The Hanging Gardens

My friends and I have a joke: These days, whenever we're explaining why we can't go to that concert/hang out/get groceries/sleep, the answer is now "Because third year."

It isn't really a joke. That's why it's funny!

Most medical school curriculums are organized so that the first two years are academic - you go to classes and learn a new language to describe all the things that can go wrong, and some of the ways we can fix it. The second two are the clinical years, where for the first time we become part of a medical team.

I am now almost two months into my third year, and I am responsible for other people's care. Not in a large way; I don't make the important decisions. But I have sat and spoken with so many people from so many walks of life who shared their pain, and I have touched more people in the last seven weeks than in the past decade. There are people who have left on a slightly different medication dosage, because I did the reading, and my resident let me make the final decision.

It's exhausting; it's exhilarating.

My brain does a thing where my focus narrows, especially when I'm stressed, and for these two months, looking away from medicine has not been something that's occurred to me. I'm sorry for dropping off the map, though I'm afraid I won't be around much for the next ten months.

Because third year.

(To entirely ruin that ending, I have also been playing dragons, because it provides excellent five-minute brain breaks, and also dragons make everything better. My life is all medical puzzles and pixel dragons at this point. If any of you are playing, we can be ruthless dragon capitalists together maybe?)

Being a medical student means being the worst sort of hypochondriac. I've been having these odd dyspneic episodes, which are uncomfortable enough on their own, and are made infinitely worse by the inevitable consideration of whether they're the shiny anglerfish's lure indicating a terrible, toothy disease lurking below. It doesn't matter how unlikely the possibilities are, I always find myself putting together a differential diagnosis while I gasp for breath.

Never mind angels and devils on my shoulder, or internal editors in dire need of a gagging, I would pay good money to silence my inner physician on occasion. Most especially when I'm abruptly very aware of needing to breathe in the worst way, and an inordinately cheerful little voice suggests: It could be congestive heart failure :3

I sincerely doubt it's CHF. I think I would have noticed a few other signs by now? And it's not like I have any risk factors for it, besides maybe high sodium intake? Let me tell you, internet, my diet is dire. I exemplify the stereotypical terrible student; I'm practically the Platonic ideal. I ate brownies for breakfast today, and I'm not even a little bit sorry.

Maybe it's COPD. :3333

I really don't think so, what with the no smoking history.

Maybe you have pulmonary hypertension. May. Be.

My blood pressure was checked this week, it's normal. High for me, but still in the normal range. Knock it off.

Anemia? Bloodwork was done a month ago.

Surprise pulmonary embolism? Pneumothorax? Now this is just getting ridiculous, and also, nope. The lack of giant stabby pain and immediate need for critical care kind of rules those out.

Well, what if cancer? Self, you can shut your filthy gob now, that is right at the bottom of the list.

My actual differential, at this point: Being very out of shape, new and interesting allergic reaction, adult onset asthma exacerbated by being very out of shape and/or allergies, psychosomatic manifestation of anxiety.

The first is far and away the most likely, and until I get evidence to the contrary (ie. I fall over and flop around unable to breathe), I'm operating off of the assumption that exercise is more likely to make things better than worse. A fast walk/slow jog for half an hour had my heartrate up to 140+. It's resting at 90 right now, which. Yeah. I should know better than to let things get that bad. At some point I should probably grab my stethoscope from the FLTC and actually listen to my heart and lungs, just to make certain everything sounds normal, but this is almost certainly an internal PSA on "Why You Shouldn't Attempt to Be One With the Couch, Chel, No Really. Exams Are Not An Excuse." And my chipper little internal doomsayer can go hang and take its catastrophic differentials with it.

HEY HEY GUESS WHAT, INTERNET, I'M GONNA BE A DOCTOR!

I just got accepted to my first choice medical school, one of the top ten in the country. And I kind of thought the voice on the other end of the phone was a recording and swore in sheer joy, but the nice doctor on the line took it and the following babbled apology-and-squee in stride. Hopefully he got a chuckle out of it, at the least, and didn't hang up wondering what sort of foul-mouthed maniacs they're letting into the school these days.

Now I'm leaping up every few minutes to dance and the cats are looking at me like I'm crazy and holy stars and garters, this is actually happening.

I am starting to get interview offers. On the one hand, yay! On the other hand, I'm left with a lingering desire to hide under my covers until the scary things go away.

This being life, where hiding under the covers is a distinct non-option, I'm trying to focus on the yay part.

Forward into the breach!