All I need is a couple (more) days off...

(A la Huey Lewis)

So I'm at Starbucks. It's my last day of "vacation" and I'm debating how much more I want to be productive vs being a bum. Bum might be winning, especially given that my first patient tomorrow is at 7am and then I'm there all night. Bleh.

So, to answer Danielle's question from the comments the other day, here's how you become a subspecialist physician in two short decades: you start with four years of college, heavy on the sciences. Somewhere in there, you take the MCAT, do the first scary application process, and then you go to med school for four years. At the end of that, you're an MD, but you can't do a whole lot with it. So during your fourth year you go through the match, which is insane, and roughly this: You apply to residency programs, they can then offer you an interview, and after all the interviewing is done, you rank all the places you want to go in the order of preference, and they rank all the candidates in the order of their preference, and then some big computer in Texas matches everybody up. Sometimes this works well, sometimes they send you to Hell. Anyway, assuming this works out, you do between three and eight years of additional training (residency) in your chosen specialty. And when you're all done with THAT, if you're really insane, you do sub-specialty training, Fellowship, which is typically between one to three extra years. And if you're completely crazy, you might do more than one fellowship. Some of these fellowships are "accredited," i.e., recognized and regulated by the governing bodies that, um, govern these things. Some aren't, but can be equally valuable because they provide additional training in some area that just hasn't been approved by the big folks yet.

So, let's recap/project my career as an example, not including the false start between med school and psych residency. College (4 years), medical school (4 years), psychiatry residency (4 years - I'm currently in Year 2), child and adolescent psychiatry fellowship, which is an accredited fellowship (2 years, but your first year of fellowship can overlap with your fourth year of residency, so it only adds one year total to your training), and possibly an unaccredited fellowship in Traumatology (1 year). And then, THEN - 14 years of training after high school, not including my year of OB/G - I get paid like a real doctor and get to start paying back my loans in earnest.

Fun, right? Well, okay, actually it is, a lot of the time....

So, of course, every step of this process is full of applications, personal statements, references, interviews, and uncomfortable shoes (although - yes, Allison, Dansko does make dress shoes! They weren't bad, actually, just new). And my interview for THIS particular step in the process was Wednesday. It went....well, I'm never a good judge of these things. I'm sure it actually went fine. I mean, these people know me, right?

The problematic thing, for me, was that I felt like I spent the whole day talking about the Emerald Palace. All five of my interviewers asked about it. One pointed out that it "raised concern." Three of them asked me if I'd had any problems with anyone here, and then agreed they hadn't heard that I'd been trouble here (so why ask??). It was probably fine, but on my side of the couch, it's really frustrating. Haven't I done enough penance? My life fell completely apart. I'm still dealing with the financial and logistic aftershocks (which says nothing of the psychological fallout). I mean, I got out of an abusive situation. How long am I going to have to apologize for that?

My program director up North threatened me when I left, that they were going to haunt me for the rest of my career, that this was going to "follow me" and they'd make it so I had to "explain myself" every time I applied for a license, a job, or a training position. Turns out, she was right.

Fuck. What the hell was I supposed to do? It was bad. I got pulled into their enactment. My job, my personal life, my well being were in peril. So I left. I wasn't the first one. I wasn't the last. It's completely amazing they still have accreditation with their rate of attrition alone. But fortunately for them, those of us who have left are either so glad to be out or so traumatized that no one's taken formal action. So they just keep going.

Look, we all make bad choices. We all stay in situations we shouldn't because we want to hold onto hope, or we're scared of the consequences, or we think we're the primary problem.

And I suppose if I were divorced, my prospective new spouses would want to know what happened. I guess this isn't a whole lot different. Except, in this analogy, I've been dating this program for a year and a half. If it's thinking of proposing, shouldn't it look at our time together instead of worrying about my tarnished past? We've had a pretty darn good relationship, I think. I like it here. I like the people here. It's why I want to stay. I've worked hard, I've taken good care of patients, I've done some interesting stuff. Why not focus on that?

And, ultimately, maybe they won't. I'm sure it was fine, and it'll work out the way it's supposed to. And as Corrina (the program coordinator. Her full name is, of course, Magical Corrina The All-Knowing) pointed out, my odds were less than 1 in 10 when I matched here in the first place, and they're currently 5 in 6. I just really, really want to be one of the 5 (see above, re: really liking it here). And I think it's a great training program. And I like to think that maybe some day, they'll be like, oh, Dr. Kate? Yeah, she was one of ours, back before she was one of the most prominent names in trauma/wrote that New York Times Bestseller/opened that cool yarn store (you know, whatever).

And maybe then I'll be able to say, well, that false start just was what it was - a chance to learn a whole lot about myself.