fellowship

The Tenth Circle

I am currently house-hunting, in another state, which is a special kind of hell. The area where I’m looking is rapidly gentrifying (and I guess I’m about to contribute to that?) which means that it’s awash in fixer-uppers that have been fixer-upped with the trendiest possible design.

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Jobs

I have a job.

Yay?

I mean, it’s great to be done with training (or almost done — six months to go!) I started on this journey a dozen years ago, in January 2006, when I began studying for the MCAT. It’s been a doozy of ups and downs along the way.

There has been nothing more doozy-ing than the academic medicine job market, let me tell you.

I had very specific goals in mind for a job. I had to have movement disorders. And I had to have narrative medicine. So what I did, in early 2017, was make a list of all the academic centers that had both.

It was a small list.

Then I reached out to them individually last spring, a sort of pre-application inquiry. Like, hey, are you hiring?

One place had just hired a movement specialist the year before, so no go. Lots of places were looking for more traditional research-oriented physicians, not educators, so no go. It was stressful and dispiriting. I ate a lot of cookies.

Slowly, though, better news started filtering through. I got interviews. (Fun fact: on faculty interviews, they pay for everything! It’s an actual recruitment!) Magically, somehow, I had two offers roll in at close to the same time.

I read Getting to Yes, which multiple people had recommended to me as a “how to negotiate” book. The biggest take-away I got from it was that negotiation is about finding out where your priorities align. As someone with an inherently relational worldview, this made a lot of sense.

 

In my heart, there was one place where I really, really wanted to be; they were the clear front-runners since the beginning of this process. They had an opening. They had a humanities center. They had a tenure pathway for clinician-educators. I knocked the job talk out of the park. (Detailed how-to-job-talk post later.) We found multiple (multiple!) areas of alignment. The details of the offer were basically crafted around using my strengths to fill their needs. Things were looking good. I was prepared to sign. I started looking at houses on Trulia.

Then.

Something deeply deeply shitty happened. I don’t want to get into specifics, but it was confirmation of a suspected terrible pattern of behavior. I tried to set it aside for a week, pretend it didn’t happen, but I couldn’t. It was a really big deal. It was a deal-breaker.

So, I cried a lot, and then took the other offer. Then I called people at the first place, and told them, and cried even more as soon as I hung up the phone. For days after, I kept having to run out of the shared fellows’ office at clinic and go hide in the stairwell so I could cry.

That was two weeks ago. I’m no longer crying every five minutes, but I still feel really, really sad about it, especially when I tell people where I’ll be headed. Because I want to be able to say, “I’m going to FirstPlace.” I’m trying to think about all the positive things about the place I’m actually going. There are plenty of positives!

But still.

I guess what I’m trying to say, for anyone looking for advice, is not to get emotionally attached to anything in this freakish environment known as academic medicine.

fellowship

Who do you want to be when you grow up?

Earlier this week, I met the guy whose job I want to have in 20 years. Physician and scholar and novelist! The guy talks about getting medical humanities grants like ordering a salad at Chop’t: “So one of my colleagues had this idea and we got a grant and studied it.”

For the last several months, as I’ve been on the academic medicine job market (post on that struggle later, once I actually Have A Job), my attendings have asked me, “do you want to be like … Ned? Or Emerson? Or Lonely Tourist Charlotte Charles?” And I’ve always answered, “None of the above?” Not really, I pick a name usually at random. (But I’ll take Chuck’s dress sense any day.) But frankly, none of the career paths that my current attendings have, really fits with my goals and interests. They are great people, who clearly love what they do and are fun to work with, and I have learned a LOT from them, but what I want to do is pretty niche, and while I’ve had some excellent role models as a medical student and resident, there isn’t anyone here at my fellowship institution who does what I want to do.

There are times, intermittently, when I still feel I missed the mark and should have stuck with literature. Don’t get me wrong, I love taking care of patients. But I love it because I love their stories. I am doing NaNoWriMo this year, and I cannot wait for November 1.

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A Play in Two Acts

ACT I

Interior: Clinic Room. Morning. 

ME
And how far did you get in school, sir?

PATIENT #1
Sixth grade. I had to quit because of the Depression.

 

ACT II

Interior Clinic Room. Afternoon

ME
Any family history of tremor?

PATIENT #2
No, but it’s just my parents, they were orphans. The rest of their families were killed in the Armenian genocide.

 

You forget, sometimes, how close some of the tragedies of the 20th century are.

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Winning and losing

Today a 87 yo demented man who has called me “young lady” for the last year, ever since I told him he shouldn’t be driving, told me that he liked me and that now I was a “real doctor.” (I think he has just forgotten about the driving issue.)

And someone else hugged me because I reprogrammed their DBS to give them better tremor control with less speech impairment.

And then, just before I left work, I got to tell someone over the phone that their spouse had an incurable, progressive, inherited condition. They started crying. They were at work. Note to self: never ever ever do this over the phone ever again.