Planes, Trains and Automobiles

There comes a time in every potentially US bound, USMLE-sufferer's life when one starts believing in the stories. There goes a tale of a mythical road, the Interview trail. Fair warning, O naive soul. The Trail is a long and arduous journey. Do not glance unto the treasure at the end, 'cos it is a thing of terrible beauty. It will entrap your soul and lead you to commit heinous deeds. The path is narrow, and many will fall along the way....I think it's better I stop before I compare my "epic 3 month journey across the United States" ,as I've told everyone who cared to listen these past few months, to the wanderings of Odysseus. Also, since I don't call Ithaca home and have no plans of visiting in the near future, I guess that'll end the comparison.

The thing that gets to most people is the planning. I'd say I am one of the fortunate ones who've had the chance to geographically plan their interviews - (I mean, I'd love a situation where I got a dozen more calls to interview and had to exhaust myself all over again) - nonetheless, 10 places to visit over 8 states isn't easy. When you have to add hotels, and train bookings and connecting flights - not to mention food, and laundry and searching for a "base" to stay - it can knock you out before you start. And, no matter how many times your Dad tells you to forget about the costs, you can't help but keep adding it up.

You always remember your first. Everyone's scared before their first interview. I mean, the online forums, the endless tips, the First-Aid books can only help you so much. You're trying to show how "cool" with things you are the night before - inside you're shitting bricks. For all my pre-interview research, I barely slept the night of my first interview. It's not that I'm short of confidence or don't know my stuff, it's just the unpredictability of it. For all the guys online telling you it's ok and it'll pass off without a hitch, there's always someone who had a bad experience. Someone who's going to ruin it for you - and pile on the doubt. I'm not sure how much Vineet and co. noticed it in Philly, but the shivering that morning wasn't all the chill outside (Actually, it was - considering that I didn't wear a jacket over my suit for fear of crumpling it). Once the first one's done - you heave a sigh of relief and move on. A sigh is all you give yourself - 'cos there's hardly time before the next one.

After a couple, you start to notice yourself getting into a routine. It's the same shtick. Mindlessly surf the program webpage the night before - looking at things to possibly say the next day that'll make you look smart - even though you know and the interviewers do too, that a couple of hundred people before you have done the same, and a few more will after you go. Get up early - (I got people from India call me to make sure I'd woken up - that's how scared I was I'd oversleep) - shave, gobble down some food, rush to the cab/shuttle, make the usual small talk with your fellow interviewees, and "face the music'. After a while, it feels that the interviews start mixing into each other. An introduction here, a morning report there, a tour of the hospital, the same questions that you ask the residents - "Are you happy here?" "What don't you like about the program?"  "Is the area safe?". Then, the personal interviews. The questions seem to merge there too. There's only so many times, you feel, that you'd reply to "Tell me something about yourself" without putting in "I'm a sex-starved single man who's desperate to use the US doctor status to score chicks". But, you keep a straight face. You make the small talk. 'Cos you know despite the "boredom" that now comes through as waves, you've put in 2 years or more of your life into building your own "USMLE project" and you're not letting it go.

The thing that's a killer. Loneliness. Yeah, the travel hurts - I mean (and here's my 6 millionth travel miles plug) I've covered close to 5000 miles over the past two months, and I'm way off the top. But, the feeling that you're in this alone - is really hard to shake off. Whether it's staring into the darkness on a slow moving bus in the snow, or it's "celebrating your birthday in Augusta - smiling to the cameras - and posting statuses that you keep checking every couple of minutes - as if 1 more person liking it on Facebook will make you feel like that much closer to home. You feel it at the airports - waiting for a connecting flight. You feel it if you argue with people you love - and feel like you've overstayed your welcome. And you feel it most, when you're sick, and all you want to do is have your mother "make it all better".

But, you know what, it gets better. (No shit, Sherlock - you'll say). Honestly, this is a lot for me to say. I mean, I'm as cynical as they come, a fact to which a lot of the people I know will attest to. But, if there's something I take away from this "journey" of mine, it's going to be positive. And if I say these 3 months have made me less of a cynic, and more of a believer in people, I won't be kidding. (At long as the Match results back me up).

Because this interview trip is all about the people. (Yeah, good and bad, but I'll take the good for now).

It's about your fellow interviewees - the "we're all in this together" shtick. Yeah, we're competing with each other for those prized spots, and yeah, we're secretly hoping the other one loses out - but over all the small talk and the put-on acts, you meet a lot of awesome people, who have the same problems. So you're grateful for the little talks - the ones at the railway station/airport/bus stops, you're grateful for the stories - the one with the nasty interviewer (because you're glad it's not you), the one with hospital with the white flags to ward off gangs, the one with the newly discovered coffee-shop, or the ones where you realize you have so much in common (Like, Oh My God!!).

It's about the friends who go out of their way to make you feel good - like a birthday party for you when they've got finals the next week - where the cake ends up tasting like the best cake in history; or the ones who feel guilty when they've had to work when you were there because they couldn't show you around (when you were thankful just to crash there for a few days). It's about the people who call you up to make sure you're better, and offer to get you meds - forgetting you're 500 miles away. It's about old acquaintances renewed - it's about new friends made. It's about letting go - running through Central Park, or dancing like no one's watching New Year's Eve. It's about discovering things - whether it's the best waffles in town, or  the joys of listening to "In The Aeroplane Over The Sea" over a glass of red wine.

And so it ends. Three months done, you're back home - only to start losing the rest of your hair as you wait for the ides of March. March madness or whatever you may call it - Match Day. Yes, I'm going to end this by waxing eloquent on how the Interview trail changed my life because it did. (For all the people who'll say they wouldn't change a thing, they're really wishing it was a lot easier). I still have a couple of thousand miles to go, and an exam along the way, but come the 2nd of February, I'll know I've survived. So, to end this, I'll either quote Kipling and "If" or Sinatra and "New York, New York". Or better - Ozzie "All Aboard. Ha Ha Ha"

The King and I

It's funny how I've gone a year w/o talking bout Roger Federer here. The night after yet another re-writing of the history books. The Man's done it all, and then some more. We've been here 7 times in the past. Wimbledon final. Centre Court. On the verge of Grand Slam success. But this one might just be the most special of them all. Considering where we stood less than a year back.

I won't be forgetting the USO semi-final loss to Novak in a while. Tsonga was the first to do it. Novak repeated it the very next slam. Devastating, considering Roger was playing tennis far superior to the Tsonga game. Another loss, rounding off a miserable 18 months for a Federer fan. Not because the Man wasn't where we'd like him to be, but more so because the boo-boys were getting louder and shriller. 

Look, being a fan and supporting someone means accepting the good with the bad. I get that. I get that Roger's not going to win tournaments in the very fashion he did 6 years ago. I get that he's 30 going on 31. I'm ok with criticism for the most part - especially when it's well thought out and going somewhere. But, as far as the past 2 years went, I've had to sit through a lot of bullshit. From the monotonous "High time he retired. He's doing tennis, nay his memory a disservice by playing" to the juvenile, everything from "16 Grand Slams don't mean a thing if he never had any real opposition", to him being a sore loser, to him being secretly the most arrogant Tennis player in history (this, because he "dared" to wear a personally designed jacket). I mean, if I'd heard the words "washed-up" one more time, I'd have blood on my hands.

       I'm not saying people don't have a right to criticize, but when the people who do the criticizing are ones whose Tennis viewership goes back to (gasp) 2006 while prancing around like they're meant to be the next Bud Collins ( yes, douches, I'm sure you don't know who he is. Hence, the reference) , I couldn't not get pissed off. I do fight back, but there's only so many levels of idiocy that I can get down to, to try to make sense at their level.

So, after the semi loss to Novak, morale was at an all time low. Even the actual Tennis pundits had written him off. Did I write Roger off? No, but I'd be lying if I said I didn't doubt him. And I'll be honest - I'd rather have him go out while he's near the top than playing on to mediocre insignificance the way Hewitt has been. But there was one reason I couldn't get myself to throw in the towel. Roger hadn't.

Over the years, there've been many things said about Roger. It's usually the classy, steamrolling, majestic, elegant types. Fight is rarely one of them. But that was what I saw Roger doing. 2011 had been his weakest year on tour. Dropping out of the Top 3, a title drought stretching 10 months, losing some close matches. Still, he was optimistic in his interviews; he was playing with a goal in mind, it just hadn't worked out. Then, it all clicked into place. Not really. Roger fought and clawed his way back. He took a break for 2 months. recharged. Then fought back. He won Basel, which broke the drought. Then, played Paris for the first time in years. And won without dropping a set. The World Tour Finals was won, with a very important win over Tsonga in the final. Hard fought, proving he could hang in there when it mattered. Ending the year on a high helped, and Roger continued his form into 2012. Losses at the two Grand Slams notwithstanding, Roger won two ATP titles, including a first on clay in 3 years. Still, it wasn't enough for the boo-boys.

Which is why this Wimbledon was perfect. Because it wasn't. This wasn't a Roger, all-conquering, majesting, winning in first gear. This was Roger, fighting all the way through. The Benneteau match exemplified that. For all purposes, Roger should've been out. All that remained was the knock-out blow. No one told him that. The Malisse match confirmed it. And while the quarter and semi were exhibitions in grass court tennis, yesterday's final was more of the same. Clean it wasn't. Roger looked second best for a lot  of the first two sets. But, he fought again. Murray had chances a plenty. But Roger hung on, to cap a magnificent win.

Yes, writer from the Times, Roger changed his game. Engaged in slug fests. Charged the net more. But, don't you dare tell me what you saw yesterday wasn't brilliance. The drop from the baseline in the second set was one of the shots of the tourney. Only someone stupid as you would criticize him for not adapting, then continue to call him out for doing it.

Do I think this win will silence the haters? Not one bit. They'll still come up with gems like they did today. "The 1,7,17 is selfish. The absent Davis Cup means Roger plays only for himself", OR "The ATP ranking suck. Novak is the true No. 1. Now and for ever". Right now, I don't care. The Man's back at the top. Thanks a ton, Roger, for being in my corner. I'll be in yours forever.

Death, Be Not Proud!

I do apologize for what seem like persistent pessimistic rants; true, my obsession with Death and the dying does reach depressing extremes. It doesn't behoove me, to try and laugh it off; and saying that Death and Disease are all around, like a perverse version of the Wet Wet Wet song playing on repeat, has me coming across a lesser person than anything else. I can very well attribute my somber tone to the fact that I've now started my Oncology rotation, perhaps, also, to the book I just finished reading - "The Emperor of All Maladies" - Siddhartha Mukherjee's cancer biopic.

  It's hard to try and put into words just how significant a role cancer plays in our lives. To some, cancer might still be just a statistic. Whether it's 1.6 million new cases in the US of A alone, or whether it's the 3rd leading cause of death, it's to be taken as a statistic, and stored at the back of their brains, or discarded as yet another "somewhat interesting" but ultimately useless fact. But,to a lot more, Cancer is real. Ever present. Honestly, if I asked the few dozens who I hope read this, everyone would know someone - friend or relative, living with or having had cancer.


   But, I believe I'm sidetracking. What really got me thinking about the big D this time was an interaction with a patient. I had to tell someone that we had "done all we could". That I believe, is one of the most testing conversations a doctor will ever have, that about giving up. Testing for the patient, and the doctor. I can never say I understand how it must feel to be in the patient's shoes, because I can't; and I'd rather have a life where I'd never have to. How do you react when you're told there's not a lot to do? How do you react to a timer placed on your life - a premium on the time left? How do you, basically, come to terms with the fact that you will die. "Soon". Testing for the doctor, because you will never be sure how exactly to play it( pardon me for my choice of words). How do you go in, knowing that what you say matters, but not as much as how you say it. How do you get the person on the other side to understand, at the same time sparing him/her from what could prove to most disastrous now - false hope. And how, and this is hard for me, do you not get affected? A stray conversation I can understand, but when you're in a profession where this might be, unfortunately, a not too infrequent occurrence - how do you detach yourself emotionally and yet manage to come across as someone the patient can trust in?


       And I did go and have the conversation. My first. One that I'll always remember. I was with my attending, true. He did most of the talking, but I felt that this hit hard somewhere. It's so easy when you study stuff. 5 stages of Grief, they say. When you do have to practice it, the "shit gets real". There I was, getting overwhelmed, trying to hold back, constantly thinking that I could never imagine having to repeat this conversation for the rest of my life; and then feeling guilty that I was being petty about a conversation when the person in front of me was having his life's notice being served.
       It's funny the things you notice when you actually pay attention. I went in expecting to see a man defeated. Someone who would break down at the news. Overreact. Be inconsolable. (Maybe it's just the "naive movie fan" talking). The little things touched me. the wife squeezing his hand ever tighter as my attending discussed the prognosis. The daughter trying hard not to break down for her father. And the smiles got to me. You know the kinds you put on to show that you might be ok, while you're really falling to pieces. What struck me was the calm in the room. The feeling that the eventuality that had been put before them would be dealt with, just like anything else. The sense that, despite everything that was happening, the father tried to stay in control. And the fact that he thanked us. Thanked Us, the messengers. What I'll take away from this, is the fact that I met a man who refused to let something as big as the looming eventuality of Death change who he was, and how he'd behave. Someone who would accept. Someone who would face death on his own terms. Go out being himself.


       That to me is perhaps the take-home message for me from the number of people that I encountered at Yale, and Siddhartha Mukherjee's book. Yes, Cancer (and death) is a dark and often unforgiving adversary, but what matters is how you choose to face it. The book, to me, is not so much about the history of Cancer, as it is about the personal struggles of the men and women who faced up to it. The survivors who soldiered through, and those who didn't. But chose to accept it. Go out doing what they always did.People like Susan Sontag. And that is what it's about, isn't it? Why do we remain so afraid of Death? Is it the pain, is it the loss that'll be, or is just the fear of the dark all over again, afraid of what we don't know. Which brings me back to the doubts I had before. What do you do, when you're faced with such an eventuality? I know there isn't a right answer, but learning to accept it seems a brave choice. To me, it's most of the battle won. When you can't "win" over death in the traditional sense, not letting it change you is a victory. Being yourself is a victory. Acceptance is a victory. To me, that is the closest you get to "conquering" Death.

      As John Donne put it, " And Death shall be no more. Death, thou shalt die"