Relationships in med school pt 2: Monday Nights

After a long day, Katie deals with her problems by talking through her day.

After a long day, I need to shower and get away from the world.

smile

One of the top 3 interesting things about marriage is that you learn an incredible amount about what makes a person tick, which is sometimes.. challenging.  It’s been an ongoing learning process for Katie and I to work with each other’s extroverted/ introvertedness.  One thing that’s really helped me is my Monday nights.  

Back in Portland, Monday night was my Sabbath.  I wouldn’t plan any social occasions, I’d come home early from work, and even Katie wasn’t allowed to talk to me.  I’d get completely absorbed in myself.

During my Monday nights these are the top 4 things that produce a holy feel:

4) Drink beer – A beer definitely takes the edge off, and leaves me just uninhibited enough to write something interesting.

3) Shower – There’s something holy about showering.  It probably has something to do with feeling clean, especially in humid Charleston where I always feel sticky. I prefer to shower at least twice a day, up to six per day. 

i need running buddies

2) Working out – After a long day it's a relief to blow off some steam.  I've been trying to analyze the benefits of cardiovascular vs strength training on stress.  I generally side with cardio for stress relief, but within cardio - should I go hard?  How hard?  Elliptical?  Run?  


Sidenote - I’d love to get back into running.  I should make it one of my goals in med school to pick up a running buddy.

1) Writing - Writing ranges from a self-absorbed waste of time - to a a cheap form of stress-relief/therapy - up to a surreal experience. It's like going to a place in another dimension, shaking hands with God, then coming back to communicate it to the world.  Most of the time I'd say it's a waste of time.

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I imagine getting back on the learning curve of school will drain on all the multiple facets of my life, so I’m trying to accumulate as many sanity-maintaining habits as possible.  I consider it one of the top responsibilities in marriage to take care of myself and stay sane.  These Monday nights are a prime example.

See you on the other side,

from ken

Onward and Upward

 I’m sitting on a plane to Japan, officially done with my first lab rotation.  That’s 11 weeks down, 389 weeks to go.  To celebrate being 2.75 % done, I’m vacationing with Katie in Japan. 

Sidenote - this raises the question, how much bigger do we get with the celebrations?  After finishing year one, dog?  After finishing year two, kid?  After finishing the program, house party headlined by Walk the Moon, K’naan, or Danna Nieto’s future band? 

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Anyways, here are two quick things I learned in the pre-M1 summer lab rotation:

1) I love science. 

I sometimes forget that.

For my first lab rotation I worked with Phil Howe.  His lab studies how cancer spreads all over your body. 

yeah, I'm about 30% from the line

The upside - Phil lets his students roam free, which is daunting, but I wanted that freedom more than anything. 

I wanted to find a lab where I could put myself to the test and see if I was more Kobe Bryant or Paul Pierce.  Sidenote - The breakdown: both guys think they’re the best player on the court.  Kobe has five rings and is a top ten player all-time.  Pierce has a couple rings but isn’t quite a historic player.  There’s also the possibility that I’m Jamal Crawford –same confidence level as Kobe/Pierce but 2.75% as good. 

I love comparing myself to basketball players.

The downside – it’s a huge pain to pick an interesting scientific question, there is SO MUCH BS out there. 

I spent the summer scouring the cancer literature, following big-time researchers on twitter, and talking bullshit with scientists to figure out which scientific questions are actually interesting. 

So far.. I have no idea.  Good thing I have 389 weeks until I can get a real job. 

2) Taking time off between undergrad and med school is CLUTCH. 

I’ve always been young for my grade.  I couldn’t drive until my senior year in high school, and I didn’t turn 21 until my senior year of college!  But I met my three MD/PhD classmates, and they’re all straight out of college.  A part of me is jealous that they get to start two years before me. 

At the same time, here’s what I did between graduating Kenyon (June 2010) and starting at MUSC (May 2012). 

good times

Moved to a city, Portland, OR, where I didn’t know anybody

Learned to ride a bike

Leased my first grown up apartment

Got married to the most beautiful woman in the world

Started writing/launched sidenote

Ran two marathons – Portland by myself, and Eugene with my friend Amulya

Lead two bible studies

Visited (on leisure) DC, NYC, Philly, Denver, San Francisco, and Worland, Wyoming

Those two years were crucial for my long-term survival.  I was lucky in Portland to pick up hobbies like writing, and to start a family with Katie.  Hopefully that’ll keep me from my biggest fear – being a boring student whose entire life is med school. 

See you on the other side,

from ken

Imaginary Coffee Date pt 1: Metzger/Noguchi

I wanted to start a series of posts where I exchanged emails with a friend on a topic we would usually bullshit about over coffee or beers.

Basically, I wanted to copy Bill Simmons:

Hope you like the first one.  And let me know if you want to have an imaginary coffee date posted on sidenote!

lauren and I, repping UNC blue

Lauren Metzger and I met at Kenyon College five years ago, we were breakfast buddies.  Lauren is currently an MSW student at UNC-Chapel Hill, and is a top notch triathlete.  In about a month, Lauren and one of my best friend’s Kaleb Keyserling are getting married!  She made time in her busy wedding planning schedule to have this email chain with me:

The topic: what we miss about Kenyon. 

Ken: There's a lot I miss about Kenyon - the convenience of living in Hanna and walking one minute to class, healthy all-you-can-eat meals at Pierce, but #1 is a sense of purpose.

I woke up every morning knowing I had to get up for 8:10 AM class, so I got out of bed and got to work.  Post-college it’s real vague.  I could be in lab at 7 AM.  I could also go in at 10 AM.  Odds are my boss won’t care, and I definitely won’t be seeing any report cards.

Lauren: Two things stood out to me - the first, food!  I miss walking into the dining hall and having so many options at my finger tips.  Not having to grocery shop and having local food was great- loved the turkey burgers! (I think those were local)

The second thing I miss are the people and structure. The xc team was such a source of stability, something I could always count on. I miss having teammates to run with. I could have enjoyed the people more if I had let myself. I was so worried about doing well academically and I think I was also a little socially anxious - worried about rejection.  

xc teams are apparently models of structure

Ken: I totally agree - there's so much pressure to do more and more.  I know I sacrificed several relationship for grades or to pile on more extracurriculars.  That said.. I don’t regret it.  As much as I love relationships - if I hadn't made those sacrifices I wouldn’t be in med school, and I can't imagine not being a doctor.  

Thoughts on work/play balance, post-Kenyon?

Lauren: Interesting - I was reading an article about women sacrificing top careers for family (which is a huge complex relationship).  The balance is very tricky. 

Post-Kenyon, the distance between friends only grows! You can't just text them and say "hey middle ground coffee?"  It becomes "hey can you buy a plane ticket to come see me for a weekend that may already be really busy and sorry I forgot you can't afford that plane ticket...."

lauren and kaleb

It was nice to have friends so close, but now everyone’s all over the country. It’s so much effort to keep in touch, and let’s face it - I like to be lazy and think my life is way busier than it actually is. 

Hmmm, career success....it depends on the field.  Medicine is hard, I was talking to kaleb about how he’s going to balance spending time with his family (a.k.a. me) while being a doctor. Don't think we’ve figured it out yet.

I know my balance will come with a flexible job, like academia, being a student all over again.  I HATE unpredictability. I felt like everything was so predictable at Kenyon. So structured in a way that I miss. 

Ken: Yeah, and we’re back to the structure.  It’s weird that our favorite thing about Kenyon was structure.. sometimes it felt like there was no structure and everything was a blur.  Or maybe that was just us going at blur speed within our structured schedules.  Either way, good times at Kenyon.

See you on the other side,

from ken

Top 5 Medical Memoirs

I love all kinds of books, but I devour medical memoir.  It feels like talking life with my future peers, friends, and self.  So, I thought I’d compile a list of my top 5 medical memoirs :

Where I read in Wyoming

5) Better: A Surgeon’s Notes on Performance by Atul Gawande, 288 pg

“People underestimate the importance of diligence as a virtue.  No doubt this has something to do with how supremely mundane it seems.”

One Sentence Summary – Intangibles that are important in medicine. 

Gawande is a believer in intangibles, and Better is about the intangibles crucial for medicine – including diligence, personableness, and honesty.  He tells anecdotes of historical medical accomplishments like the polio vaccine, and of current medical struggles like getting doctors to wash their hands.

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4) Intern: A Doctor’s Initiation by Sandeep Jauhar, 320 pg

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

One Sentence Summary – Sometimes hilarious/always honest account of internship.

"I should have been a doctor."

Jauhar, a former physics PhD student that changed paths to medicine, chronicles his internship year at a NYC hospital.  Rather than describing all his great doctoring moments, he takes an introspective look at his struggles with medicine.  It was refreshing to see that a real life doctor still has doubts.

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3) The Tennis Partner by Abraham Verghese, 368 pg

“Within your secrets lies your sickness.”

One Sentence Summary – A ode to a friendship between two struggling men. 

Verghese also wrote an NYT bestselling novel, Cutting for Stone,  and works at Stanford Med as an advocate of the doctor-patient relationship.  Previously, he worked in El Paso, where he bonded with his co-worker, David, over a shared love of tennis.  Verghese was going through a divorce and David was recovering from a drug addiction, so they both relied on their relationship to anchor their unstable lives.  Verghese’s sharp understanding of human emotions is impressive. 

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2) Walk on Water: Inside an Elite Pediatric Surgical Unit by Michael Ruhlman, 340 pg

“You cannot lie in this work.  There are so many people in this world who have no idea who the fuck they are.”

One Sentence Summary – Psychoanalysis of peds cardiac surgeons in the pursuit of greatness. 

Road to greatness?

Ruhlman, a journalist, spends a hectic year following a pediatric cardiac surgery team.  Peds cardiac surgeons fit the surgery stereotype to a T - they know nobody else can do what they do, and that lives depend on their hands.  He really studies the personalities that make up the team, and figures out what makes them tick.

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1) Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World by Paul Farmer/Tracy Kidder, 352 pg

“I’m going to build my own fucking hospital.  And there’ll be none of that there, thank you.”

One Sentence Summary – inspirational read of doctor in Haiti.

Farmer is a doctor bringing healthcare to rural Haiti.  I am forever indebted to Mountains, a book that gave me an idol. 

I struggle with the tensions of a Kobe-like competitive edge with my desire to help people, and in Farmer I saw an idol that balanced those tensions.  He’s painted as a selfless demigod, but I saw a cocky young doctor that fed off the rest of the world doubting him.  He believes it is his individual responsibility to save Haiti.  

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So anyways, that’s my top 5.  Let me know if you’ve read any good ones.  I’m currently reading Samuel Shem’s House of God. 

See you on the other side,

from ken

Top 3 Med School Goals

I came across an old Google Doc, “Year Goals 2010.” I set three goals to accomplish during my Portland life: 

beers

1) Have good friends in Portland – check 


2) Get in med school – check 


3) Fall in love again - check 


PDX goals - dominated 


After this good omen I put my top 3 Charleston goals on paper: 


#3) Make good friends in Charleston, then drink beers and talk shit about life. 


Token goal for my life. I have a theory that my wheelhouse of relationship-building is “camaraderie through suffering.” This describes med school/residency to a T. I’m still planning on being super intentional, just in case. Plus, I need to make Sidenote famous. 


#2) Move on to a big pond/match at Boston Children’s Hospital. 


At the end of med school there’s a process called The Match where each med school graduate gets matched with a hospital to undergo clinical training. The brief explanation: each graduate ranks their favorite hospitals, each hospital ranks their favorite graduates, and a complex computer program matches everyone up. It’s kind of like the NBA draft, needlessly complicated and surely fixed. 


Sidenote – If cancer is cured in my lifetime, I desperately want to be there. I’m convinced it will happen where brilliance and passion are fused, but I’m not sure where that is.. I assume it’s a big pond. All I know is I haven’t seen it. So I’m hoping to catapult myself from Charleston to a top pediatric hospital. 


Four years ago, I spent spring break shadowing an intensive care specialist at a pantheon pediatric hospital, Boston Children’s Hospital. I rounded with the smartest residents in the country, we reviewed mysterious cases nobody else could solve, I watched a peds cardiac surgeon nonchalantly cut open a four day old infant’s chest. It was awesome. 

a hot pond

The best part? 


The attending was a Kenyon alum. It’s a sign, I swear. 


I want it. 


#1) Be a good husband. 


I know the gunner side of me will come out in med school. A part of me really wants to crush med school. I want to violently shove it down the throats of all those top ten schools that rejected me. 


At the same time, I’ve watched enough Scrubs (every episode at least three times) and read enough meaning-of-life books to know happiness does not come from matching at a top hospital. Sidenote – my top 3 meaning-of-life books + conclusions: 

some great meaning-of-life reads

3) Walk on Water by Michael Ruhlman – Life is about pushing yourself for other people 


2) Home Game by Michael Lewis – Life doesn’t make sense and you just have to accept that you can’t win 


1) The Book of Basketball by Bill Simmons – the secret of basketball, is that it’s not about basketball. It’s about avoiding the temptation to believe it’s all about your own stats. Sidenote – I really need to write another post about this book. 


Anyways, I do better in life with a goal-oriented outlook, so I hope the prospect of The Match will keep me entertained during med school. At the same time, I hope to remember that life isn’t about matching at hospitals, it’s about investing in relationships, especially with Katie - since she just drove across the country to hang out with me while I write blog posts. 


See you on the other side, 


from ken