Thursday, March 31, 2011

match (day) madness part three -- dark

Note: Dark honesty is hard to read and harder still to write.
You don't have to comment. You don't have to sympathize or make excuses for us. It's an ugly post and we were ugly people.
Hell, it only gets worse from here.
I won't ask you not to judge. I won't even ask you to read it.  I just thank you for letting me write it.
Regularly scheduled ridiculosity will resume in a week.
And thank you. Sincerely. From both of us.

We put ourselves to bed and stared at the ceiling. There was nothing left. Only waiting.

We considered the outcomes over and over, talking out each city, speaking in circles. Like some twisted Pandora's box, the door cracked and the pestilences of uncertainty poured in. There was doubt. There was dread. There was worry, mistrust, wariness, harshness, cynicism, there were cracks and there were faultlines, and with every tick of the clock we became more snappish, more irritable, more defensive... until finally we weren't Nicki and Derick anymore, we weren't the young doctor and the writer, the pair of dog-loving, vinyl-collecting, dry-humored foodies and borderline alcoholics.We were circling animals, poised to attack.

I have to hand it to Derrick. Through it all, he remained honest to a fault.

Me? I lied. I lied like hell.

Derrick paced. I soothed. Derrick ranted. I listened. Derrick was a caged animal with haunted eyes. I was the silver-tongued siren. I'd cover his hand, tell him not to worry. I'd tell him that we'd make it through anything. I'd tell him that wherever he landed, we'd be fine. Shit, if he hated it that much, we'd transfer after a year. I kept one eye on Derrick. I kept one eye on the clock. I kept one hand on Derrick's shoulder...but I had one hand on the door.

And Derrick knew it.

While I soothed and supported and reassured like my life depended on it, my mind was working frantically. You said you'd never let a man rule your life, the voice hissed. You don't need him. You're independent. You're strong. Why are you attaching yourself to him? Go to Boston or Baltimore on your own. Don't follow him to hell. Go there yourself. 

Forge your own trail. Don't let him blaze it for you.

I can tell you every bump, every paint swirl on our ceiling. I can tell you exactly how many burnt matches were on my night stand (three). I can tell you how many times my dog shook his collar in the night (five). I can tell you how many different bird calls I heard as light slowly filtered in the room (twelve). I can tell you this because for three nights in a row, we didn't sleep.

We tried. We counted sheep. We tried nightcaps. We tried medication. Then we tried sleeping pill-and-alcohol cocktails. Nothing worked.

We were awake.

And we were haunted.


Wednesday, March 30, 2011

match (day) madness: part two -- the silence

At first we celebrated.

Not having to undergo the Scramble is pretty amazing, right? No last-minute interviews, no last-minute stress. Someone wanted Derrick. Someone on his list of ten schools had said yes. Yes, I want this young man in my program. Yes, I choose him over the others.

And so we celebrated.
We gorged ourselves on cheap oysters and $1.25 beers. Derrick told anyone within earshot he had a job--after ten years of higher education, he had a job. It was exciting. We laughed, we chattered to strangers, we grinned like fools from ear-to-ear.

Then we got home.

Home was quiet. Dark. Settled. And we both heard all too loudly the click and whir and plod of the clock with sixty hours to tick away before we learned where he was going.

Derrick had a job, sure.

But where?
Baltimore? Boston? Worcester or DC? Richmond or NYC? Gainesville or here in Norfolk?

Derrick wanted Baltimore or Boston. He'd be okay in Worcester or Richmond. DC or NYC for a shoreside surfer with a large German Shepherd? It'd be a stretch, sure, but he could do it, right? He'd learn to live with the commute times, the constant stretch of city, the cold shoulders of passerbys.

And then there were the safeties. Gainesville. Beth Israel in Manhattan. Staying here at EVMS.

And then there was me.

We'd already agreed to give it a year. We had too much invested, too much planned. I can write anywhere, right? I'm a gypsy. I adapt. I can live anywhere. In a house by the beach, in a ramshackle row home in the bad part of town, in the suburbs, on a boat, in a shack, in a cardboard box. But with every second that clock ticked away I'd picture my life in a new city.

Baltimore, exiting a painted brick cafe with a black coffee and tattered manuscript in hand.

Boston, with legs crossed on the T, camera slung on a shoulder, heading to a lecture on Virginia Woolf.

Commuting to NYC with Kindle in hand, savoring Susan Orlean or John McPhee.

I was so clear in each of these city fantasies; I wore a checked chenille scarf in Boston, gray suede boots in NYC, dangling feather earrings in Baltimore. Each one was this beautiful urban Bohemian fantasy, where I'd sit at my typewriter and write stories that snagged the heart the way a calloused hand catches satin, poetry that closes with firm fingers around the throat. I would make the knitting needles pause, the jackhammers quiet. I'd hush the songbirds, turn the head of the harshly lined lawyer, make the stirring cook sigh with pleasure.

And I'd do it all from the window seat of my North End apartment, my yellow house in Baltimore with the chipped paint, my cluttered townhouse outside the NYC city limits. Heavy dreams, but I could see them all so clearly---

Then there was the rest.

Worcester, Mass. Easily commutable to Boston. A little pretentious, a little boring. Not ideal, but managable.

DC. Terrifying. Harsh. Gray suits and black heels. Laughing party girls, silenced museums. Cunning, skilled, fierce ambition. Intimidating as hell, but manageable--especially if we lived outside of Baltimore and commuted in.




For the last three I saw nothing. I'd never been to Richmond, couldn't judge it. I knew there was a theatre scene, rich history, tall white Southern buildings, charm. But I've lived in Virginia for almost three years now. Too long. I'm ready to ramble on, set my eyes on someplace new, explore, live in a new world. I've tired of this one.

I could imagine staying here, but barely. My sights have been trained on the mysterious unknown for months now, waiting for the envelope to be opened to tell me my new home. I couldn't imagine opening it to reveal...nothing. Same apartment, same town, same life, a long stretch of endless sameness with no discernible end.

Yet I latched on to Gainesville as the worst possible outcome. I'd been to Gainesville. It was gorgeous. It was warm. It was friendly.

Even the trash cans are owned by the university
It was my worst nightmare. It was a college town. Not "a college town" as in a town filled with dive bars and college students, but a town run completely by the University of Florida. A town existing solely for the purpose of the university. It would be hot. Without beaches, without water. I'd sit in my 1960's one-level home and I'd write and I'd wait. For four years, I'd wait.
I can't write like that.
I can't live like that.

I'll find something, I told Derrick brightly. Wherever we go.

I wondered if I was lying.

Gets a lot worse before it gets better, kids. Tune in tomorrow for a train wreck of brutal honesty, heavy drinking, and self-destruction... or as I like to call it, Part Three.

Friday, March 25, 2011

match (day) madness: part one -- the scramble

We left off yesterday after a lot of kvetching and general whining and some pictures of awkward dogs and cakes, right?

Great. We're all caught up, then.

For further reading, though--or even just to add to my credibility besides screaming "MATCH DAY IS HELL! MATCH DAY IS HELL!" over and over, you may want to check out this article by Time called "Match Day: Young Doctors in Hell." It's a quick and easy read, and it's review of a book called Match Day.

Match Day
Yes, someone actually wrote a book about it. It was written by Brian Eule, the significant other of a young woman facing her own Match Day fate. It actually brings me comfort to know I'm not the only deer-in-the-headlights writer standing on the sidelines with the urge to tell the world about this rare breed of cruel and unusual punishment.

So you already know the basic gist of Match Day, then. Med students rank their top residency programs. Residency programs rank their students. And on Match Day, you open up an envelope with your fate sealed inside. Literally.

God, I love it when cliches work in my favor.

 But there's a whole different torture that happens right before Match Day: the Scramble.

The Scramble: You Can't Make a Residency Program Without Breaking a Few Med Students
You've ranked your med schools. You have a cool, perfect list of where you want to go. You spend every night praying to the deity of your choice that you'll get your number one choice. Some of the choices on your list excite you. Some of them thrill you. And some of them absolutely terrify you. 
But in the back of your mind, you know that you might not match to any school at all. When that happens, it's every med student's nightmare. You have to scramble.
Am I taking the whole egg metaphor too far yet?

"Scrambling" is when you're left without a date on prom night. The algorithm didn't work in your favor. Maybe you ranked too few schools. Maybe you aimed too high or aimed too low. Whatever the reason, you have two days to figure out where you're going to end up for the next four years.

Yes, you read that right. Two days.

Scrambling doesn't necessarily mean you're a bad medical student. It just means that the stars didn't align in your favor. If your schools had three resident openings, and you were number four on everyone's list...well, then you scramble. You could be ranked #4 out of 4000 candidates....but if those three before you said "yes," you're SOL, my friend.

The same goes for medical schools. If they're left without filled spots, they're in the same hell as you are. Ladies and gentlemen, welcome to Residency Program Speed Dating.

It's Just Like Speed Dating...Except That Instead of One Awkward Night at Olive Garden, You're Going to Spend Four Years of Your Life With the One You Choose

So really, it's like Speed Betrothing.

At noon on Monday, you get one of two emails: "Congratulations, You Have Matched!" or "Contact us. Now."

The latter means it's Scramble Time.

Your phone and inboxes explode with desperate residency programs trying to schedule phone interviews with you. Suddenly, you're a med student who was just yesterday saying, "Oh, I only want to stay on the East Coast for my programs..." and you're taking calls from Kansas. Oregon. Minnesota. Michigan. Desperate times call for a desperate restructuring of your ideals, and this is your most dire hour.

So the girl with big dreams of NYC and DC is now interviewing in Oklahoma. The boy who wanted to stay close with his sick mom in Georgia is now interviewing for a school in Seattle. And the family who was praying to stay close to home so the wife could keep the job she loves and the kids wouldn't have to switch schools is now interviewing on the other side of the country.  Your life plans get smashed in one little day...and you've got two days to plan out where you're going next.

This scramble, made from eggs, crab meat, and leftover camping veggies,
was heated on the engine block.
Med students have got to be resourceful, y'all.

The Days Before the Scramble...

...are tense, sure, but they're nothing like afterwards. Before the Scramble, you're anxious. You're tense. You're a little snappy and you're definitely stressed. However, there's this small sense of "Why worry?" floating in the back of your mind. You know that you'll be at any one of the cities on your list....or anywhere in the country. You've got two obstacles on your plate--the Scramble and Match Day-- but the double focus makes it a little easier to get by. You'll either match or you won't. You'll scramble, or you won't.

If you scramble, your last few days before Match Day are going to be some of the busiest, most manic days of your life. If're in for three days of hellish purgatory, waiting for that one stroke of the clock that tells you your future.

Derrick didn't scramble.

This concludes Part One: the Scramble.
I know I promised some rowdy daydrinking, hair-bleaching, and Princess Zelda and Link playing beer-pong...and it's coming. I promise. Hang in there, darlins.

Thursday, March 24, 2011

match (day) madness: backstory

Here's your relatively boring backstory. If you want the rainbow, you gotta put up with the rain, right?

I complain a lot about being a penniless freelance writer, but compared to the life of a penniless fourth-year med student?

My life's cake.
Funfetti cake.
Funfetti cake with gold dust sprinkles.
Funfetti cake with gold dust sprinkles, unicorns, and sparkly fountains that spew forth rainbow sunshine, good will, and cheer.

My life.

Let me tell you about everything I've witnessed Derrick go through in his 4th year. Without a word of complaint, I might add. (But you know what, kids? This is my blog, and I can complain about anything I damn well please)

Besides all the stress, exams, essays, letters of recommendation, presentations, call nights, 6 PM-3 AM shifts for four nights out of the week, rapid-fire examinations, 6 week-late disbursements from an incompetent financial aid department, massive student loans, and the whole "watching patients die or telling patients they're ABOUT to die" part...'ve got to get into a residency program, where you'll spend the next four years of your life.

Getting into a Residency Program: It's Like Prostitution, But With More Diseases

To get into a residency program, you also have to pay an obscene amount of money to submit your application--which you've spent a three months completing-- to various programs who will then contact you and offer you select dates to come interview. Some of these programs will offer you just one interview.

Naturally, this date will conflict with three other residency programs who have also offered you that one date.
That one date will probably also be on a previously scheduled exam date, your birthday, or Christmas.
Yep. That stressful.

As a med student, you're not getting paid to spend your nights in an on-call room or work twelve-hour days. In fact, you're paying hundreds of thousands of dollars in student loans JUST TO GO TO WORK. Now you get to pay even more to travel around the country and put on a smiling song-and-dance routine for each residency program. We're talking flights, hotels, food, the whole nine, kids. You can sit at home, smirk, and say "but he's going to be a doctor! They're practically millionaires!" Sorry, dears, that's an outdated misconception. Derrick's so deep in all kinds of debt right now that it's going to take him about twenty years to claw his way out. Fan-bloody-tastic.

It's Like 19th Century Courtship from a Laura Ingalls Wilder Book... or Maybe a Complicated Mating Ritual on Animal Planet

I didn't have a picture of a Laura Ingalls Wilder book on my hard let's just pretend this is a complicated mating ritual, shall we? For all I know, it is one.
The song-and-dance residency routine goes like this: you wake up at the crack of dawn and put on your best business attire. You sit through 8+ hours of interviews at each program where you get to explain exactly why you want to go to their particular program, and you have to pretend that program is drastically different than any other program in the country.

Spoiler alert: their program isn't drastically different than any other program in the country.

So you learn quickly to analyze the literature they provide in abundance for buzzwords. You slip in phrases like "diversity," "research opportunities," and "state-of-the-art technology." You smile a lot. You sell yourself. Meanwhile, your residency program is trying to sell their own program and convince you to go to their program. Then you get to repeat the whole damn process again. And again. And again. Rinse, repeat, smile and shake another hand.

It's a pretty sick-and-twisted form of courtship. You're each trying to convince each other that you're the hottest girl at the bar. In other cases, you're trying to convince each other that while there are certainly hotter girls at the bar, you're at least a better candidate than the one-eyed fat girl in the corner. The residency program buys you shots in an effort to convince you to go home with them:  a mini-box of chocolates, a gift box of tea packets, a free backpack with the school mascot on it.

But the truly twisted part is still yet to come.

After the whirlwind interview process is over, you go home and you rank the programs. The residency programs rank you. You go up your list, they go down theirs. The NRMP uses a complicated algorithm to "match" you with a residency program.

"If the Millionare Matchmaker can do it, why can't the NRMP?" you ask. "How complicated can it really be?" Well, here's the "simple" explanation on how the Match Algorithm works.

(You got to the first set of charts and closed the link, didn't you? Yeah. So does everyone else.)

Here's the most horriblest, terriblest, awfulest part of it all:

Every soon-to-be doctor learns where they're going on the same day. At 1 PM EST, every 4th-year med student in the country opens up an envelope and discovers where they--AND their families-- are contractually obligated to go for the next three to five years of their life.

No choice. No choosing between three offers. No negotiation. If it was on your list, you can go there. If you ranked eleven schools, you're going to one of those eleven cities.

And you have no idea where... until 1 PM on Match Day.

This concludes the backstory behind Match Day hear the rest of the story, which involves zany costumes and heavy drinking before 9 AM, you'll just have to hang in there. Tomorrow: Part One-- the Scramble. It's kind of like eggs...if the eggs are med students being scrambled in the burning fires of hell.

Tuesday, March 22, 2011

match (day) madness: introduction

Hey lovelies,

Three quick things:

1.) Working on the aforementioned "Match (Day) Madness," a series of posts about a.) where I've been, b.) where I'm going, and c.) why I'm moving forward. Oh, and most importantly: d.) the secret life of the American Med Student. Might be heavy. Might be lengthy. Might involve Jameson's. Not sure yet. All I know is that yep, it's important; yep, it's worthwhile; and yep, it involves hair-bleaching, turbans, and my immediate future as we know it.

Suffice to say that I just underwent one of the most rollercoasterish weeks of my life and now you get to hear about it. If I was musically inclined, I'd sing about it with one of those "follow the bouncy ball" videos so you all can follow along at home.

2.) Unburying my Google Reader, so bear with my week-old comments.
I'm unthawing my RSS I posted this pic of Baltimore Harbor ice...GET IT? GET IT???
Oh, just shut up and look at the pretty colors.

3.) While I'm writing and blog-reading like a mad fiend, check out some amazing blogs I've discovered recently:

Tapetum Lucidum

A Lot of Layers

I love them. And I'm betting you will too.


Friday, March 11, 2011

snap: anguish

(our thoughts are with Japan today)

*taken in downtown Boston, between Washington and School Streets