What a difference a year makes

I recently came upon a text I sent about a year ago to a friend who had asked how I was doing. It really encapsulated what last year was like, both in content and in tone:

I'm in a much better place right now for so many reasons, and it makes me sad seeing my state of mind less than a year ago.

Throughout that year, I told everyone that at baseline I'm not a bitter and angry person, that the circumstances and the year had turned me into that. This text (and any time I talk about that year) are consistent with that point because I'm doing just fine these days, while that text is seething with negative emotions. The only difference is that I've moved because my future is just as uncertain now as it was back then.

The short version is: last year was TERRIBLE. I still have PTSD from it* and have had to unfriend/block people from Facebook just so I'm not reminded of how awful it was.

As soon as I left the hospital on my last day, I felt free. I was headed to a better place, both physically and emotionally, and I couldn't be more excited. Despite the fact that my future was no more certain, at least I was leaving a situation that was destroying my mental health and was bringing me no closer to my ultimate career goal.

These days, I'm living the good life. I'm doing a research year in orthopaedics in a program that appreciates me with several attendings who said they'll do everything in their power to have me match. I'm cautiously optimistic that it'll work out, but I'm also realistic about my chances and don't truly believe that I'll get happy news in March. But at least my day-to-day is SO much better.

It's taken a while, but I've rediscovered the things that make me happy...and finally have time to do them! I've taken up hobbies I hadn't done in years. I have friends. I've taken road trips. I still work long hours, get up well before sunrise, and continually worry about what people think of me and what the future holds. But the work is interesting, everyone is kind, and I don't feel like the thorn in anyone's side.

It's been <6 months since I left my previous program, but it feels like a lifetime. I don't even recognize who I was back in June, although those scars are still there and will take some time to completely heal.

I am so grateful to have ended up here. I needed this year not only to get closer to matching ortho, but also to regroup and rediscover who I am. I had completely lost myself over the past couple of years, and felt like a shell of who I used to be. It's been slow going but I'm starting to get back to being me, and it feels so good!

In short, life is good today (and this entire year).

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* That's a post for another day, but it's coming.

My last move

Intern year is coming to an end and I could not be happier. Despite the awfulness and struggle of this year, it's a little bittersweet, partly because I have met some good people, but mostly because I hate change. Mostly, it means I have to move again, cross-country, for the third time in five years.

I'm moving to take advantage of an amazing opportunity in a fun city with lots of close friends, which is a nice change from this past year. I will be starting a job in orthopaedic research in a department that appears supportive of helping me achieve my goal of eventually matching into ortho at some point in the future. I'm excited for so many reasons, and I believe it's a step in the right direction both personally and professionally.

Having said all that, I've decided this will be my last move in pursuit of being an orthopaedic surgeon. If this doesn't work out or turns into a dead end, I'm done. I'm not moving for another research spot or another prelim year or another hope that things will eventually work out.*

I'm mentally exhausted from having such an uncertain future, and uprooting and relocating annually to pursue this pipe dream that may never happen has added even more stress onto an incredibly stressful situation.

What I've desired most throughout my entire life is stability and this is quite the opposite of that. This past year has taught me that there is more to life than work and I'm ready to prioritize my personal goals over my professional ones for the first time in years.

I still plan on busting my butt over the next year to impress my superiors and work towards an orthopaedic residency because ortho is what I really love and want to do. But I'm also coming to terms with the fact that the process of achieving that goal may not be worth it and that there will come a time to let that dream go.

I haven't gotten to the point yet where I'm ready to move on. I have a few more tries left in me but I also don't want it to come at the expense of my sanity. While I plan to pursue ortho for the near future, I'm also not going to keep putting my life on hold and sacrifice my personal life to the extent I did this past year.

While I cannot control my professional stability at this point in life, I am going to work very hard at feeling fulfilled and stable in my personal life, which is where the "No more moves" rule comes into play.

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* The exception to this is moving for a categorical orthopaedic residency position. That's about the only reason I would move away from my new city. That, and family. Family trumps all.

Graduation tam

This week was my medical school's graduation so my social media is blowing up with peeps celebrating their accomplishments. I'm happy for them and all that jazz, but it brings back hard memories from my graduation last year.

You'd think I'd be upset about the fact that I was the only one of my friends without a defined career track or that I'd be sad to see my prelim year permanently documented in our graduation publications.

Nope. The thing that bothers me the MOST is the way I wore my stupid graduation tam. Seriously.

The proper way to wear it like this, with the hat parallel to the floor:



My millennial classmates convinced me to wear it similarly to the woman in this picture*, except even more angled and sitting even more at the back of my head. It looked like I had a freaking black starfish perched atop my cranium.



I regrettably obliged. Partly because I thought I'd look stupid wearing it the regular way (hindsight is 20/20), and partly because it seemed "cooler" at the time because the stylish people were doing it. Now, 1 year later, I'm still regretting it.

This is such a stupid thing to be upset about considering everything I've gone through in the last year and a half, but for some reason I just can't let it go.

Luckily, there are a few pictures before I changed my tam around and also others after I had realized my mistake and changed it back. But the pictures where I get my diploma immortalize my stylish "mistake".

I'm hoping some day I'll get over this because it is so. Damn. Silly.

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* BTW, I can't even find the way I wore it on Google images. Shows you how unpopular this way of wearing actually is. But I wasn't in the right state of mind to Google how to wear my graduation regalia prior to the ceremony. My only goal that day was to not break out in tears in front of everyone. 

ETA:
After I wrote this post, I found a picture that had almost the same tam positioning as mine (the woman on the far right). See, it looks ridiculous!

Progress

This whole year has been incredibly stressful not only because I've been worried about my future, but also because I've put an incredible amount of pressure on myself.

I've felt the need to be perfect in order to impress people at this program so they could advocate for me during the match. Every time I messed up that perfection (usually, only in my eyes), I would beat myself up about it mercilessly thinking I had blown my chance and the world was coming to an end.

Now that I haven't matched and I know I'm not staying here after the year is done, I've let all of that pressure go. It's been so freeing to not worry so much about the little things that really don't matter in the end.

For example, for the first time in my entire professional life, I overslept work. I woke up 10 minutes before our entire team (upper level, fellow, and attending) was supposed to start rounding. Obviously, I was going to be late, but I didn't rush in getting ready, I didn't speed, and I didn't jog from my parking space to rounds. I figured there wasn't much difference between being 10 minutes late as compared to 20. So, I took the usual amount of time and strolled in as we were talking about our 3rd ICU patient. With the exception of the PGY3 who had to hold the pager for those extra 20 minutes and unluckily got a consult in that time, no one seemed to notice. And I only apologized once, let it go, and went about my day as if nothing had happened

I'm not saying I didn't feel bad about being late, because I did and obviously wish I hadn't slept through the 4 alarms I set every morning*. But it was freeing to not feel guilty, angry, and awful about myself all day. When I'm at work, I kick ass and I think that speaks more to my character and work ethic than the one morning I overslept. It took me a while to realize that and it's been awesome.

This more Zen-like approach to my year has been so refreshing and I'm so happy I've finally reached this point. It makes my life less stressful and less angry at myself, which I sorely need right now.

I guess when you have bigger things to worry about, such as what I'm doing "next year" when really it's next month, the little things really don't matter.

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* I stagger my alarms for situations like this. They go in the following order:
Alarm #1 - It would be really nice to get up right now
Alarm #2 - I should get up if I don't want to rush
Alarm #3 - I really need to get up if I want enough time to grab things
Alarm #4 - OH SHIT, I'm going to late!

Hindsight and regret

Hindsight is 20/20 and I am really feeling the truth in that statement these days.

My second attempt at the match went the same as the first in that I'm unmatched yet again. Looking back on how the year went, I have so many regrets about my career course. I blame some of it on myself (not doing well on Step), but I also realize I got bad advice from my home program and I'm paying for it dearly these days.

Back when I didn't match the first time, everyone (EXCEPT for my ortho chairman) said I should take a research year rather than do the prelim year. But I stupidly listened to one person rather than the whole crowd and now I'm paying for it. I've found there are more research opportunities for medical students than graduates and now I'm hosed in finding a job for next year. By graduating, I also didn't get a chance to do more aways, which I really believe could've helped me get a spot in the match (I was soooooo close last year after kicking butt at one program).

In an ideal world, I should've taken a research position after MS3. I honestly don't know why I didn't do it. I think I reasoned that no amount of research was going to make up for my Step score so why delay graduation if it wasn't going to change anything? I immaturely wanted to graduate with my class and unfortunately that was a large part of why I kept pushing through. I was also worried that I wouldn't get a research spot due to my Step score, which was partly true, but I should've tried anyway.

In retrospect, that research year would've given me the advocate that I'm sorely lacking right now. I need someone to make phone calls for me, to believe in me, to help me get a job. But my home program is not responding to my messages and the ortho PD at my current prelim position thinks I should give up on ortho entirely because I will never match. So I'm all alone in this world facing a really steep mountain I can't climb on my own, with no one to help me unfortunately.

I need to stop thinking about the "what ifs" because it's not going to change anything besides make me sadder than I already am. But it's also really hard to move on when I know a couple of decisions could've changed my career trajectory dramatically.

Now instead of being excited about starting an ortho residency, I'm wondering what kind of job I'll have in three months (if I'll even have one) and what other specialty I can imagine myself doing because that is a real possibility at this point.

This sucks.