Three months in

It’s been 3 months, can you believe that?

And I'm writing less. What I do is no less terrifying, maybe, nor less momentous, but it’s now routine again.

I still miss having an attending, but I don’t feel like I’m going to work completely naked anymore. Maybe like I’ve forgotten socks, or a jacket. Or my shoes don’t match one another. Maybe like there's marinara sauce on my forehead.

So that’s it then. For the rest of my life. Now it’s just the daily grind.

But wait, that can’t be right. This sounds too much like complacency. See, when I’m terrified, I at least look up everything I can. I rack my brain for the differential diagnosis and document things really well. When I’m comfortable, I think of the most likely thing and treat that, then go home and check Facebook. Not cool.

That’s not the kind of doctor I want to be. I want to be able to live with uncertainty, but strive for excellence. Advocate for my patients. Seek out the latest standard of care, question it, and meet it when it’s worthy. Solve difficult problems. Learn every single day. Be humble, but don’t back down when I know I’m right, and when it makes a difference in patient care.

I’m saying these things out loud because I’m not there yet. This kind of doctor is something between the two extremes in which I often find myself. Not just the average of the two, but something so much more. It might not be perfect every day but I won’t be happy with a goal of anything less. The extremes are unsustainable.

And that’s not all. I’m still dreaming.

Yesterday I got to assist on a c-section for the first time in 6 months. Actually, the last time in that surgery I was the one cutting. So it’s been at least 9 months since an assist. And… I still absolutely love that surgery. I wanted to be the one operating.

As soon as I feel like I’m truly comfortable in clinic, not just complacent, but competent, I’m going to kick myself in the pants and learn c-sections. I’ll do a fellowship. Then I’ll start a women’s health clinic in Africa or India and be their back-up. I’ll train midwives and nurses and help out local doctors.

Then when that gets routine I’ll move back to the states and become a politician or design an innovative new health care delivery system.

And then I’ll go on expeditions to Mt. Everest and jungly places as their doctor.

Then I’ll start a farm in order to prescribe my patients beets.

I love family medicine.

If I Couldn't Be

Sometimes I think about what I might do if I couldn’t be a doctor.  You know, were I to become incapacitated for medical work, or lose my license due to a lawsuit or clerical error by the Medical Board (not inconceivable), or were the apocalypse to be nigh, for example on Dec. 21, 2012.

Here are some ideas I’ve thought of.

·      Physics instructor

·      Actor

·      At-home parent (GB laughs at this idea, but maybe I could do it, right?)

·      Faxer of Things (see The Other Shoe Dropping 12/15/11)

·      Forest ranger

This morning as I pulled in to the hospital parking lot I realized ALL OF THESE THINGS ARE INSANELY BORING.

Obviously I would be a helicopter pilot for Life Flight (or similar.)

Probably I have never thought of this before because I have never parked directly next to a helicopter before.  It is a lovely beast.

It would be fantastic.  Not only would I be rescuing folks from remote hospitals with mediocre specialty access and possibly SAVING LIVES but more importantly I would be FLYING A HELICOPTER.

Probably I’ve never been in a helicopter before but I don’t think that matters too much.  How hard could it be?  Ask me a troubleshooting question.

What happens when there is a storm approaching?

·      Fly away from the storm.

What happens when the helicopter turns upside down?

·      Obviously you reverse the direction of the blades.

See?  Easy.

What if all the power goes out on the helicopter?

·      You should have brought your battery.  I would always bring a back-up battery.

What if there was a mutiny on board the helicopter mid-flight?

·      Obviously I would start singing Kum-Bay-Ah or a made-up song about helicopters.  Works for my kids.

What if a velociraptor appears from the sky and tackles you?

·      Consult Up-To-Date for Helicopter Pilots.  (They have that, right?)

I am so excited about my alternate career I might even see if they will allow me to ride in a helicopter one day so I can subtly talk them into letting me fly it, such that they will not even realize my pretext until it is too late.

I will grasp the steering wheel (Console? Handlebars?) with my pasty-white, overly-dry hands and conjure up reflexes and dexterity long-held dormant to guide the lovely beast safely through the air.  I will push buttons (lights?) and talk on the radio with a headset (is it called CB or CV?)  “Roger, 40, what’s your 20?  I’ll have a number 17 with Ranch Vinaigrette.  Will be landing shortly if that’s ok.  Do I land on the X or next to it?”

After we land I’ll take a moment to relax and drink some lemonade while reading a little bit about Helicopter Piloting Terminology.  Probably I’ll be considered a prodigy and earn a medal.

But first I guess I will round on a few patients.