Aug 21, 2013

Wait, what, already?

Fellowships?  Seriously?  Already?

If I haven't mentioned it before, pathologists are pretty much required to do a fellowship to get a real job in reality land and start paying off those monster loans.

I'm sure I've mentioned *that*.  What I should have mentioned, and been thinking of, is that you have to start applying for fellowships like... uh... now.  Yes, 18 months prior.  And I'm already out one fellowship because you have to start cranking out the paperwork even earlier than that (A program that rhymes with Who Be Ann Sancisco).  So now I'm in the eternal dilemma of whether I stay nestled in the safe bosom of a program that already has done well by me and where I know I like the cytopathology person, or whether I fly out, try to get an in back in my home state, or at least my home coast, and rack up some new experiences.

The fortunate thing is that fellowship applications don't cost money until you book a flight.  This contrasts to residency applications through our match monopoly which cost me 1800 dollars before I left my apartment.  The unfortunate thing is pathology fellowships are far less vetted, since there aren't all that many of us, so I'm throwing my applications into the abyss and hoping they want to grow me into a decent community pathologist, rather than using me for scutwork or ignoring me entirely.

Then the job hunt after that.  Then maybe, I can settle into being an adult with a job and a house and a place that's home rather than living the life of a perpetual student.  Not that I can really complain much other than the six figure debt leavings.

Scary though.  The last two years have flown by, and I by no means feel ready for the next step.  I'm just happy I don't cry during readouts anymore.

I'm at a weird stage though.  I don't feel ready to be independent but I feel far removed from it.  I was attempting to remember who wrote a poem quoted by my attending from a "college English class" and realized I was in college ten years ago.  The antics of the medical students seem immature and their questions weird, despite the fact that I needed to be shuttled home from a bowling alley as recently as two hours ago.  Yet I feel comfortable giving attendings from other specialties update reports.

I'm removed from a lot though.  No one really knows much outside of their own very limited experience so it's hard to know where to go for advice.  Within the hospital, you get "The job market is fine in this academic setting where I've been working".  The other residents are "I have a fellowship in 'x' secured and that's where I'm going, but I'm not an IMG or from California".  People at my level are in the same boat.  The advice on the internet is "JUMP SHIP!! PATHOLOGY IS DOOMED!!  OBAMACARE WILL HAVE US IN POVERTY!  DO ANOTHER SPECIALTY", which is disheartening, but unhelpful.

So I feel a little trepidation.  On the other hand, I think I have a good chance at securing a fellowship if I merely stay put (something not an option in medical school), good friends, a great boyfriend, and hey, kayaks.  So we'll see what happens.

Aug 12, 2013

Recreational activities, dead people, and blood

No, not *those* kind of recreational activities.

This year in Charleston has been... let's say meterologically bipolar, so my celebration of "summer is here!!" after finishing surgical pathology in June was met by about a month of solid rain.  This isn't really notable since it's pretty much been raining since February, but then I wanted to *do* stuff.

This led to my roommate, boyfriend, and I finally saying f- it and sailing in the middle of a storm.  It went shockingly well.  Even saw some dolphins.

At a certain point, I think the endless weather got to my roommate as well.  She's a persuasive sort too, so in the last month I've encountered "Let's join a bowling league" (note: I have scored a Zero while bowling, granted, while very very drunk.  I have also bowled a 50 while completely sober) and "Let's buy kayaks!!!" (my kayaking experience consists of about four trips out in sit-on-tops and the ownership of an inflatable diveyak whose sole purpose was carting gear).  Since I'm a follower, I'm now in a bowling league and own a kayak.  Since my boyfriend is apparently even more suggestible than I am, he now owns an SUV.

Yeah, it's a good thing this girl isn't into drugs or something.

Yesterday was the maiden voyage of the kayaks out of Wappoo Cut, which went shockingly well for me.  Saw egrets and jumping fish and the boaters were nice to us.

And the bowling league is going well.  But that's all fun stuff.  I've been continuing my lengthy training for the bridge run (while injuring my calf and being grounded to swimming a week), and periodically attempt to surf over at Folly Beach.  I've also been catching up Breaking Bad (god I hate Walter) and the Walking Dead (god I hate Andrea).  There's a reunion trip to NYC in a couple weeks to catch up with the medical school crowd and all is well.

So the work stuff.  Staffing continues to be an issue, but now that I'm off surgical pathology, it isn't really my problem until next month.

July, I was on autopsy with one of my best friends, who also wants to go into forensics.  Despite having one of the most death-spectacular months on record, I'd think, I can't call it anything but insanely fun given the dynamic.  Which, I know sounds weird.  The combination of our working well together and our general experience now that she has three months of autopsy and I have four absolutely thrilled the attendings, and they know they hooked her before she started, so now they've started working on me.

A forensic pathologist that thinks she can sway you into the field is a bit like a Baptist who thinks you have an interest in Jesus.  They are *relentless*.  Highlights were "You're gonna push glass!  You're gonna be miserable!!"  And I'm like "No!  I want to go into cytopathology!  I want to be a general pathologist!  You're not my real mom!"

But still fun.  There's also a thing that goes down in autopsy where you get really sick of having dead people with no relevant findings so you have no good answer as to why they're dead, and this happens more than you'd think.  Usually toxicology clears it up (sorry CSI fans, but that takes 3-6 weeks), but it's less satisfying.  So when your gross examination reveals a smoking gun of a cause of death (ruptured berry aneurysm, saddle embolus, aortic dissection), you get really excited about it, but you can't express that if the surgeon happens to be in the suite with you, which happens occasionally.  So you have to wait for him to leave, which usually provokes a dance.

Yeah... it is neat.  I'd be more tempted, but as you can probably glean from my previous fire experiences, I *hate* court, and that's part of the job.  I will do virtually anything before I spend an hour in court.  The entire process just makes me rage like the Hulk.  I'm wondering if I can use it to get out of jury duty.  "Hi, yeah.  I have no opinion on this case, but I'd just like to say, judge, that I hate you, I hate both lawyers, and I hate everyone in this courtroom.  Can I go?"

Now it's hemeland, with it's chaotic leukemianess.  And we've had a ton of people rotating through so seating is always an issue, but so it goes. That used to be my chosen specialty before I got led away from the fold by cytopathology.

That's the update for now.  Next month will be back to surgical pathology.  Next few weeks, we'll see if the heme team slows it up a bit.  Oh, and fellowship applications need to be consolidated around September 1st.  Eek!