Belated update: No longer a med student
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Loading ...A thousand-mile journey begins with that first step, and so too does a long-overdue blog post also begin with the first words. You just have to start or it’ll never happen. That first step of a journey is pretty much the only one guaranteed to be 100% directly towards one’s goal. I mean, you don’t take the first step of a trip to the North Pole going south. You try for all the other steps on your journey to be equally directionally efficient, but detours happen, large and small.
I am on one such detour right now. The title is true, but I admit it is a bit “sensational” to get you to read further. 
The unvarnished truth is that I am not in school this semester by choice. I completed my 2nd year. Done. No doubt about it, grades official. Instead of plowing ahead and making the academic, clinical, and physical leap to the hospital setting, I decided instead to take a breath after having the wind knocked out of me so many times recently. What more natural academic break would med school give than the traditional space between 2nd and 3rd year? So to put the title in perspective, no, I’m not currently a med student, but I am not quitting. I will be resuming exactly where I left off in January, thanks to my school having rolling semesters. So in essence, I am giving myself a 5-6 month break.
Why am I doing this? Simple: “Physician, heal thyself.” My life was no longer in control, at least not to a standard needed to excel in school nor to be happy with life. Several pending health issues, a marriage going through some serious valleys, numerous separations from daughter, being shafted by my school regarding my USMLE timing for petty bullshit reasons, and certainly not least, crippling financial hardship (my loan year was months away from cycling yet I was approaching zero in the bank with a wife and child to consider) were the main factors pushing this decision. I could have been stubborn and said, “Fuck it–I’m no quitter; I’m going ahead anyway,” and people could have even applauded my determination. But I’d be a ticking time bomb, literally ready to psychologically detonate at any moment with the increasing pressure. Practically speaking, it seemed wiser to handle this on my terms in a “controlled” fashion than push ahead and wait for said meltdown in the middle of a semester where it would have academic impact as well. Speaking from the heart, though, there are certain decisions just feel right independently of all the mental masturbation of pros and cons, to-do lists, spreadsheet forecasts of finances, etc. One can’t ignore such realities completely, but some decisions in life live “in the gut”–in this case, borne out of some archetypal survival instinct–and I had to concede the silently obvious. The final thing I needed to do to seal the deal was work it out with my job to ensure I had the funding to work these months since not going to school meant no student loan money. Once that was settled–literally days before classes resumed–it was like a huge weight was lifted from my shoulders. I was sad that first Monday and Tuesday when I knew all my classmates were starting without me, seeing the emails fly back and forth about all the scuttle I was not there to experience, but in my heart I knew it was not yet my time–there were more pressing matters at hand.
In spite of my waxing philosophical above, don’t think this is all touchy-feely goodness. I still have the issue of what the hell to do with my USMLE Step 1, for example. There are no good solutions, but the “proper” decision, not taking any risks with the ECFMG, is to take it upon returning to school. That’s 6 months away and feels like board suicide for someone who had geared up prep to take it yesterday. I am constantly reminded that details of various fungi, adrenal gland enzyme deficiencies, and properties of Class Ia anti-arrythmics are certainly draining out of my recall at a nice flow rate every time I even attempt to pick up a study book. However, I have to trust myself–I am certainly no dummy–and that I can figure out a plan to minimize the leakage in the interim and re-prep (which for a 2nd go-round should be faster/easier) over the holidays and still have the confidence I’ll get the score I’m capable of. It’s hard, though, to have that self-discipline for something so specific when your life is not currently revolving around it.
In the end, this, like all the other things on my plate, are challenges I have to rise to meet. I’m not handling everything as neatly as the words on this post, I promise you, but I hope to get there. Claudia is on board with me, my daughter’s back, and we can finally be a family again, settled in here in Mexico for good. 3 months of Claudia living out of suitcases and various family members’ houses as she did her surgery, therapy, and other things back home reminded her that home is, as we say in Texas, “where you hang your hat.” Our home, the place we as a family call our own as long as I continue my studies, is here in Guadalajara.
Hopefully, my temporary status as med-student-in-limbo doesn’t affect whatever readership I have. I know I’ll always have my true blog friends, but I promise that in spite of not having personal medschool stories to share for a while, I still have lots to say. My stories of the next few months may not be sexy material for Grand Rounds, but they will as always be honest, unique, and hopefully interesting, too. I hope you are here to read them.
Fatherhood, Medical School, Personal | enrico | 
August 21, 2007 11:34 pm
By Celeste, August 22, 2007 @ 11:46 am
Count me in to keep on reading! I
You have to do what works for your family. Before we couple up and have kids, we have all of these ideas about how it’ll be. Then real life happens, and you find that the script goes out the window. Whatever works is what is BEST. What is the point of getting your degree by a certain time if you kill off everything that makes life worthwhile in the process?
I know there is a lot you can do to keep your place with your studies. You are motivated, and you can make it happen. What job will you do in the interim?
By Tiffany G, August 22, 2007 @ 2:18 pm
Actually, I had not heard any rumors or anything because I tend to keep to myself in those regards. I had no idea what was going on, but I knew things were a bit rocky within your family at the closure of last semester. I have to admit I have been worried that you put your career on permanent hold, but so goes it when you have a family. I support your decision to take some time off without a doubt, as long as you continue and give you and your family an opportunity to better your future. To be here is an opportunity of a lifetime, eventhough things are clearly not up to par here. However, being in Mexico has taught us a plethora of lessons that will serve in our careers as physicians. I tip my Texas 10-gallon hat to you (I am not originally from Texas, nor do I have a 10-gallon hat). We greatly anticipate your return, Enrico!
By Sam, August 22, 2007 @ 2:18 pm
I look forward to seeing you at the hospital next semester. You are not the only person that stayed out a semester to rest. You also will have the experience and advice from us guinea pigs that are over there now learning our way around the mazes of our new school.
By punchberry, August 23, 2007 @ 1:47 pm
You have made a courageous decision, and it sounds like you were able to do that because you have a strong sense of your priorities. As always, I admire the way you handle difficult situations. And of course, I will keep reading!
By Sid Schwab, August 25, 2007 @ 11:05 am
Once again, I admire your struggles and your ability to find ways to deal with them. “Admire” may not be exactly the right word. I’m sorry for the struggles, but admire you for facing them as you do. Keep writing, and keep on keepin’ on.
By er doctor, August 29, 2007 @ 10:51 am
Taking time off seems like such a final decision…at the time.
When I decided to switch from anesthesia to emergency medicine….I actually quit the anesthesia program as a PGY-2. Just decided one day that “these assholes are crazy…and I’m so done!!” And I quit. I didn’t just walk out one day…I mean, it was calculated, and discussed with the program director, etc. But, my mind was made up. I hated anesthesia…my program was ass-backwards…and I was tired of waking up at frikin 5am!!
Anyway, at the time, people discouraged me from leaving mid-year. What will the program do? How will that look on your CV? You’ll have to explain why you quit for the rest of your career!!
To that I say…fuck the program…I’ll get a job to keep gaps off the CV….and I’ll *very gladly* explain why anesthesia sucks to a bunch of non-anesthesiologist for the rest of my career. Gives us something to discuss on interviews….
Enough about me…
My point is/was….at the time, it seems like such a *big deal* to take a break. But, honestly, it’s so not. After you graduate from medical school….it’ll be just a story you tell….like I tell you mine.
No worries!! You’ve made the right decision!!
By enrico, August 29, 2007 @ 7:15 pm
Thanks for all the comments. The next 5-6 months will be challenging as always, but I hope the “difficult situations” decrease for a bit.
The idea is that I put my house in order, literally and figuratively. I appreciate “er doctor’s” comment that it seems so catastrophic right now, but like many things one looks back on, is nothing more than a period in time. I hope I have good stories to tell, too.
By er doctor, August 29, 2007 @ 9:27 pm
catastrophic it is not….
By Tiny Shrink, September 10, 2007 @ 8:35 pm
If you need the time off, I’d hope that no one in your future holds this against you. I’d rather see someone take the time to deal with what they need to instead of dropping out later. Best of luck to you!
By Wana Be, September 24, 2007 @ 4:34 pm
Hey Enrico,
Just found your blog on 9/24/07 and have read today’s plus a few earlier posts. Keep your head up.
Got a question for you, for someone like myself who was only recently pointed in the direction of Mexico for my own med school, can you tell me how to find scholarships / loans etc?
I’ll keep reading the earlier stuff to see what you’ve got up.
Many thanks!
Deb – a wanna be Doc