Saturday, December 25, 2010

Hypochondriasis

I’ve lost 5 pounds since Thanksgiving.  Some people might liken this to a sort of Christmas miracle.  Others might brush it off as a general lack of nourishment and exercise while studying for exams.  But I’m a medical student.  So I think I have cancer.  This is the funny thing about stuffing your head full of facts on disease.  You are exposed to so many ways your body can malfunction that you become incredulous to the idea that anyone can actually be healthy.
I think this is why rheumatologists don’t run or play basketball.  They’re afraid of getting osteoarthritis and needing that bilateral knee replacement.  And I have yet to meet an ophthalmologist who wears contacts.  Because there’s this pseudomonas infection that eats through your cornea in 12 hours and leaves you blind.  Heck, I’m surprised Ob-gyns don’t just adopt.  It may seem a little crazy, but med school has a way of infusing some anxiety into every little ache or pain.
I remember accidentally puncturing the outside of my right ankle while cycling about 6 months ago.  It was a nice deep puncture, full of dirt and bike grease that oozed blood onto my sock.  I vividly recall worrying about all the tendons with funny Latin names in that part of my ankle.  Crap, did I slice my flexor digitorum longus?  But even as images of ankle anatomy flashed through my mind, my more sensible inclinations took over, and I forced myself to rinse out the wound, put on my shoe, and continue cycling.
Three days later, my foot swelled up with infection.  Now, I was sure I had necrotizing fasciitis.  I remember turning to my girlfriend, Tiffany, and telling her that I would need my foot amputated, at which point she promised to still love me.  But of course, the infection went away with antibiotics.  It turns out there was no necrotizing bacteria, and I still have my right foot.
I think they warned me before starting school that I would become a hypochondriac.  I’m pretty sure our dean even addressed this at our white coat ceremony.  But at the time I laughed it off, certain this only happened to the crazy kids.  I didn’t have to worry because I was level-headed and still fairly invincible.  But that’s the thing with studying tumors and tendons—you lose a bit of that invincibility.  So I guess I am susceptible to bouts of hypochondria after all.  But really what I’m worried about is this new bump on the back of my head.  Like I said, I think it may be cancer.

Saturday, December 4, 2010

A Holiday Toast to Not Being Miserable

When interviewing for medical school, a student interview is often part of the hoop-jumping process.  In these interviews, they always ask you if you have any questions.  I think you’re supposed ask about stuff like research, curriculum, and the latest scholarly article on treatment of disseminated intravascular coagulation.  It shows that you’re genuinely interested in medicine.  During my interviews, I always asked students if they were happy.  Along with medicine, being happy is one of my genuine interests.
Asking students about their happiness earned me a good number of calculated smirks.  Most students would slip on this knowing grin before assuring me they were not miserable, which was comforting, of course.  There was, however, one student tour guide who glared at me and flatly asserted, “We’re in medical school.”  I remember some of the applicants around me chuckling and even nodding.  But he was being serious and I don’t like to laugh at other people’s misery.
What transpires over the course of years, or perhaps decades, that turns wide-eyed applicants into weary-eyed professionals?  None of us enter medicine with aspirations of becoming jaded or cynical.  I wonder if some of us just end up sacrificing too many of our meaningful daily experiences under the piercing focus of our long-term ambitions.  True, we all sacrifice for the things we love.  Medicine is no different in this regard.  But then again, as students we tend to lay especially grand offerings of time and energy at medicine’s alter—trusting that our intellect, emotion, and efforts are being poured into a worthy pursuit (and trusting that this pursuit is nothing like a subprime mortgage).  What is sacrificed now will be reimbursed with interest later.  At least, that is our hope.  Yet in our fury to get things done, joy often becomes ancillary and delayed gratitude becomes a habit.  Maybe even a way of life.  If foregoing happiness becomes our nature, how soon until it is forgotten altogether?
I knew before entering medicine that there would likely be holidays spent at the bedside of unhappy patients.  There will be attendings and residents who will chew me up and spit me out for the least of my screw-ups.  And on occasion, my textbooks might not leave as much room on my bookshelf for poetry or comedy as I’d like.  Yet, in spite of all this, people before me have survived to smile and tell jokes and some to even still laugh at them.  It makes me think that perhaps joy isn’t so much the result of choosing the right school, or even the right specialty.  Maybe it’s more of a skill, like inserting an IV or stitching together a nasty wound.  Sometimes you watch a skilled physician perform a procedure with such ease that you forget the practice and effort behind it.  Maybe the same thing can be said about joy.
I have this theory that babies are born with this unbridled capacity for joy and excitement, but perhaps as we get older, cynicism starts to creep in as our ability to express joy with child-like abandon simply atrophies with disuse.  Really, I’d rather not find out for sure whether the latter part of this theory holds any truth.  So I force myself to keenly cherish that last sip of coffee before I run out the door, late for class in the morning.  And I savor that bit of giddy energy that dances in my stomach when a grumpy patient warms up to me after a few minutes of conversation.  I drink in the little moments of elation and hold them on my tongue until they turn into euphoria.  In the back of my mind, I know I must for fear of ever becoming that student when asked if I’m happy, can only respond “I’m in medical school.”

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