Worth It

(As of today, there are 12 days until classes begin for my second year. I guess the pressure’s on to write what I promised to write, eh?)

I’ve only completed one year of medical school thus far, which sadly puts me much closer to the beginning of my training than the end. But I’m already deep into it — I left my first career in May of 2004, which means that I’ve already devoted three years of time, money, and sweat equity to medicine. Last summer, anyone who asked me whether I’d made a good decision probably received a confused or noncomittal reply. Sure, I enjoyed my post-bacc year, and I was eager to become a physician, but I was still technically a pre-med. I had no way of knowing whether I’d actually enjoy medical school, whether I would complete the year satisfied that I’d chosen the right path for myself, or whether I’d made yet another professional mistake. Well, times have changed. I’m now a full-blown medical student, and I’ve managed to complete my first year without any major crises. So was it worth everything? Did I make the right choice?

The answer, at least this year, is unequivocally yes.

The hours were long. The material, while not tricky, was voluminous and incredibly fast. Some of the classes were tedious, some were interminable, and some felt like they were impossible to understand in the given time. Some of our lecturers were unintelligible, others just incomprehensible. There was a lot of sleeping in class, in the library, and at home with my neck crooked unnaturally over my notes. There was far too little sleep overall. There were some moments of panic.

But there was also an amazing realization. Despite all of the things that med students (sometimes rightfully) complain about, despite the unbelievable demands of our time and energy, I loved almost every day. I was surrounded by people like me, studying topics that fascinated me, imbibing a culture of science and art that I had sought for years. While I liked most of my old coworkers, and made some great friends to boot, I never felt like I belonged in the office. Here, sitting in even the driest of lectures, I am finally an integral part of the fabric. I understand what drives my classmates, and they in turn understand me. This is all the more remarkable when I consider that I’m significantly older and in a completely different social situation from most of them, which separates me from interacting very much with them outside of class. It’s a great feeling, knowing that I belong.

There are some moments that stick out in my mind from last year, some things that I intend not to forget. Things like:

  • Pondering biology, life, and death through Gross Anatomy
  • My reaction to neuroscience — the de-romanticizing of the psyche
  • Feeling like I was gasping for breath, struggling just to pass at times
  • The comical notion that I could take control over my sleep
  • My weird place in the social network of our class
  • The real costs of being a medical student, which barely start with tuition

I will expound on these in the days to come. Seriously, I will. I can’t go into second year with all of this stuff on the back-burner! There are also some mostly-complete posts that I started back in August. They need to be touched up and published as well. But for now, just know this: Going to medical school was the best professional decision I’ve ever made. On a career basis, I don’t regret leaving the consulting world for one second.

Last Week

Hello world!

Another Year, Another Candle

The message, “Happy Birthday Father Blair,” was carefully scribed on a cookie and perched on the cake that my parents brought to our house last Sunday. As their well-meaning Engrish announced 48 hours early, today is my 28th birthday, marking yet another year of my existence on the planet. And what a year it’s been.

I was halfway through my classes a year ago, clueless as to whether my work was going to pay off in the end. I was rightfully proud of my postbac grades up to that point, but my undergrad record was still dismal and nothing could be done about it. The MCAT was too far away to be a top priority, but too close — and too important — not to add to my list of anxieties. Yeah, I was under a lot of stress. I was also happy, so much happier than I had been in previous years. It felt good to be busy again, but I’d been busy before; the difference was that I was finally taking care of myself, had finally found what I wanted and was working full speed to reach for my dreams. It was a daily struggle with textbook, problem sets, and exams, but it was a struggle I relished. Don’t get me wrong; it’s also nice to take a break from it all, and right now I’m being kept busy for entirely different reasons. I’m still as happy as ever. But there are days when I wish I was once again waist-deep in my coursework. I’m sure I’ll wonder what the hell I was thinking in another year.

A year ago, Kim and I had talked about starting a family, but (obviously) hadn’t actually started one yet. I’d be lying if I said it was an easy choice for me to make, and I pontificated on the subject in October. I’m still a little scared and uncomfortable with parenthood. I’ve always been excited about it, though, and I’m starting to understand why it’s just so cool to be a dad. Emerson shows little flashes of herself throughout the day, and those are the moments I remember when she’s asleep or when she surprises me in the middle of a diaper change. Sometimes I look at her and imagine her as a child, adult, mother. I find myself eager to see how she develops but hoping she could stay this small and innocent for just a while longer. I’m going to have a hard time coming home and having to study with her just outside the door. As a matter of fact, I’m less worried about my workload as a medical student than my ability to be a good father while also being a medical student. She’s going to be nine months old when I start, and I predict that I’m going to be a lot more interested in teaching and playing with her than I will be in the minutiae of human anatomy. At the same time, I think I’ll be consumed with my studies and extremely motivated to be a top student. This will be a challenge, to be sure, but I’m sort of looking forward to it.

My friends would probably say that I’m far too concerned with my age, and that I’m too young to feel old. Maybe they’re right. The truth is that I don’t feel old at all, but I am rather scared at the increasing speed of time. I can’t believe that I’ll be almost 29 when I finally start medical school, that I spent so many years spinning my wheels when I could’ve swallowed my pride and changed paths much earlier. I’m happy with the way things are now but I do regret the risks I never took, the choices I chose not to make over the years. I think this past year is evidence of what can happen when I learn to merely acknowledge the fear of the unknown, to take risks and choose the paths that aren’t always safeley lighted.

The Rest of the Story (so far)

Sorry for the brief delay. I’m going to wrap up the rest of my application process to date, starting with late September.

During my interviews at EVMS, we were told that decisions on our files would be made in a few weeks but that no formal acceptances/waitlists/rejections would be sent before the AAMC-requested standard date of October 15. We could, however, call the admissions office before then. I thought this was a rather nice touch; most med schools will tell you whether a decision has been made, but EVMS was willing to actually give you that decision over the phone. I had originally planned to call during the first week of October, but curiosity and pre-med anxiety took over and I made my first phone call on 9/23. “Sorry, no decision has been made yet. Try next week?” I waited very (im)patiently and tried again on 9/29.

“You will be receiving an acceptance in the mail on 10/15. Congratulations!” A smile spread over my face and my eyes crinkled up with joy. “You just made my year,” I said, before hanging up the phone and trying very hard to contain my excitement. I came home that afternoon to find that Maryland had rejected me pre-interview, but that didn’t matter so much any more.

Ladies and gentlemen, I am going to be a doctor after all. The crazy plan actually worked!

I was hoping my first acceptance would take the anxiety away from the rest of the process, but it didn’t and still hasn’t. I still want to hear back from the schools I’ve interviewed, and I’d really like to know where I stand with the six schools who have received all of my materials but haven’t said anything to me about an interview or rejection. (For the curious, those schools would be Cornell, UPenn, Temple, Jefferson, Hopkins, and UVA.) At the same time, I’ve learned that having to actually pick between a few schools is not as easy as I thought it would be vytorin 10 40.

Yes, I am fortunate enough to have a choice. On 10/15, VCU updated their applicant status page, and I logged in to discover that I was accepted in the first round. I received an acceptance letter from Drexel on 11/02, and I was emailed an acceptance from Wake Forest on 11/07 (last Monday). I haven’t heard from Georgetown yet (my fifth, and currently final, interview) but I expect to get something from them within the next week or two. I can’t believe it. I’ve gone from being cautiously hopeful in the spring to actually holding FOUR acceptances this fall, possibly more. It’s an incredible feeling.

So….now that I know I’ll be going to a medical school next fall, just where will I go? That question is still unanswered. I’ll get into some of the arguments for and against each of my accepted schools in a future post.

Success is supposed to breed more success. Those extra lost pounds are supposed to inspire harder workouts; that first million is supposed to inspire more hard work and creativity; the first A is supposed to inspire harder work to keep up the grades. Until the summer session started, I can’t say that was the case for me. The beginning of the school year would always start with plenty of promise, and I’d do reasonably well in the first exams. However, while most of my friends improved or at least stayed consistent over the semester, I would invariably start to fall behind. By the end of the semester, I’d be hopelessly behind and my grades would reflect it. The spring semester would start off on a bad note and only get worse. I could never figure it out — why wasn’t I inspired to work, to keep up the grades and succeed in school?

The answer may lie in something I only accepted recently. Until the summer session, I never worked for any of my grades. My high school Magnet program was supposed to offer higher level courses, and it certainly did…but I got a decent GPA on minimal effort for all four years. The first few weeks of any course are always easy, and I always did well without studying very hard for any of them. The resulting grades were never much of an inspiration because I had invested so little of myself into them. As a result, there was no feedback mechanism telling me to work harder (or to work at all) for the next exam. My grades would suffer, but at that point I was unconcerned, and the ultimate grades in the end were always good enough. I’m not proud of my high school GPA at all, but it was good enough to get me into an excellent college.

So what happened at Cornell? Having never truly studied in my life, I attempted to pull off the same feat in the fall of 1995. Again, the first round of exams was reasonable, and again I had convinced myself that no real work was necessary to do well. Well, that barely worked in high school and it most definitely didn’t work in college. The fact that I did as well as I did (which was not very well), and that I graduated on time, is a testament to my creativity and problem-solving skills more than my work ethic. Looking back, I can’t believe I totally squandered the academic opportunities that were right under my nose. I can’t say that I spent all of that time doing something more productive, because I truly didn’t. I never had a passion for my school work; while some of that couldn’t be helped, I now realize that a lot of “passion” is really the dividend of good hard work.

While consulting was never truly for me, I think I repeated the pattern at Accenture. I very strongly believe that my talents were underutilized and that my first few roles really left me burnt out. In retrospect, however, I see some situations in which I could and should have acted differently. When faced with a seriously distasteful task, there were better ways to express my annoyance and better paths to finding a solution. In the end, I think I still would have left. But maybe the last five years of my professional life would have been a little happier, a little less bitter, and a lot more personally satisfying if I’d understood the value of true effort.

I hesitate to say that I’ve wasted a lot of time. I can think of important lessons I’ve learned every year, and I’ve certainly grown a lot since leaving college. But the fact is that I’ve sort of reset myself, put myself at the beginning of a long path, one that places me some seven years behind most of my academic peers. I can’t do anything about the lost time, and it’s tempting to ignore the years, but doing so would probably be dangerous. I have a lot to offer from my experiences, as well as a lot to remember for myself.

Most importantly, I have to remember that nothing in life is free. The biggest rewards have the highest prices; surprisingly, those prices have little to do with money. Indeed, the non-financial costs figure to be much higher and more dear than anything my checkbook could buy. And our greatest asset — time — can be our most powerful ally or our worst enemy. Making the most of my time, using it to invest in myself and work towards a goal, is really the only way for me to find satisfaction in any field. It’s not just about the passion.

Ugh. The lectures on neurobiology have been pretty interesting, but the corresponding chapter in the textbook is drier than sand. Time for a break.

I made a series of posts last May discussing my decision to quit work and pursue medicine. At the time, I was fully committed to becoming a clinician — the type of physician most people interact with at hospitals and clinics. I still want to do clinical work, but going to school has opened my eyes to the possibility of doing medical research as well.

One of the reasons why I left my old job was that it was utterly uncreative. For the most part, the business of implementation and maintaining solutions is a copy-paste affair, and any real brilliance is deeply hidden. I didn’t like the fact that I was basically repeating someone else’s work, slightly modified if at all different, and getting paid for it. I wanted to do something more difficult and integrative, as well as something that would stir up my inner passions. Clinical medicine is undoubtedly more rewarding and more challenging than IT work, and most clinicians are given novel situations on a regular basis. But just how novel is it? How varied are the treatments, and how much can a physician innovate in a clinical setting?

Without digging beyond the superficial, my gut reaction is to say “not much.” In a clinical or hospital setting, doctors are counted on to cure disease reliably, which doesn’t leave a lot of room for new or untested treatments. While every patient is unique, requiring attention to detail and slight differences in the approach of care, I believe that clinical care also has some “copy/paste” aspect to it. Of course, advances in medicine would introduce new therapies on a regular basis. But at the heart of the matter, most of the work would involve using someone else’s solutions slightly modified to suit the individual. Sound familiar?

To me, the big downside to doing pure biomedical reasearch would be a lack of interaction with patients. I want to see that my work is having a real and direct affect, and there is no more explicit display of success or failure than the fate of the patient. But wouldn’t it be great if one could develop new therapies for disease? Rather than, say, using existing chemotherapy techniques to fight a tumor, how rewarding might it be to develop a new form of therapy, try it on a patient, and directly observe its effectiveness? Not only would one be involved in patient care, one could potentially find an entirely new treatment. That would be far more rewarding to me than simply treating (and hopefully curing) a long list of patients. It’s analagous to treating the cause rather than the effects, or the disease rather than the symptoms. I could think of no better or more important contribution that I could make to society than a new way to save lives. So why not go for it — why shouldn’t I work towards an MD-PhD?

Well, for starters, reality is not so willing to accept the rose-colored vision that I espouse above. For one, it’s a lot of work. In addition to the traditional four-year program, MD-PhDs require some time to research and defend a thesis. The most aggressive timeline for obtaining both degrees is about 6.5 years, but most students seem to do it in at least seven. Furthermore, there’s no guarantee that research will result in a revolutionary new discovery. The specificity and relatively obscurity of most research groups won’t automatically lead to a cure for cancer or HIV. A scientist would have to be in the right place, at the right time, with the right knowledge and determination, to put everything together into something significant.

There’s also the reality that research and clinical work are probably more likely to conflict than supplement each other. Someone who is committed to research will not have much time left over for patient care, while a dedicated clinical physician won’t find it easy to work in a lab. I don’t know how or where the balance is struck, or if there even is a balance at all. I would be disappointed if I didn’t work with patients after medical school.

Finally, there’s the reality of getting into this kind of program and seeing it through. NIH offers funding through their MSTP program for some schools to take on formal MD-PhD candidates when they first apply. MSTP pays for school tuition and also provides a stipend, so this would be ideal; unfortunately, most MSTP-funded schools accept something like five students per year. My nontraditional situation, coupled with a lack of formal research training, would make me a poor candidate. Most school do offer PhD funding by itself, though; this might be a reasonable option. The other related issue is time. I’m already a few years older than the typical medical students, and taking time to receive a PhD won’t make me any younger. Is it worth the extra time, extra accrued interest on my loans, and extra workload?

These are all questions I plan to answer relatively soon. I want to take on some part-time work (paid or unpaid) in the spring semester. Preparation for the MCAT in April will keep me pretty busy, but it’s absolutely crucial that I form a stronger idea of how much I want to pursue research. Georgetown’s medical school is on campus and seems to have a reasonably sized research department, so I guess I’ll start my inquiries over there.

But that can wait until after the holiday. Happy Thanksgiving, everyone!

Well, that was fast. I took my final yesterday, and grades should be posted within the next day or so. It was much more difficult for me to focus this week, but I’m feeling very confident about my performance anyway.

This was certainly one of the fastest summers in recent memory. I was nervous about the transition from employee to student, and it turned out to be about as difficult as I had feared. On the other hand, I definitely put forth my best effort and it appears that that will be more than enough. The fall semester should be less intense, but I’ll be taking three courses at once and there will be far less individual attention in class.

Enough school talk. Abbie and Jack are staying over tonight, and tomorrow we’re all heading to Ocean City. In typical Blair fashion, the weather forecast calls for rain, but we won’t be deterred; really, the beach is only a sort of side attraction to the main goal of our trip. It’s time for the fifth annual crab fest! Just as we did last year, we’ll be going to Hooper’s to take advantage of their all-you-can-eat feast. We’ll be happy and full even if the beach washes away overnight; sure, it would be a waste of an overpriced boardwalk hotel reservation, but I suppose that’s the way it goes sometimes.

Mmmmm…..crabby.

In other news, I need to update my project car page: I sold my M3 last week. 🙁

I placed an ad on Roadfly early last week, and within a couple of days I got a very eager phone call and email from a college student who was home for the summer. He came over to test drive it and fell pretty hard for the car, which is a common phenomenon with the E30 M3. Two days later I had a deposit check in my hands, and last Sunday the rest of the money arrived and the car left its parking space without me in it.

The sale of that car symbolizes the material sacrifices that I’ve already made, and will continue to make, as I prepare for my new career. I know that Kim and I will always have a relatively comfortable lifestyle, but an extra car of that much value with that much required maintenance is obviously a luxury that doesn’t make sense. Despite my reluctance to let go of such a jewel, I also wanted to do it in some ways. There’s a part of my inner self that needed to realize some of the costs of my big decision. While material things are not ultimately important, they are certainly tangible and very real to anyone. My car obsession/hobby is as much a symbol of my prior spending power (or, perhaps, spending excess) as anything else, so letting go of the M3 is a strong reminder of where I’ve been and where I’m headed.

The spiritual challenges that Kim and I faced as a result of my decision are certainly more important in the holistic sense, but the world is invariably measured in material progress. So, to the outside world, this is perhaps the biggest change that many people will notice. And it’s a significant one to those who know me.

Of course, I haven’t really changed all that much. I’m still affected — or, perhaps, afflicted, depending on your point of view — with cars and other things with wheels. I’m developing a latent interest in motorcycles, and I still own a car that speaks to my enthusiast genes. But I won’t be able to play the way I’ve played for a while…and, actually, I’m fine with that. I miss my M3 dearly, but I’m more excited about my future now than I was a week ago. Maybe that’s partly a coping mechanism, but I’d like to think that it has to do with the closure I felt upon seeing, hearing, and feeling my car rumble away from me last Sunday.

School has certainly taken up more of my time than I had expected. Nevertheless, I have prevailed — I ended the first session about two weeks ago with a high A. At the risk of sounding overly pompous, I probably would have earned an A+ if they were offered by Georgetown.

There was certainly a good amount of adjustment involved in the beginning. Combined with the fact that I had been out of school for so long was the constant reminder that I had not been a stellar student (to say the least) back then. I was unsure enough of my abilities that I scared myself into studying like I was insane. For first time, ever, I went over the day’s lecture notes at home, then followed up by reading the book and taking notes as I went along. In the end, I would typically have taken notes twice for each topic. I’ve never done that before, and I think it made a big difference. I definitely can’t credit my performance to prior knowledge of the subject material — yes, I’m sure it helped somewhat, but I know that every lecture felt like totally new ground to me. That’s not too hard to imagine, since I took general chemistry some nine years ago.

The second session is going about as well, but I haven’t been able to focus or work quite as hard. I think some of it is the typical student laziness, but I’m also being a little more selective about how and what I study. I’m still reading the book and going over lecture notes, but I’m less careful about topics that I get very quickly and more careful about the ones that need more attention. I’m spending less time studying, but the subject material has remained at largely the same level of difficulty. Still, my strategy seems to be paying off — I’m on track to get anoter solid A (so far) and I’ve been able to spend more time on things outside of school. In the fall, when I’ll be taking organic chemistry, physics, and biology all at the same time, my performance will absolutely depend on the ability to make effective use of my time. And having time for myself will be absolutely essential if I don’t want to burn out before the end of the semester.

Well, that went by quick. One thing’s for sure — I’ve definitely forgotten everything I supposedly learned in general chemistry. Yeah, covering a semester’s worth of information in a month is pretty intense, but in some ways it’s better for me. Being subjected to the material for a full three lectures per day, four days a week, doesn’t give me much time to forget anything. And the pace of the course forces me to hit the book every day, whether to do the homework or just stay current in the text. The lecture and lab take up about six hours of the day, and I probably put in an extra four hours or so at home. I suppose that’s not unreasonable, but I’m very glad that Fridays are free. It’s certainly a good crash-course reintroduction to the world of academics. I’m pleased enough to see that I haven’t lost my ability to reason through the course material, but I’m definitely rusty when it comes to calculations and some alarmingly simple math. It’s coming back, but I need more practice…which ties in nicely with the intensive nature of the summer schedule.

I more or less have to ace both terms of the summer to be admitted into the post-bac program this fall, so there’s plenty of internal pressure and motivation to do well. I’m no longer expecting to be reintroduced to anything at this point; it’s all basically new to me (again), so my uphill climb is no steeper or easier than anyone else’s. If anything, it’s easier for the ones who are either still undergrads or who have recently graduated. Work is not pleasant or easier than school, but the academic rigor required to attain the level of success I need is uniquely intense. And the stakes are much higher for me than they have ever been. It is perhaps fitting that I have worked harder since June 7th than I ever did as a regular student. I hope the fruits of my labor are sweet.