Saturday, March 29, 2014

Like Walking on Water

Walking on water is easy; it's when the waves turn into giants that things get sticky. ~ Beggar

I don't usually quote myself but since there was no one else to blame for my opening line, I figured I'd best come clean. Walking on water, metaphorically speaking, isn't hard, as long as the water's quiet and glassy smooth like the surface of a Colorado mountain lake on a summer evening. The storms that come from out of nowhere in late afternoon, however, before the evening calm, those are what separate the men from the boys.

That image has been running through my mind almost daily, the past few weeks. Walking on water, trying to "keep the faith" when all around the waves are lapping and a glance at my feet tells me I'm going under. Walking on water is precisely what seeking a residency position has felt like, walking on water without a life-jacket.

On March 9, 2010, I wrote a blog post entitled, "Medical School Through the Back Door," describing my experiences as a psychotherapy intern in the company of a group of  psychiatric residents. Back then, I was a street urchin off the pages of A Christmas Carol or Oliver Twist, my face pressed against a restaurant window, gazing hungrily while patrons dined sumptuously. The memory of that internship kept me going through medical school. I knew residency was out there, or at least I believed it was, it was just a matter of reaching it. That was in 2010.

2011 was different, or it looked to be, when I began clinical rotations. The basic sciences were behind me and board exams and I had battled it out, sword on shield, sometimes tooth and nail. Starting rotations in mid-cycle meant I wouldn't have a predictable schedule, resulting in graduation being pushed back a year. 2012 brought an unexpected gap between rotations and once again, I watched graduation skip away with the alacrity of a child playing hopscotch.

In 2013 I received my degree at long last and applied for residency. The Match came and went, leaving me without  "a date for the prom." I'm not sure there's much worse news for a fourth year medical student or recent graduate than, "We're sorry, you did not match with a program." As with any loss, your first reaction is shock and disbelief, followed by anger and frustration, and then despair sets in and you start wondering how you'll ever pay student loans. Hopefully, acceptance comes along soon, enabling you to regroup and get busy chasing available positions and contemplating Plan B or C.

The truth is, I was up and down. One day I felt optimistic, based on nothing more substantial than a phone call with a polite departmental secretary, and the next felt certain I was totally screwed. All the years I'd spent loving and learning psychiatry were circling the drain and there wasn't a single thing I could do to stop them. My Plan B involved a family medicine residency for a year and then reapplying for psychiatry. It had been done before, successfully, by others, why not me? If that failed, I'd go to Plan C: finish family medicine and see psychiatric patients. It was a good strategy, it was workable, but it really did feel lousy. It was like giving up and that's what hurt most of all.

Still, I had to face reality, painful or not, and so I began contacting family medicine programs about openings. Then a call came from the Midwest. I tried to sound casual and friendly, but I could scarcely contain myself as the voice on the other end said, "I'd like to offer you a position in our psychiatric residency program." Talk about the cavalry riding to the rescue. I even think I heard bugles blowing. Until that point, my "best day" was a Saturday morning in January, 2005, when I learned I'd been accepted to medical school. Now it had a contender.

I'm not sure what it's like to "walk on water" that's calm and placid. I'd like to find out. The past few years, though, it seems there's always been a storm brewing, either because of my own frailty or stupidity or because that's what storms do. I'm not complaining; it's better to have to negotiate a storm than sit on the bank, watching others make their way to the other side. That I've managed to come this far is a testimony to good people who stepped onto the water alongside me when the sky was at its darkest. Thanks in no small measure to them, when someone finally opened the door to a psychiatric residency, I was standing on dry land, free to walk through.

(Creative Commons image of Trout Lake, near Telluride, Colorado by Mountain Belle via Flickr)
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