sidenote: June 2012

Relationships During Med School pt 1: An Intro

katie

A little over a year ago, I was considering getting engaged to Katie. I asked one of my similarly pre-med friends what he thought, and he told me:

"No way! Med school is too big of a strain on a relationship. I’ve heard of so many couples breaking up during med school, it seems like too much of a risk to go through a divorce, or have a marriage really suffer. I’d only do it if I had a super solid stable relationship going into it."

top 5 moment from the wedding

It’s an interesting point, and one well taken. Except for the part where I still got married. Documented here in my #1 most popular post: Pre-wedding running diary.
Anyways, the point remains that relationships are stressful during med school. Sidenote - if you believe what med students tell you about med school, it’s the equivalent of Vietnam crossed with giving birth, except more intense. Realistically, it’s probably like an overconsuming full-time job. Work 50 – 60 hours a week and struggle not to think about it at home, but it’s not quite running through jungles and getting shot at, and it’s probably manageable if you think about it.

If I want to keep going down this track of hypercompetitive academia, it only gets harder. A few years ago, I worked in a lab at Harvard, where I mostly worked with one of the junior faculty, Dr. Liang. He was a fairly recent MD/PhD graduate that was trying to start up his own lab, and he told me about the interview process he went through at Harvard. Dr. Liang had concerns about the stress that a competitive environment might place on his family. The department chair gave him this advice:

“The second wife is always happy.”

The whole medical/research career track isn’t exactly family friendly.

science in action

But like any difficult task, it can be done. There are neurosurgeons with healthy family lives and HHMI lab scientists known for prioritizing their kids' soccer games. I want to know how they did it, so I’m going to write a series of posts throughout my time at MUSC analyzing relationships during med school – primarily Katie and mine. Hopefully this will become my third book.

Sidenote - the first two:

1- token memoir of internship, aka rip-off of Sandeep Jahuar’s Intern.

2- running interview with me on my cross-country road trip publicizing my first book, aka rip-off of David Foster Wallace’s Although Of Course You End Up Becoming Yourself.

This is already getting long, so I’ll leave you with a question I’ve been wondering about.

Is it easier for a power couple – both med students – or a couple where only one is a med student?

My answer: it depends on the stage of life. During med school, it’s easier for a power couple since they experience all the same things, study together, suffer together, etc, but after med school, ESPECIALLY after residency when people start to transition from a “school” to a “real life” stage of life, it progressively gets easier for non power couples.

Anyways, I welcome your opinion on this.

See you on the other side,

from ken

Tell your friends about me.

The REAL reason I want to go to med school

One of the many place I pretended to care about people.

I have several friends going through the med school admissions process this year. Just having finished it, I am extremely worried for their mental health.

The process is a lot of acting. There’s a vague template that med schools want, and there’s unbelievable pressure to dress in suits and say cookie cutter snipits to please the all-powerful admissions committees.

In order to appease such bureaucracy, I wrote a post last year [link to med school personal statement here] that evolved into my med school personal statement. To summarize: I want to be a doctor because I had been privileged and given the opportunity to flourish, so I wanted to lead a life where I could give other people that same chance. Medicine seemed perfect – I could turn people’s lives around.

The personal statement is part of the reason I want to be a doctor, but it’s also the “best sounding” reason. Now that the powers-that-be have signed my acceptance letter, I can give you the top 3 REAL reasons why I chose med school:

#3) The results are tangible. In the lab, I constantly struggle to sustain intrinsic motivation through countless failures. SO MANY long days are meaningless. The clinic provides a lot more extrinsic motivation – patients come in, you try to help them, rinse, repeat.

#2) My favorite show growing up: Scrubs. I'm hoping if I become a doctor I will become JD from Scrubs – over-the-top introspective, selfishly cares too much about other people, slowly develops as alpha male. So far it's working. I seriously debated for at least seven minutes the pro/cons of putting this as #1.

Sidenote – Sandeep Jauhar wrote one of my favorite medical memoirs, Intern. Jauhar used to be a physics PhD student, but decided there wasn’t enough meaning in PhD research so he changed tracks to med school. The book is about his intern year, the first year of training after medical school. It’s infamous as the hardest year of medical training, and Jauhar writes a hilarious and honest record of the year.

He describes one scene when he and the fellow interns are burnt out and giving all the wrong answers on rounds. The attending physician walks them over to the window, and points to the river, at a guy looking up at the hospital. He says:

“That guy in the boat, looking at the hospital, do you know what that guy is thinking? I should have been a doctor.”

#1) The scene struck a cord with me because the #1 reason I want to be a doctor is that I need my life to have meaning - I never want to be the guy in that boat. My life is a never-ending balance of comfort and meaning. Whenever life gets too easy I always question if my life is meaningless, and whenever my life is involved in too much stuff I feel like I'm teetering on the edge of sanity.

Sacrificing time and mental sanity sucks, but I would rather struggle with burnout than meaninglessness.

Sidenote – this desire to have a meaningful life is the #2 reason why I got married, but that’s a whole different post.

See you on the other side,

from ken

Feel free to comment! I would love to hear your thoughts.

The Consequences of Caring

yeah, I had long hair once

"And there are those who give with pain, and that pain is their baptism."

- The Prophet, K Gibran

Years ago, I was involved in competitive athletics. You might be surprised because I’m as skinny as a straw, and not like the ones you see in milkshakes, more like the ones you see in cocktail drinks, and you self-consciously wonder, “Is this to stir with? Or drink from? I’ll just watch what everyone else does.” Seriously, I still don’t know what I’m supposed to do with it.

I used to run cross country for Kenyon, and five years into my competitive career I had a Steve Nash moment. Sitting in front of my locker. Another track season over, ending as usual in disappointment. I had come a long ways from where I started - I was a legitimate member of a collegiate cross country team, but I couldn’t help but remember a legendary running quote:

“To give anything less than your best, is to sacrifice the gift.”

I understood that my body had athletic limits, but it haunted me to consider that I could give more. Before I could put the period on the running chapter of my life, I had to confront the edge of my limits.

That summer I lived in semi-isolation in Wyoming, and totaled over 1000 miles. A previous post. It was a daily ritual to run upwards of 20 miles. It was also a daily ritual to question what the f I was doing.

When I got back to Kenyon, I had a pantheon cross country season. I shattered my personal bests and walked away from that season knowing I had given my best. But after a few weeks of sitting around, watching everyone else gearing up for indoor track, I knew I wasn’t ready to go back. I decided to train by myself and take a break from running. Mentally and emotionally, I was burnt toast. I never had another great running moment again.

kind of looks like the gel took a poop

I’m currently training to become a scientist. I love my job, but there are moments when my head might explode.

The two hardest parts of science:

1) It’s all behind-the-scenes, so it totally depends on my intrinsic motivation. All of my long days at the bench are only the first step for clinicians to come up with novel treatments. Is this doing anything for people?

2) Experiments go wrong all the time. Some weeks I literally accomplish nothing. Shouldn't I be sitting at home and watching funny youtube videos instead?

This past week was no good. I messed up my own experiments. I messed up my co-worker’s experiments. A lot of stuff went wrong, and it’s a daily ritual to question what the f I’m doing.

For now, I love science, and I know caring about it gives me an edge. I’m in the lab early. I’m in the lab late. I obsess about doing everything right. I study all the little ticks that make baller scientists baller. But I know that same edge that gave me one great cross country season is the same edge that burned me out on running forever. I could see myself watching one last gel leak, not so calmly walking away, and never looking back.

“The sharp edge of a razor is difficult to pass over; thus the wise say the path to Salvation is hard.”

- The Razor's Edge, epithet

See you on the other side,

from ken

Inspired by my writing idol Bill Simmons “The Consequences of Caring”

The Champagne of Beers

“Watch where you’re FUCKING driving!”

Standing in the middle of a crosswalk, I threw my hands up as a car cut me off.

I’m tired.

I’m tired of walking back and forth to the freaking store. I want a car.

Of course, I had to pick out the heaviest possible groceries – whole wheat flour, plain yogurt, dried beans, six-pack of Miller High Life.

My back hurts. This can’t be good for me.

Sidenote – one of my top 2 influences is David Foster Wallace’s This Is Water, a commencement speech he gave at Kenyon. Sidenote-within-a-sidenote – the other, Mountains Beyond Mountain. Anyways, This Is Water is about two young fish swimming in a hurry. They run across an older fish that asks, “Howdy boys, how’s the water?” The fish continue on their way, but after a minute, one of the younger fish asks the other, “What’s water?”

I loved the connection to Kenyon, I loved what DFW stood for, and I loved his edge, so I gave This Is Water to all my groomsmen as a wedding gift. I’ve been emailing with one of them about the significance of the book. For me, it boils down to the word, “This.”

“This” represents the act of pausing and seeing the water around us. The currents flowing, krill swimming, whales giving chase.

Sidenote2 - I read a couple of Bulls/Lakers/future-Heat coach Phil Jackson’s memoirs. My favorite was Sacred Hoops, a great read about the intersection of spirituality and basketball. What I took from it:

The 90’s Bulls said the Lord’s Prayer before every game. I figured if it worked for the Bulls it would work for me, so I’ve been saying the Lord’s Prayer every time I shower. I imagine it helps me in the same way it helped the Bulls. Obviously, life gets tough for everyone - even the Bulls had tough losses, but at their core they were twelve guys that wanted to go down in the history books. With the Prayer, Jackson gave the team a few precious seconds to remember that they had to push through the struggle, and keep playing their game.

That’s why the best part of This Is Water, is “This.” DFW knew the tough moments in life were the most crucial - that’s where the battle between good and evil exists. But sometimes, the hard part is noticing when we’re engaged in that battle. Sometimes it’s about taking that second to see the battle.

After a grueling walk I made it home. I slammed my sweaty clothes in the laundry basket, still pissed off about everything.

I wish I could just buy frozen burritos like my roommates. I wish I could drive to the store like them.

As I turned on the shower I remembered.

This is water.

No, wait. I walked to the fridge.

This is beer.

Shower beers. Ah.