Fatigue

As salaam alaikum,

I don't know what it was about today...maybe it's Friday and maybe I'm tired and after a week of studying for finals that required silly memorization of things I wasn't ready for the assault that was the last lecture in my Gender and Health class today. The speaker basically said that the DSM-IV (and previous editions) and therefore much of the field of psychiatry is based on poor evidence and cannot be trusted as a diagnostic tool for...anything, essentially.

And while I speak candidly about religion (sometimes), some things that I do not discuss so candidly are my clinical opinions because, like with Islam, I am unconventional in the way I think of things and realize these thoughts. All I will say is that there is a reason that I did not choice to specialize in any particular field of medicine, and that's because I understand the limitations of the research within each field, and while being a physician means taking on the challenge of functioning within an sometimes unstable, ever-changing evidence-based paradigm, I felt more secure going into a field where the need is less questioned (at least in my mind) and obviously needed...and that is, being a primary care physician, concerned with the health of families, providing a medical home in a sense for people who need their care translated from the specialists.

Okay, but the end. That's more than I wanted to say about that.

Well...maybe that's not all I want to say about it. I also want to say that seeing that woman so adamant about what she believed, in summary, that the DSM is complete garbage, that I remembered something that I remember sometimes in my most desolate of moments...the realities in which we live on this earth are subjective. She lives in a reality in which most mental disorder diagnoses are bogus, and my classmate lives in a world where, acknowledging the limitations of psychiatric medicine, those diagnoses are founded and absolutely necessary. Neither left the classroom convinced of the other's argument. Meanwhile, I didn't participate at all during the lecture.

Not that it insulted my sensibilities...I live in a world where people usually don't agree with my viewpoint. But it's pointless for me at this point to contribute my perspective, except for the fact that someone who lives in the same realm of thought that I do may agree with my take and nod. It doesn't matter. Reality is subjective. Physicians have to live within a very specific realm oftentimes that precludes the possibility of doubt beyond what is reasonable to continue clinical practice. I exist in that realm, too...the difference for me is that I've been learning, in the past three years now that I've been in medical school, to operate in that realm while not believing in its absolute right without paralyzing cognitive dissonance.

So while others were invigorated, I was drained by the end of the lecture.

And mark my words, at the end of that lecture, I felt a sense of impending doom. This happens from time to time, but I felt suddenly like my shuttle was going to be in an accident, that we were going to crash somewhere in the middle of Downtown Boston between the Pru and the State House. Alhamdulillah, nothing ever comes of these feelings, but I usually have these sentiments when a positive change will come about in my life. I may actually be tapping into a sixth sense that I've not yet homed. I write it down so I can't deny it later if nothing comes of it. We'll see.

But I'm tired of more than just class this week. I'm tired of...this world, essentially. This existence is exhausting. People not doing unto others as they would have done onto them, essentially. And one of my biggest pet peeves is people acting like nothing's wrong when there is so much wrong, or people minimizing or brushing aside wrong when the wrong is so blatant. Maybe they can brush aside the wrong because they're not affected by it, but as a person who is the personal recipient of some of these wrongs, I can't just brush it off.

I'm getting cryptic now, but it's because I'm tired. I'm tired, and I'm reaction to this now diminishing impending sense of doom. If this is the way I can tell that something good is about to happen, it sure is a funny premonition. And by funny, I mean strange. It's not amusing at all.

I'm so tired, I'm not planning on going to the HLM social Saturday night. Sometimes it's fine because I could just exist. Among my classmates and those under me, I could just exist. I never had to explain to them why I was Muslim. Now that we're all dispersed, I'm finding myself socializing with Muslims and ending up explaining my life story too often...abbreviated version, of course. I'm tired of that. Some of us seek attention and I must admit, I do like attention sometimes, but sometimes I just want to be, do salat, eat, laugh and go home.

If my first name weren't Chinyere and were some more identifiable (though not characteristically black) Muslim name, no one would question. But then, I wouldn't be me, because having to pronounce my name to every teacher since preschool has, at the very least, built character.

But I'm tired, so I'm ending this week with happiness. Happy thoughts and happy times with happy people who don't remind me of all that I'm tired of. Heh.

I'll post later when I'm in a better mood...

USMLE Step 2 and Life Ahead

Salaam,

So, it begins today...studying for USMLE Step 2 CK (clinical knowledge). The task is actually less daunting than I imagined. I think after a whole year of taking standardized exams at the end of each rotation that lasted two hours, an exam on all I learned during third year in an 8-hour block is not that scary.

I'll just think of it as all of my shelf exams smashed together...and not even, because that exam would be 12 hours long.

Actually, I have a lot of other things to do today as well. My room is a mess, by virtue of my clothing. The laundry is in the hamper but I do not have enough room in my closet for my clothes. Now I sound like a total glutton, and I probably have too many clothes, anyway. But I recently took down my winter clothes to hang up my lighter spring clothes, and all of my sweaters right now are on the floor in front of my closet waiting to be put in the little wire receptacles on the floor of my closet that hold all of my out-of-season clothes. There are still a few things that need to be hung up. As a result of these receptacles, however, I don't have room for my shoes in my closet...and I dont' have that many shoes. I haven't bought a pair of athletic shoes in a couple of years and I'm wearing the same pair of sketchers I've had since undergrad because they haven't come out with a new style and I like these.

I'm becoming old...well, let's just say more mature and more sensible. There was certainly a time when I thought I needed to buy a new pair of tennis shoes [yes, I'm from the tradition/part of the country that says tennis shoes instead of sneakers] every year.

So there's laundry to be done, I'm going to dust in my room...probably in our living room, too, because for some reason, a fine yellow dust has covered everything from our windows being open. The bathroom needs a good once over, too. You know, I like when people help clean, but not when they do a half-a** job. My new roommate, bless her heart, sometimes cleans the bathroom...and honestly, besides the sink, the side of the tub, the mirror and the toilet seat, I don't know what she cleans.

[And if you're sitting there wondering what else there is in the bathroom to clean...you are one of those who also does not know how to clean.]

I'm actually excited to study for CK...excited to be done with it as well. I'm also a bit excited for public health school. I actually remembered that I had deadlines for admission coming up June 15 so I took a break from this entry to actually get some of that underway. I remembered that I had an official copy of my transcript sent to me by Michigan so I can just drop that off at the admissions office at the school of public health. I'm going to the office of the registrar and I'm going to drop off my transcript request form by hand.

Part of me still wants to have been doing a regular MD and be graduating next year...part of me is not sure what I'm going to do with two months of unscheduled time (actually, three months if you count this boards studying time...but for me, that's as good as scheduled time). I've just been in the go-go-go mode since I entered medical school. I take step 2 insha'Allah July 6. I don't take CS (clinical skills) until sometime next year...I think I'll try for late August during my week off of clinical responsibilities, and after I've been back in the hospital for a little bit and not horribly rusty at my physical exam skills.

This whole process...medical school, standardized exams, the strange way of grading third year, residency applications...it's very stressful. It's made me re-evaluate my faith in many ways. Like, I used to believe that everything ultimately happened for a reason, and even if it didn't fit into our personal plan, it fit into the plan Allah (swt) has for us.

For example, Step 1...I didn't do quite as well as I would have liked, but I did well, like, way good enough for the main specialty I was considering at the time, OB/GYN. I'm thinking, what if I had gotten an out of this world score, like 275 (the mean is 220). Would I have felt like going into something like family medicine was below me? Would I have set my sights on dermatology? Or, for example, what if I had gotten a few more high honors? Would I have considered then a more challenging specialty?

Do I still believe that everything happens for a reason? Yes, but I'm more apt to believe that things happen because they do. No one knows so by extension I can't know how Allah (swt) works. Just as I had previously said with pretty much every guy that I've liked in the past with whom it didn't work...it didn't work because it didn't work. It was like, rounded and angular cogs that didn't fit together in the machinery. If it would have worked, the cogs would have turned and things would have gone naturally from there. But it didn't work. And I've always been the cautious type, not pushing things, trying to let things happen. If either of us forced stuff, the cogs would destruct and the machine would break. Not good.

I consider the same thing about my road to my specialty choice. I think with my grades and my Step 1 score and all else I have going for me, I'll be more than okay for family medicine. I'm not choosing this because it's easy, but I am choosing the specialty because I think it'll be awesome for me to take care of moms and babies (ultimately what I want to focus on) and because I can see where I'll have space to have a life.

Third year has proven to me...I cannot handle tons of stress. Obstetrics and gynecology would afford me just that...tons of stress. I mean, residency itself is stressful enough without entering a field with such low satisfaction rates, a field in which a large chunk of it, benign gynecologic surgery, I'm not too crazy about.

And in terms of the year off...that happened because it happened, too. Third year was stressful, I didn't get as much time as I would have liked to read like I wanted to, so here's my chance. Here's my chance to collect my thoughts, to rest, to do all of the things that I wanted to do, like writing RMD [I'll talk more about that here later, for sure]...

Anyway, yes, things are happening for a reason. Like my patient who I nicknamed Mystical-Magical Patient had the Spirit that guided her, I believe I function on a similar paradigm. Between praying istikhara (which I needed to do more often during third year) and going with the flow, I'm making the best possible decisions for my career.

Anyway, now I'm all worked up. Back to the gym!