Apr 7, 2009

We're talking mega-ecstasy-bliss

So I was going to write an encouraging blog post about the major depressive episode that is the last few weeks leading up to taking the Step 1, but then some housing stuff went foul for a couple of days and I found myself envying the dead again, so it seemed like a poor time.

But that's resolved, and now... holy crap, there's nothing left to study. I have very very few responsibilities for the next few weeks other than those shared by the general population. It is indescribable.

It's not like right now my life has undergone such a drastic change. I don't know people very close by, I'm lazily packing up my apartment to spend a few weeks back in Cali before the march to Brooklyn, trying to struggle through the school's deathweb of red tape, and spending a lot of time vegetating in front of my laptop.

But prior to the exam, I was experiencing a depression that was creeping up insidiously. Started with just an "oh, I'm sick of studying", but it wasn't even so much that, since I actually liked most of the material I was reviewing and stuff was beginning to mesh together and make sense in ways it hadn't before.

No, it's more that there is this constant and unending pressure. ANY time I wasn't studying, I felt guilty. Days off, I felt guilty. Taking too long to go to sleep. Felt guilty. Watching tv. Guilty. Talking to my family. Guilty. Walking the dog. Guilty. And gradually, while not feeling actively miserable, I was experience what I would call a "happiness black hole" in which normal situations that would induce pleasure no longer did. So I would go out, take my dog for a walk in a beautiful night, look up at the stars, look out at the river near my house, and then walk him up to the town hall, which is still lit up and old style Dickenesque, and think "huh".

And not even "I need to finish off the glycolytic pathway by noon tomorrow so I can get started on the..." or being *distracted* from what I was seeing, since I was far too braindead for contemplation, but more "Hmmmm. That used to make me happy. Ah well." And walk home.

It's sort of like I bypassed acute panic because you just can't suffer from it for 10 weeks or your heart will explode, and went beyond it. Even the morning of the exam or the night before wasn't panic so much as just a more elevated tachycardic depression.

I would recommend after the exam, NOT suddenly having your personal life go to shambles, because it makes the transition more confusing, and that tingling peripheral neuropathy in your limbs and tightness in your chest sticks around.

But then... ahhh... It's beautiful. I enjoy the taste of food again. I enjoy the church bells I can hear from my bedroom (yes, I am currently living in a town *that* quaint).

In the meantime, I'm preparing for yet another fantastic birthday adventure provided by Dave, so I get to meet him this weekend in New Orleans, also notable as being one of my favorite cities outside San Francisco and Prague. Upon my arrival back, I'll be piling into a car and driving cross country (again!). It'll be on I-40 this time, so I'm guessing I'll amass a lot of pictures of bleak nothingness. On the good side, I think the scenery is generally so uninteresting that you're legally allowed to bury the needle on whatever car you're driving to make the time go faster.

My "task" at the moment other than packing, consists largely of sorting out my health forms for SGU. They changed the TB requirements from two in a year (which I had) to two in six months (which I didn't), necessitating two TB tests in two months.

Ohhh, and my varicella titers aren't sufficient (A-FREAKING-GAIN, I can't get chickenpox! Just accept it and stop charging me astronomical amounts of money to stab me in the interest of preventing a disease no one gives a crap about!). Oh, and my still-not-two-years-old mumps part of my MMR underachieved too. I hate my stupid antibodies. Except the Hep B ones; those RULE.

This is also relevant because (and fortunately by harassing the nurse I got this info), had I gotten the MMR and V vaccines *1st* as I initially intended, this would have negated the TB test for the next 4-6 weeks, which is definitely relevant since I NEED TO START CLINICALS THEN. Sigh.

Also fun is that one overpriced chickenpox vaccine isn't good enough; I need two, and they need to be 30 days apart, which starts to cut it close... which adds to the fun because no one wants to give a varicella vaccine to an adult, so even finding a place to overcharge you for it is a rare thing.

I got my TB test read today after spending 48 hours willing there to not be a mark. The one I got a month ago reacted so little, I finally just circled it because you couldn't see where the hole had been. This one got the proper wheal when it was inserted and then... freaking stayed red for a while, so I'm just going "if you false positive me and I have to then arrange a stupid chest x-ray on top of everything else, I am going to cut that section out of my arm."

It was impressed, and retreated. 0 mm! Suck it!

I've also been faxing the physical and first TB test, the receipt from the testing facility for the USMLE, completing my MPNs and all that other fun stuff that reminds me why I wanted to be a doctor and not jobs that involve mass quantities of paperwork. Oops, except doctors do. I also got to do the NY health requirement CE course, a newly introduced (after last term was up) cultural sensitivity class the school made up. This is particularly important because if you are SO thick that you can't become culturally sensitive after attending a medical school that has representatives from like 150 countries, that is actually located in another country, I'm sure a last minute online class administered in your USMLE study period will cement in the love-of-fellow-man. Oh, spoiler alert... if your patient has not-Western-medicine beliefs and you like, point at the patient and openly mock his culture, religion, and ways, that may harm patient communications, and could, potentially, get you sucker punched by a holy man. I hope that doesn't constitute giving away answers.

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