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.
Humor, Medical School | enrico | 
August 30, 2007 10:07 am | 
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