I’m on long call on motherfucking fourth of fucking July!!!!!

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You have to be kidding me.  Why, why why do they always have to take my beloved Independence Day?  I’ll get a good view of the fireworks from the CCU windows, that is, if I’m not busy trying to resuscitate one of the thirty or so patients I’ll be carrying from my team, the other CCU team, and the telemetry floor.  Since there will be only one resident and myself on call, the rules for maximum number of patients carried by interns go right out the window. 

And those expectant two or three 3:30am-6:59am admissions…tons of fun.

As bad as it is, I’ve learned more medicine the past week than I’ve learned two years on medical school rotations.  Then again, judging from where I’d been rotating, it is not much of a surprise.  Whereas I was a medical student about three months ago, I’m actually in charge of my own students now, and I’m delegating tasks and running a tight ship like a mofo, that is, until yet another code breaks out and 60% of the unit gets derailed for three hours. 

Thank God the nurses are on top of things when one of those whoppers breaks out, because the newbie doctor that just happens to be on call (me) is usually running around like a headless chicken paging every consult imaginable and trying to get the shock paddles fired up.  You know that saying, "Never ever get sick in July"?  Well, that's because the doctor taking care of you would most likely be green as grass.

I thought I was to be eased into residency at a much slower pace, but I’m being given serious life-or-code-blue responsibilities on very very very sick patients, some critical and on vasopressors, and, a week ago, I barely knew how to dose a beta-blocker.  I am supposed to work from 7am to 5pm every day, but I’ve been coming in as early as 5:30 and leaving at 6:30 just because my patients are so sick.

And as for having a life…ahh sweet life…what’s that?

My eyelids hang heavily and my verbiage has taken yet another a turn for the vernacular.  I need sleep.

And just in case any of you nay-saying reprobates don’t believe me when I say I got myself into excellent shape:

And here is a "before" picture from approximately a year and a half ago, for comparison:

I did it without steroids, HGH, DHEA, “nitrogen activators,” weight loss pills, or supplementation of any kind, only an energy drink, a protein shake, and a professional-athlete-caliber training regimen.

So, kiss it.

Oh, and by the way, if you want to see $250k+ of tuition put to excellent use, I recently applied my kickass doctoring skillz to an injury of mine, wherein a 70lb dumbbell was dropped on Right LE 5th digit.  Yeah, I buddy-taped that motherfucker:

Boo yah.

Hmm.  $250,000, eh?  I don't suppose they would give me a refund?

It swelled up almost twice it’s normal size and it hurts like a bitch with weight bearing.  However, it’s fairly mobile I can’t identify a displacement.  It’s probably a non-displaced phalanx fracture.  There is also a nasty bruise on my 2nd digit, but that one has full range of motion and doesn’t even hurt.  I could get an x-ray, but it doesn’t change the treatment, and I, in a financially responsible fashion, want to save on that $15 co-pay for the office visit.

The good news is that I’ve been using the injury to my advantage by applying the knowledge I acquired during my psychiatry training and extensive research on Cluster B personalities in order to leech sympathy and attention from others (It's part of my self-instituted training regimen in extroverted social skills), just like a real Cluster B.  People can't even tell the difference.  Check this Machiavellian shit out:

Hot Milf at the Gym:  Hey, John, why are you limping?

Me:  Oh!  It’s HORRIBLE!  I fractured my phalanges, and it’s crippled me!

Hot Milf at the Gym:  What?  Oh my god!!!

Me:  Yeah!  Some guido dropped a 70lb weight on my foot and a bone is broken!  My foot is in so much pain.  I’m taking all these medications (250mg of Tylenol…haha.) for it, but it still hurts.  I don’t know if I’ll ever be able to walk properly again.  My foot is probably going to turn out deformed, or even worse, there is a chance that my circulation wont return properly, it will become necrotic, and I’ll have to get my whole foot amputated!  Oh, why did this have to happen to me…why!!!?

Hot Milf:  You poor thing…

Me:  If that happens, my career, my whole life is over…*sob*.  To think, I had flown so high just to be cut down at the prime of my life.

Hot Milf:  Are you exaggerating?

Me:  NO!  This is a serious injury.  You have no idea how horrible it is.  I am in so much pain and no one gives me any sympathy.  I might as well be dead.

Hot Milf:  Aww.. I’m so sorry.  I feel so bad for you.

(hug)

Hot Milf:  Poor baby…is there anything I can do?

Boo Yah.

Well, speaking of my irresponsible financial behavior, it seems I am about to make an impulse purchase. 

Tom Ford has been a credit to male fashion ever since he left Gucci.  You gots to love them Brits.  I never thought the double breast could be mondernized until I saw this:

I think I just jizzed in my pants…

Tom Ford outlets, however, do no exist outside of the UK, and I need to shop very fastidiously to find a Tom Ford suit at an affordable price.  This will include ebay, overstock stores, and government foreclosures.  But I am determined, and you can bet your ass I will own a Tom Ford double breasted suit within six months.  And it will most likely cost as much as a modest 1-2 karat engagement ring.  Sorry Steph, but a man has to prioritize.  When I do own one, I’ll post a picture, and you can all moan and weep in jealousy.

When I started medical school, I had the impression that landing that awesome residency is the end of it.  NOT TRUE.  I should have known better than to get into that thing I got into the night before our financial aid lecture and show up an hour late, because I had to figure all this shit out the hard way...by making 23,423,534,535 phone calls to my student loan lenders.

Student loans are a fucking mess to deal with.  

If you’re a moron and decide to totally flake on your loans for the duration of your residency, interest can climb up to 100k on a 200k loan (like certain brain-dead emergency medicine residents I know who just absolutely HAVE to live in Union Square or the upper West Side, drive a car in the city, and live on their credit card even though they are barely getting enough money to eat…poor decision making, poor life choices, poor insight…).  

If you try to pay the interest alone on all your loans, you’re looking at shelling out 1000-2000 a month, which is unaffordable, since you’d be very lucky if your salary as a resident is 3000 a month.  Otherwise, you can reduce the damage with income based repayment, which is something to the effect of 500 a month, which will most likely reduce the accrued interest by around 70%.  However, it is a large sum of your income and the loan companies will still shave a good 50k off you, assuming that you are able begin a normal repayment cycle (2-4k a month) once you become an attending.  This, of course, does not include private loans nor loans amassed during undergraduate years.  

Rule of thumb: private loans = rape.  

For anyone doing primary care…good luck.

And, of course, it’s going to be that much more difficult for me, as I will be paying a mortgage and supporting a house at the same time.  The good news is that loans, the mortgage, and federal tax credit are all deductions on my tax return, and if I can buy a house in which I can take on a boarder, his rent can pay for my utilities and then some.  Just to be safe, I'll be either deferring or forbearing all my low interest loans (anything under 5% or that I can defer) so that I'll have enough money for Italian clothing and my plasma TV (basic necessities).  I will eat out a maximum of one day a week.  Everything else, I'm buying at Costco, Target, TJ Max, etc.  I’ve run the numbers over and over again and even made adjustment for “emergency funds,” and I should be all right. 

It’s a bit frightful to take all this on my first year as an intern, but it’s something I feel that I need to do.  There are many people in my life who believe that I am not frugal, responsible, nor financially meticulous enough to buy a house at the age of 27, knee deep in debt, and I want to prove all of them wrong.  Am I playing Russian roulette with my finances?  Yes, but I’m only pulling the trigger once.  I've got a greatly higher chance of surviving than blowing my head off, and I refuse...refuse...refuse to be the kind of man who is too weak and timid to take risks in life.  The profit I stand to make off acquiring a house during a rock-bottom buyer's market and selling it when the economy plumps up is utterly phenomenal, that, plus the money I'll be saving on taxes and the money that I won't be blowing on rent is far more than whatever interest would accrue on the sum of my loans even if I were to forbear them for four years, like the retarded Emergency Medicine residents I previously mentioned do. I can take the risk now, live like a pauper, and be financially secure by the time I’m 35, or I can grind away at my job and be a miserable slave to debt, like so many others, until I’m 55.  It’s well worth the effort.

10 years from now, I want to drive a Benz.

It’s 7:45am.  No sleep last night.  Why am I still awake?  Because I’ve been trying to get my piece of shit palm pilot working for the last five hours.  I’ve reinstalled all the crappy software, reset the memory, and even tried reformatting my computer.  Nothing.  This sort of ass-goblinry is so unacceptable when I have three more weeks of medical school left.  So unacceptable.

Speaking of school, I’ve been hearing rumors about a few of my classmates landing impressive residency matches.  These students have clearly proven, assuming that the rumors are true, that they were able to live up to their aptitude, and I am very happy for them and actually somewhat proud of my school…somewhat, as the little pride I do have for the top one percent of the class is vastly outweighed by the staggering number of duds who ker-plunked the match, or, even worse, scrambled into something that may very well be career suicide for them. 

When one’s stats are low, one should aim low.  There are some real geniuses in my class who barely scraped by on their boards and applied to nothing but the top hotshot Derm spots in the country and then wondered why no one wanted to offer them an interview.  One cannot blame this solely on the school’s lack of career guidance, as someone who can manage to pass the boards should be expected to have some capacity for independent thought and, at some point, figure out that, perhaps, pediatric neurological radiation oncology may be a bit of a reach for them.  Whether it be poor decision making, laziness, or a global lack of intellectual capacity, I’m willing to bet these fifty-some-odd winners, who ended up scrambling, are the same fifty morons who thought it would be a good idea to go to Las Vegas for a week right before a big exam during our second year. 

You wet your own beds, now enjoy your residencies, bitches.

Anyways, my mother, in one of her many futile attempts to control my life (yes, but I do love da momz very much), is trying to set me up with a fresh-outta-Shanghai Chinese girl, and we have a traditional-style double family get-together on Thursday.  My mother has become increasingly irritated at my choices in women as of late, and is now taking a more desperate and passive-aggressive approach rather than forcibly confronting me about it.  I tried to appease her a bit by asking a Chinese female friend to drop by the house and hang out for a while, but unfortunately, that stunt doesn’t seem to fool da momz any more (I won't even mention the disaster that happened when I tried to pass off a Korean girl I was dating as Chinese).  The woman is on a mission.   

But, perhaps da momz has a point.  Perhaps I should pay some heed to the role I play in my own family’s dynamics.  I am, for all intensive purposes, the last of the line, and the tradition lives on, or dies, with my choices.  To marry an authentic Chinese woman, one unpoisoned by American culture, would mean a chance to maintain some of that identity, rather than to lose it completely.  Also, I hear this woman’s a real looker.  Apparently, she was some sort of a soap opera actress in Shanghai.  (That’s the real reason I’ve agreed to this meeting.)

Then again, no one said those traditional Chinese values are all that wonderful to begin with.  I am rather ambivalent about them.  The empirical social unit in Chinese society is the extended family, rather than the individual, and to be Chinese partially means an utter lack of freedom and privacy and that your relatives will always be clumping together on you like a ball of sticky rice.  Everything you say or do is a reflection of your family.  If you succeed, they ride on your accomplishments.  If you disgrace yourself, they scramble to minimize the loss in social value.  However, in a functional Chinese family, one never gets the sense that there is no one there for him.  The family will allocate all of it’s resources to it’s children to ensure that they live well and receive the best possible education, even if it is at the expense of everyone else.  I would not be where I am today without my parents, and da momz constantly reminds me of it.

Well, I’m the type of person who works very well in groups, but only as the leader (I also grunt when I get my swell on at the gym).  I am a spoiled brat, and I totally run the house.  I enjoy making plans, allocating tasks, and bossing people around.  But I’ve also grown up and am bothered by a sense of duty towards myself and my family…you know, the element of leadership that includes sacrifice and responsibility towards others.

The social challenge that I face with this meeting is staggering.  I’ve changed significantly in the past two years, forcing myself beyond my comfort zones, beyond what I thought was reasonable, and beyond what I imagined was possible, on a personal journey to become an amphibious introvert.  Whereas I was too inhibited to even introduce myself to a stranger two years ago, I can now walk into a busy social setting full of people I hadn’t met before, get their attention, gain popularity, tell stories, and walk out with five new friends and a girl on my arm.  It was a one of the most painful and difficult changes I had ever made (I believe it took me two months just to develop an appropriate social smile and about 100 conversations with strangers to get the courage to start a conversation without looking like a nervous wreck), but I could not be happier for having made it.  Still, as much as I’ve built a strong social façade, I have yet to apply anything I’ve learned to a social setting involving my parents.  

With them around, I cannot but clam up and sit quietly in the corner observing the situation the same way I had always done.  My parent’s continuously remind me to not embarrass them at this meeting by acting like an aloof and dismissive social turtle.  This is why it is so important that I put on the most amazing performance now, as I have a lot to prove.  I cannot, and will not, fail.  I will throw down every thing I’ve got: knowledge, wit, charm, humor, confidence, warmth, sincerity, everything, at these people who want to marry off their daughter to me.  I will raise my social value to astronomical heights.  I will apply everything I’ve learned about women in the last two years to demonstrating the correct values, which turn on her attraction switches.  And then I will choose, cordially and on my own volition, whether or not I want to see her again. 

The truth is, I want deeply my parents to see that I have surpassed them, not by education, but by the very fiber of my being.  I want to show them to value of individualism, self-reliance, and independence, the part of me that is not Chinese.