Sunday, June 10, 2007

The long haul

Everyday is the same. I wake up with a sense of dread and turn to glance apprehensively at the clock. no matter what time it is 7 or 11, I cringe at the idea of having slept away precious learning minutes. As my lids weigh heavily down obscuring the view and lulling me back into sleepy denial, thoughts of bacteria, tumor staging and endless drug trivia release their painful grip. This is boards season.

Actually, the day usually looks up in those 20 minutes between coffee roused and over-caffeinated. It’s the act two in the monotony of the daily boards grind, the first act having ended with me lugging 30lb of books, computer, and stacks and stacks of scribble covered note cards to the library and unloading the vertebrae compactor into quiet corner. The coffee, coupled with a calorie laden bagel/creamcheese/tomato combo is a recipe for energetic over-inflation, which is about the only thing holding the lone strings of my sanity together. When on the west side, studying within the intimidating architecture of Columbia’s Butler library, there are 4 mexican men in a converted basement storefront who load me with enough xanthine to get a normal person through a day and a half, though they know I’ll be back in 5 hours. What began as a business relationship has delved into one of my most interpersonal interactions of the day, likely because I see so few people and talk to even less. Young and attractive as they are, I don’t mind their doting attention and sometimes linger for a minute or two after the void in my cup has been filled with warm wet nutrasweetened blackness.

Today, though, as is my custom on weekends, I am studying on the east side. With it’s streets lined with half the shops and three times the public housing, I have to admit, nothing feels more like home than this strange upper-east-harlem hybrid. Also admittedly, the caffeinating options are far more limited. I trip into the closest “cafe” that is little more than a glorified sandwich shop and am spotted immediately by my old friend who works behind the counter. I suppose one could make the argument that I’m using the term “friend” rather loosely, since I don’t even know his name, but the fact is that after pouring my coffee and mixing up handpicked salad creations for the past 2 years, I would say he knows me intimately enough to bare the title. He has my drug ready before I reach the counter and I show my gratitude with a swipe of the creditcard. On my way out I stop to pet a friendly golden lab tied tightly to drain pipe in front. Two boys dressed for the part of frat guys 3 & 4 in a summer teen dramedy, saunter out to tell me the dog’s name is Barrett. “Like barret’s esophagus?” I want to inquire, but I don’t. Doing so would lead me down a path of pedestrian confusion. Inevitably I would wind up explaining that I was sorry, but as a medical student, I couldn’t help the slippage of a few nerdy associations here and there. “Medical Student,” they would say, and then add praise or disbelief, followed by an awkward compliment. There may be a shrug or roll of the eyes, but that’s a rare occurrence. The fact of the matter is, once you tell someone you’re studying to be a doctor, or are a doctor, they’re generally waiting in line to tell you how great that is, whether they believe it or not...and they do so with the full awareness that you knew that they would. This knowledge of their knowledge of my knowledge is a pretty good reason not to mention my scholastic endeavors to strangers. It’s rather “braggy”. And when it’s not, it only comes off as a self serving narcissistic self endorsement.

And yet....

And yet...today I am fighting the raging urge to tell these boys. To tell everyone I come across, actually. To stand in the street with my white coat draped on one shoulder, stethoscope hanging with authority from my neck and inform each passerby that I’m studying to be a doctor. Ask them if they need my to take their blood pressure or check their reflexes, 2 of the 5 things I’m actually partially qualified to do. Qualification aside, I need, today, that praise like I’ve never needed it before. I am aching for it. Because when midnight rolls around and I’m sitting before this same computer or an opened book with 8 colors of penmarkings squeezed into the margins, when 1 am ticks by and I’m construction new acronyms to remember the divisions of the hypothalamus or the bacteria that have capsules, when 2 am arrives and I’m nestled into a ball on my bed, surrounded by neatly stacked piles of flashcards each one reminding me factoids about a drug who’s name I cannot pronounce, and I still haven’t saved a single life, or changed a single patient outcome, or made a single diagnosis or even unsheathed my pocketed hands to grasp another’s in weeks, I’m gonna need to know that I’m doing this for some fucking reason.

Crawling around in the filth of endless brutal factoids, I am reminded of the 90’s classic gameshow “Family Double-Dare”. The one in which reluctant parents are bullied by their 90lb offspring into carting them to and participating in what is effectively quiz bowl with ooey gooey food covered physical challenges. I’m sure the parents of those vivacious young ones, upon finding themselves between the folds of the 6 foot diameter pancakes into which they are layered along side gallons of sticky maple syrup and rapidly melting whip cream at some point stop and think to themselves “what the hell am I doing?” Then, feeling the wet penetration of elephantine proportioned condiments seeping through their monochromatic jumpsuits and beneath the chin-guard of their helmets, they see their screaming manipulators, joy (and a touch of sadism) twinkling in their youthful eyes. They know that forever, they will be able to share this day with their children and, amidst reminiscent laughter and bonding, remind them why they will be doing their chores without argument or protest until their cold crisp bodies are safely in the ground.

We all need that end-goal motivation. Everyday is just another day to me. Another earthly rotation. Another 24 hours in which I learn only half of what I endeavor to. But, reminded of my purpose by the encouragement of strangers or a glimpse of a white coat, confidently gliding off to save a life, or hold a hand, I zip higher my sweatshirt, fending off the library cold and uncap another highlighter. It’s a long lonely challenge set before me, but at least I’m not covered in whip cream.






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