond all that, I tell him about my striking apathy about everything. For him this isn’t news…he INVENTED apathy. This boy sleeps till 2:00 and calls it early. It drove me crazy when we were together, and now I get back at him with 7:00 am wake up calls to tell him the birds are chirping and it’s a fucking beautiful day outside. Really, for me to not want to do this is…new. Beyond just unusual. It feels like someone has poured tar into my brain and I can’t seem to think about the future. I can’t even make a fucking decision about what specialty I want to go into! Jesus I’m a mess.
Anyways.
I tell him all this and he listens and asks questions trying to sort it out. He asks, “Do you think if your health was better you’d be able to concentrate on this residency stuff?”. I pause. Yes. Yes I definately do. It isn’t as if these doctor’s appointments are taking up that much time or anything, but it makes me FEEL sick. It makes me feel weak. And I honestly start to question whether or not I want to go into a specialty where you have to work your ass of. Can I even handle it? Or should I do something easier? “Psht, you should do something easier regardless of your health,” he says, “Why would you do something with more work!”.
This from Mr. I’m-a-partner-at-a-hedge-fund-and-sleep-2-hours-a-night. He’s just trying to be funny, to make me feel better, but I’m not in the mood. He says: You’re just finishing this thing off! This is the end of all the stuff that happend to you!…but it’s not. My bones are thin already and I’ll have vertebral fractures by the time I’m 40. This fucked up knee will STAY fucked up, and now…now who knows what badness has happened to my liver and other parts of my body.
“Well, there’s nothing you can do now!” He’s getting on my nerves now. I don’t yell. Yes I could do something. I could go on bisphosphonates, which is what I’m going to the doctor to discuss tomorrow. The drawback is that I can’t have kids. Or rather, I can, but they’ll be all fucked up so I’d prefer not to for both of our sakes.
“Oooh…so you can’t have kids. Well, there you go.” His tone has a light finality that only someone with a penis could have. “I mean, can’t you just freeze one of your eggs or something before you take that medicine?”
Yeah. Yeah I could just freeze one of my eggs. I’m too tired to get all riled up. For maybe the third time in the 10 years we’ve known each other I brush it off. “Yeah. Anyways. I’m gonna go to sleep”, I whisper, and listen to the silence on the other end for a full 5 seconds before hanging up the phone. I know my lack of fight makes more of a statement than anything I could have said at full volume.
This. Sucks.
Filed under: Uncategorized | Tags: body image, eating disorder, medical school, morning
5:00 am – Phone alarm goes off. I roll over, look at the phone, and stuff the blankets in my ears.
5:05 am – Alarm clock #2. Reflexes take over and I shut it off before the third beep. I flip onto my back and stare at the ceiling. There is nothing I want more in the world than to stay horizontal.
5:07 am – Phone alarm goes off again. Oh fuck it. Stumble to bathroom to grab toothbrush and wander blindly around kitchen making coffee while brushing my teeth. Slap together a PBJ, grab some snacks and toss them into a bag along with gym clothes and some gum.
5:15 am – What it would be like if I just didn’t show up. A renegade med student…would they kick me out? Would I get another chance? Fantasies of playing hooky cloud my vision. I could be at the airport in 20 minutes, I think, as I shove my body into clothes that don’t fit right. The familiar self-critique starts and grows until it fills my head: You eat too much, you’re too big, your clothes are too tight, what the hell are other people going to think when they see you, etc. There’s a pressure behind my eyes and I pop a prophy Aleve. I strip off the dress shirt that overnight has become too small, exchanging it for a large sweater.
5:20 am – Put my hair up and throw in contact lenses. I lean in close until my face fills the mirror: Eyes are red and puffy, hair is nappy but passable, skin is clear as usual. Grab some eyeliner and run it under my eyes, in keeping with my promise to myself that I’ll try to make an effort with this body. Stepping back I do a once-over of my head and switch off the light before my eyes have a chance to skip below my neck.
5:25 am – Find white coat and start filling it with various medical-looking stuff. I take a swig of coffee and savor the warm, bitter liquid as it passes over my tongue, through my esophagus and into my stomach. Before the next sip I gather my collection of daily pills: Vitamin D pill and a probiotic (which look like gems); calcium and a Flinstones pill (which look like stones). A gulp and a swallow and they go into my gut where they’re supposed to heal my stress fractures, regulate my intestines and make me whole again. Oddly enough this makes me feel better. Healthier. Like I’m finally doing something good for myself.
5:30 am – Ooh yeaaaaah…Coffee is beautiful! LIFE is beautiful! I start to think maybe this ORTHO month will be beautiful! Goddamn I love caffeine.
5:40 am – Grab my bags and head towards the door. Pause to light incence in front of ghandapati statue: “Please don’t let me fuck up. Please keep me sane.” Translation: Please help me not become an out of control fat pig. Give me the strength to not eat like crazy. Oh yeah, and here’s to hoping that Day 1 of 4th year goes well.
…Here we go for Round 2.
When I started medical school I was 73 pounds and damn proud of it. Starvation takes over your mind. The body has some built in mechanism where once you pass your lowest weight threshold you’ll try to do everything you can to survive there. I try not to bore myself with the details of my journey thorough thin and thick and really, I don’t think I can remember the details. It turns out that your brain also disappears with the rest of your body, so I can’t remember a lot from the past few years. I do remember some things: Running myself to exhaustion in -15 degree weather. Ending up in the ER a week before college graduation, getting pumped full of fluids while two of my best friends sat with me in the dark. Curling up with my grandmother in the couch-converted-into-a-bed where she spent her days until she died, our body frames comfortably fitting between the cushions with room to spare. We were disappearing together, and then it was just me.
It stayed that way through the first two years of med school. I tried to go out, make friends, see people…but it’s hard when people realize that you don’t want to eat. Through some fluke the girls that I’d gotten to know in class also happened to be “foodies” and I was scared to death. They sat around and talked about recipes and restaurants and ‘healthy eating’ and it all made me want to vomit so I tried not to see them much. I studied instead, a huge change from my previous life in undergrad. No more random 3AM drop-ins to see friends, skipping class, thursday night happy hours, etc. Nope, I took medical school seriously because I’d started taking EVERYTHING seriously. I thought my body was perfect, and everything else should be perfect too: my grades, my new condo, my life. I started reading home décor magazines and making scrapbooks. I tried to make my mom happy (an impossible task). I ate salads and obsessed over my hair and got upset if someone interrupted my routine. Everything was transient, nothing really mattered beyond school and whether or not I’d met my calorie goal. Maybe the body has a way of protecting the mind from starvation, because I felt euphoric every day. I would sometimes go see my ‘eating disorder doctor’ between classes and he’d tell me my heart was dying and I’d tell him I knew and then I’d leave, thankful that I hadn’t broken 80 on the scale. Every now and then I would freak out, eat too much and have to get ‘back on track.’ Sometimes I would run away to see a good friend in Chicago and take comfort in her stability while she sat with me and fed me pancakes. All in all it was a shit way to live, but I didn’t really know it or care.
Anorexia isn’t like breast cancer or a car accident. No one says “You poor sick thing, let me stay by you in your time of need!”. Instead everyone looks at you like its your fault and then leaves. The last year of college my friends banded together and elected one of my closest friends to talk to me. “They just can’t handle you,” she told me one night, “They want me to say something to you but I don’t know what to say.” I stared at her. This is the girl who I’d stayed up with while she freaked out about getting into medical school, she was the one I stood up for when she tore herself apart for being “stupid”, she was the one I was sure I’d know till we were old and grey. To her credit she tried to keep in touch but she had her own life to lead while I tried to destroy myself so it was a very unbalenced relationship. Either way, the rest of my friends pursed their lips and moved on, telling each other “well, she just has to help herself before any one of us can help her.” My own theory is that anorexia makes people uncomfortable because, somewhere deep down, they’re morbidly in awe at the level of self-control it takes to achieve such low body weights. I wasn’t scaring anyone with my mortality; I was scaring them with my determination. I wouldn’t go as far as calling it ‘jealousy’, but something akin to that. I could feel my friends retreating, watching me like they were watching a glass doll make her way through a windstorm (i.e with squinted eyes and clenched teeth). And I didn’t even notice because anorexia is a very self-absorbing diseases, but now I realize that after three years of medical school there isn’t a single person in this town that I could call up to get sushi or see a movie. I intimidated them with my bony frame, reminding them of their hidden desire to be a medical nightmare.
It’s a curse being big and fat again because I feel like I’ve been in a coma and have just now come out of it. It’s like the past almost-four years didn’t happen and I’m suddenly the same girl I was at 21, all bubbly and excited and ready to take on medical school and the rest of the world. But everyone’s gone and married or in some other career and I’m wondering where the hell I was the past few years. I spend hours on FaceBook trying to piece together people’s lives that they’ve been living while I was busy dying; trying to remember what it feels like. I have to teach myself how to be a person again and somehow find a way to re-enter normalacy. Before all of this I was hilarious, brazen, strong. I stunned people with my self-confidence. All of this sitting alone stuff is…new to me. I don’t like it.
But I’m not alone. I have a wonderful bestest-friend-in-the-whole-wide-world who is like my other half. He never left, probably because he one day wants to marry me and father my children (and after all that! I can’t beleive it either). There are a few friends in Chicago who I can always call and go to when I feel like cutting myself open and some scattered friends througout the rest of the country. The people I still talk to are the ones that stayed, the ones who treated me like the person I used to be even though I was nowhere near it. They’re the ones that came to see my in the hospital and cried when I reached my goal weight. It’s a handful, but they’re out there.
Somehow I’ve managed to find people in school here that I talk to and get along with and, recently, go drinking with. It’s like grass after a snow: it keeps growing. No one “knows” about the anorexia but it’s not like they can’t guess. A 30 pound weight gain is hard to miss. I don’t doubt that things will get better because, unbeleivably, I’m not bitter or jaded or cynical. Yeah, I was really sick, did things I’m horribly ashamed of, watched my friends give up on me and somehow I’ve come back. I don’t blame anyone, not even myself for the past few years. And now? I’m returning after my time away and looking around with wonder and awe. Little things…colored leaves, a good song on the radio, weekend trips to Chicago…. I could have missed it. I could have chosen to lose faith in people and withdraw and decide to just fuck everything and everyone. I could have left it all, but instead I’ve started taking up space again.
Ooooh I got a long way to go and will probably spend the next year getting myself together. I have massive stress fractures in my legs, I haven’t had a period for almost 4 years, I have no concept of when to eat and when not to, I hate my body, and the list goes on. But today a classmate emailed me to see a movie, and I had dinner with my dad for probably the fifth time since this all started and I wasn’t scared. I have to beleive it’s coming together. I’m picking up my armor, cracked and warped from years of abuse and dusting it off. I’m putting the pieces together and shining all the parts so that this time, after I straighten out all the kinks, I will blind people in the right angles of sun light. I will be fucking bulletproof and move on and over and OUT of this forever.
“She’s going to make a great physician!”
It’s a sentiment that I’ve heard from more than one patient, usually said when the attending and I are in the room after discussing the patient’s case and deciding on our recommendations. The first time I heard this said I didn’t quite know how to react. A small part of me was proud, thinking that my behind-the-scenes work of ear peeping and note writing had finally paid off, and in front of the attending no less! Another part, the larger part, was embarrassed. I could just imagine what the attending was thinking: “A great physician? Because she takes a mean blood pressure? Yeah right!”
The truth is, I’m not that smart. My shelf scores hover around or slightly above the average in my class. I did do well on my boards, but I’m sure it took significantly more time and energy on my part than my colleagues. I worry every day that I’m not going to get into the residency program of my choice because of “numbers”. On the wards I’m only slightly better. I’ve been told my presentations are alternatively “scattered” and “too organized and detailed.” I keep trying to gather my thoughts into a concise formulation of assessment and plan but usually end up falling short. It’s not that I don’t know the pathology or that I don’t care; it’s that I don’t know how to spit it out so it sounds like I’ve been doing this my whole life and takes yet only a second. It’s a different experience for me; someone who has done well in academics her entire life. It feels unbalanced and unfamiliar to not be at the head of the class.
I do have some unexpected strengths, none of which are conventionally measured. My last attending told me that I have the “unique ability to identify a patient’s barriers to care and help confront them.” I have an extraordinary ‘third-sense’ about things or, as it’s more commonly called, clinical judgment. And, most surprisingly, I’ve become good at comforting people. I’m not a comforting person. I’m not very emotional and I really don’t know what to do with people who are. But throughout this year I’ve learned to say phrases such as “I understand that this is difficult for you” and “We are all here to provide care and support “ without sounding like I’m faking it. And I’m not (faking it, that is). I really do mean it because despite my hard exterior, I care so much about what happens to these people. My attempts to identify my patients barriers aren’t to get them out of the office. Rather, it’s to help them feel well as fast as they can so they can get back to living this glorious life.
The patients that tell me I’m going to make a “great physician” aren’t the ones I’ve spent the most time with, but they are the ones who I’ve listened to. We all know the type: People with multiple medical problems who have been through the system, seeking care and something else. These people want and deserve a “cure” to whatever ails them, but they also are looking for comfort, reassurance and someone to listen to them. Whether or not that job falls on the physician is a question that’s been debated. In today’s world of 15-minute office visits and mountains of paper work a physician is hard pressed to find the time to be the support system for their patient. It’s easier to punt to social work or support groups or non-existent friends and family members. But the truth is, it doesn’t take much longer than 5 minutes to ask “Tell me what’s bothering you” and then offer some phrases of comfort. People argue that a physician’s our job is to cure the body, not heal the soul, but these patient encounters tell me otherwise. They don’t care that my attending and I have no new ideas or medicines to offer them and that we still have no idea what’s going on. They say I’ll be a great physician because I listened, cared, and tried to help them help themselves.
I’ve always favored reading over socializing, math over social studies, analysis over memorization. I can spend hours taking apart a problem and putting it back together or researching a diagnosis and trying to find a solution. I’ve never been good at talking to people about their problems and never really wanted to be. Nowadays, I find myself in the opposite situation. I am learning medicine, but I’m not excelling at it the way I have in my past studies. However, somehow during the course of this year I’ve mastered is what’s been called the “humanistic” side of medicine, the part that was always lacking for me in the past\. I have a long time to iron out the kinks in my presentations and fill the holes (thankfully not gaping) in my knowledge. But what I’ve learned about connecting with patients couldn’t be taught to me through books and numbers and it’s something that will stay with me throughout my career to becoming a “great physician”.
