Tuesday, February 20, 2007

The view is nicer in middle of the bell curve, anyway

Okay. I've done my first practice test, and it turns out I'm not a biochemistry moron. I got 72%, which sounds like a C until I tell you the class mean is 75%, and the mean is also, somehow, a nice, solid B. (I got an A in statistics, so I know enough to just go ahead and trust that.)

It's like I was saying earlier: this doesn't seem to be the kind of thing where you can possibly survive any length of time if you have to play to win, and give 110%, all the time. This heavy-duty stuff is something you need to respect and work with, not try to conquer. If you think of med-type studies as a game that has to be done with utmost focus and excellence at all times, any simple human failing seems like disaster. And that's no way to live, much less a way to mold the healthcare team of tomorrow. It's a big part of why premeds and med students are sometimes such miserable people, and often so stressed-out and weird.

Here's what I wanted to say in interviews, but never got a chance to: you always hear these driven, ambitious, talented people say, "I'm excited for the chance to compete. I love to compete. I feel I'm very competitive as an applicant for this [school/ job/ reality TV show/ elected office], and I can't wait to prove it." And I call bullshit on that. I think in actuality, what most of these people enjoy so much isn't competing, but winning. They're winners. Always have been. And who doesn't love to win? Winning is great.

The problem is, if someone always wins, the first time they lose will be the first time they've ever lost. The first time it happens to someone like that, they don't know what just took place. The second time, they fall apart. A bad test score, a lousy evaluation, a personality conflict with someone in charge. Your classic Type A student will do just about anything to maintain stability; that's why they study 10 hours a day, worry about insignificant details, kiss ass with near-sociopathic skill, and never go out to the bars. Keeping their etch-a-sketch unshaken is a full-time obsession.

But medicine -- and it's not like I'm all that qualified to talk about this, except inasmuch as I've spent two and a half years clomping around in my Danskos on the factory floor -- is only partly about keeping the remaining events in your day as predictable as possible. It's largely about keeping yourself consistent, quick-thinking, and useful, while the entire rest of your world gets as unpredictable as it feels like being today.

It's like cards. If all you ever play is some five-card version of the game where nothing can start except with Jacks or Better, you'll be folding and folding again all night, like a cheap lawn chair. And I would think that much of the really relevant learning takes place in the process of playing as many hands as you can. Not so many that you run out of chips, but enough that you get past the bare theories and the expected results, and get into learning from your own observations, including your own mistakes. As someone said, good judgement develops with experience -- and experience usually develops from bad judgement.

The kind of training a lot of students put themselves through is simply wrong for development of this skill. Unfortunately, it's the kind of training that gets great results... for now. It gets them in, and it gets them through, to a point. In other words, the stuff I will be great at doesn't come until the end, and people who are great at the beginning stuff drive me nuts.

I don't mean to imply that a half-assed, vodka-soaked approach is in any way superior to, or even as good as, some discipline and hard work. I only stress the distinction because every now and then, I get concerned. This is the time of year when the system is cranked up to uber-competitive mode. Many of my classmates from last year did fine; many are still up in the air. Match Day is coming up, so today's fourth-years are freaking out about getting to become next year's interns. And out there, somewhere, 50-some people are about to become my classmates.

I hope they're cool, and they'll help me with the stuff I'm not naturally adept with. I promise to help them with their videogame skills.


Tim said...


I am a first year law student and everything you say rings true for my situation as well. Well done, well done indeed, good sir.

"Keeping their etch-a-sketch unshaken is a full time obsession." That is the single greatest (and truthful) line I have read on a blog in years.

Enjoy school, but more importantly, continue to enjoy life.

Febrifuge said...

And a tip of the hat to you, sir!