nANIMOv

Right now I’m kinda in the process of really trying to figure out where in medicine I want to end up. We just wrapped up 3rd year this past Friday and tomorrow is the start of 4th year. I completed all my core rotations and at no point in the last 10 months did have that “aha” moment that people always talk about. I feel like my problem is that I have an tendency to tolerate, or dare I say enjoy, whatever I am doing. There was nothing I absolutely hated (that doesn’t mean I didn’t rule anything out), but also there wasn’t anything that I 100% fell in love with, and I’m not sure such a thing exists.

I’ve spoken to a few advisers in the specialties I’m interested in which has been helpful. I have also spoken to family members and friends, and while I’ve very much appreciated everyone’s input, it’s hard to know who to trust. I feel like no one I’ve talked to fully understands me as person nor due that fully understand my my values or my philosophy towards medicine. Many of the doctors I’ve spoken to, including those within my family, seem to have come to medicine from a slightly (or more than slightly) different angle from me with their own set of values. The metrics are different, but often in conversation we speak as if they are the same. What is a downside of a particular specialty for one person, may actually be a bonus to me and visa versa. Then to make it even worse, just because a particular thing matters to me now, doesn’t mean it will matter to me 10+ years down the road.

At the end of the day, I will eventually have to make a decision based on whatever information I’ve obtained by that time and then live with that decision. I just have to remember that regardless of what happens, my satisfaction and contentment with life is based on so much more than the outcome of what currently feels like the biggest decision of my life.

In 2023 we have the solution to boredom. We’ve actually had it for a while now and it comes in the form of these tiny rectangles we keep in our pocket. The moment boredom rears its ugly head we have the perfect weapon to ward it off. Not a single minute of our time need be wasted sitting idle when we can fill it with videos of people dancing at work or of people showing the silly things they did at Disneyland or of 5 tips for making yourself rich TODAY.

No more wasting our time with useless mind wandering and daydreaming when our attention can be continuously captivated by an endless stream of catchy and misleading headlines, targeted ads, and controversial content. We can check our emails, be entertained, catch up on the news, connect with friends, make business connections, or love connections (or both?) all without taking our eyes off our screens. It’s called productivity and productivity how we keep up in this world lest we fall behind into cultural irrelevance.

There’s no need to reflect, there’s no time to pause because we already have notifications piling up that we need to attend to and trends we need to participate in. Boredom and idleness are problems of the past, and in this day and age we finally have the space and the tools to be focused on what’s really important.

We’ve all been there. After hearing the phone buzz after that risky text; after being told the results for the exam you didn’t feel great about have been released; after lifting the cup from over a cockroach you think you trapped, there’s a fear of finding out what the outcome is. Our minds have a tendency to perseverate on the worst possible outcome (or at least mine does), regardless of the true likelihood of that outcome. And as they say ignorance is bliss.

I feel like I used to be really good at combatting that fear; at telling myself and believing that knowing is better than living in that dark, but as I’ve become less confident in myself I’ve found that fear starting to win more battles (even though in most cases I end of needing to confront reality at some point, and usually it being fine). I’ve been slipping. I want to go back to that mindset, and part of that involves taking back control of my competence and identity.

I came across this term, FOFO somewhere but I can’t remember where so I apologize to whoever inspired this thought, and thank you, and I definitely do not take credit for coming up with it.

I started to get into rock climbing about 5 months ago and recently it has been the only physical activity I’ve been engaged on a consistent basis recently. I been taking it pretty slow, trying to nail down easier climbs, improve my strength and endurance, and develop my climbing IQ before jumping into higher level climbs. What I’ve enjoyed about climbing is that each one is a puzzle, and as you move to more difficult climbs it doesn’t just get more physically demanding, but it also requires you to think more critically and creatively, and just like with mental puzzles, even when you get it wrong the first time something about it has you coming back to try it again to figure it out. There is not just one way to do any particular climb, but there usually is a “best” or “lowest effort” way. The freedom to fail and to try things out and work slowly is something I’ve missed since being back in school, so it’s been nice to have this as an outlet.

When talking about seizures, we often talk about a postictal state – a period of altered consciousness or fatigue after seizure stops. I only recently made the connection between that term ictal and something I learned about back in high school marching band. Ictus refers to an inciting event and is often synonymous with the onset of a seizure. In music, the ictus is like a recurrent beat and in the case of conducting, I was taught that the ictus was the bottom of my arm strokes, which indicates the exact moment of the beat (can also think of it as the apex of the stroke). I’ve known both these terms, at least since I was in high school but didn’t realize the connection/ similarity until my attending said the word ictus in clinic the other day (usually when talking about seizures we always hear -ictal).

I don’t have a deep life-lesson or reflection to glean from this realization, I just thought it was interesting.