Fatigue of unspecified etiology

oncology

We were sitting across from one another in my call room when you asked, “how does it feel to spend a month doing what you believe is your calling?” You’ve always been that way – getting straight to the point. Our conversations of substance are why I tell people that you’re one of my residency big sisters. My answer: “I’m tired.” Fatigue of unspecified etiology, likely multifactorial with at least some emotional component.

“Okay so? We came here to work hard. If you want to be hot at this job…if you want to be brilliant at what you do…forget tired. We’re chasing our passion.” You’ve always been that way – dispensing tough love when I want a hug and ice cream. You’re always right.

“And it’s a privilege, I know. I feel an indescribable amount of gratitude to be on this journey,” I said tentatively.

“Residency teaches us to bemoan what makes us good. We gotta snap out of it. Challenges make us better. Sleepless nights mean we are learning. Don’t whine about not being a white cloud. Be grateful.” You answer your ASCOM: someone wants you to push TPA. I answer my ASCOM: someone wants me to assess a kiddo with altered mental status.

I thought about what you said as I spent the rest of my call awake. I thought about what I described as the hardships of this month: the patient turnover, the acuity, the loss of a patient I loved, the painful conversations during which “I’m sorry to tell you, we don’t anticipate a cure” was dropped, the moment when I held the hand of a child soon to pass and she smiled, the moment when a patient having received a diagnosis of lymphoma paged the overnight nurse to ask me to stop by for “girl talk” because she needed a friend (I can’t blame her), and the moment when a patient in excruciating pain pushed her PCA for upwards of 400 times and then reached for my hand and wept.

One of my attendings said it best: “you’re the type of human who feels everything deeply.” I nodded. She was right. It’s why I danced with a patient’s parents when he was approved for an experimental study drug; it’s the same reason why I cried next to them when he coded. It’s the reason why I say nothing when parents yell; it’s the reason why I again say nothing when they apologize in the light of day. It’s the reason why I went to say goodbye to all the patients I cared for before I left the floor. I saved my favorite (and I know I shouldn’t have favorites) patient for last.

“Hi, I just wanted to say goodbye because it’s my last day on the team.” She teared up, her mother teared up, and I (naturally) teared up as well. “I want you both to know
it’s been such a honor to participate in your care and to walk alongside you during this journey.” She reaches out to hug me. She’s an early adolescent with the hopes of becoming a physician. She just finished her first day of chemotherapy. She wept (I can’t blame her) when she received the diagnosis of stage 4 cancer. I wept (can you blame me?) after we told her. “You’re a really good doctor,” she says. She doesn’t know that I’ll replay these words again and again. “You’ll be a good one too.” She beams and I question what I said – there’s a fine balance between being hopeful and ludicrous. Now rested, I think I may have toed the line.

“How many years left in your training?” her mother asked. They wanted all the details: where did I see myself in five years, how did I get here, and how proud is my family? We remained in silence for a few moments before I collected my belongings. “Thank you so much for everything you’ve done for me. I’ll never forget you.” To which her mother followed (in the typical West African fashion) “continue to work hard and make us proud. We will pray for you.”

To the patients who challenged me, thank you. To the patients who encouraged me, thank you. To the patients who became like family to me, I’m forever changed. Thank you.

How to Survive Medical School: Residency Application Season

Hello friends! This post is very belated. It was meant to be my first official post since graduation and clearly multiple posts (although not as many as I anticipated) have come between that time and now. It’s hard to believe that this space–that I first used to document my experience as an pre-medical student–has become such a resource for other individuals. It is even harder to believe that there are individuals who have followed my journey (via this blog) for five years. I am in serious shock and I feel serious gratitude.

Since my last life update: I completed my MD/MPH, received awards from both the MD program and the MPH program, drove a rental van with all my belongings to Philadelphia (24 hours – alone, the scenery is gorgeous; the drive was…long), and started residency. Today marks my first entire week of elective (child abuse & adoption medicine) after completing my inpatient rotations for this year. Residency is not easy but I like it more than medical school. There’s no comparison. At all.

I meant to write about residency application season right after match day but I got caught up in writing my public health analysis and then I graduated and then I moved and then I wanted to spend time with my co-interns (basically, I have a ton of excuses). I think the delay is beneficial. I have now had the opportunity to evaluate medical students and sub-interns (which feels totally wild because I was literally a medical student not too long ago) and have heard a little bit from co-residents and administration about what aspects can hurt your application.

This post will be divided into four sections: pre-interview season, interview season, post-interview season, and general tips. It is important to keep in mind that I applied for pediatrics and so not all of this advice is generalizable. I recommend taking a look at my dear friend Yang’s Match Series to see high-yield advice from now-residents who matched into specialties aside from pediatrics. For those of you who are going in the amazing field of pediatrics, I have a document that I made for my mentees applying into pediatrics last year that you can use to set goals to get your application ready.

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“I Matched!”

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July of last year, I asked one of my advisors if I should apply to institutions like Children’s Hospital of Philadelphia (CHOP) or BCRP or Cincinnati for my upcoming residency application cycle. And he looked at me and said: “Historically, people from Tulane do not match to CHOP or BCRP. And quite frankly, you aren’t junior AOA, so…if you wanna spend the money, I won’t stop you. But I just want you to be informed.”  Continue reading