Yesterday, today, tomorrow

Last night I was sitting on the creaky wood floor in the bedroom of my new apartment in Minneapolis, slowly screwing my new IKEA bed together, piece by "medium brown"-finished piece. I had dug my stereo - the one I got for my 16th birthday - out of the cat carrier box I had packed it in to make the epic two-day drive across the country from Portland. I sat there on the floor, screwdriver in hand, beer at my side, listening to my new local radio station as a thunderstorm raged outside. For the first time in years I basked in that electric ethereal glow of an early evening thunderstorm and thought, "this is where I am going to live." And I felt pretty good about it.

Until I realized that I was missing the central "midbeam" for my new medium brown Malm bed frame, which was apparently not included in the 3 different boxes that contained the other parts of the bedframe, nor was it indicated on these boxes that another crucial - nay, indispensible - part of the bedframe was also required. This necesitated a very long and annoying trip to IKEA in the midst of an early evening thunderstorm, which, needless to say, killed my moment.

But the whole experience allowed me to utter the phrase, "I am really sore from the hours of screwing I did last night." I figure that makes it all worthwhile.

That was yesterday. Yesterday I was in Minnesota moving boxes up three flights of back stairs, purchasing an awesome red formica and chrome table and chair set, wrestling with the construction of my first actual new bed ever(!), and then, steeped in dried sweat, drinking microbrews with some old and new friends.

And then there's today. Today I am in Los Angeles. I am sitting in a coffee shop where I am supposed to be studying for my boards. Which brings me to tomorrow.

Tomorrow I am scheduled to take the Clinical Skills portion of the United States Medical Licensing Exam, Step 2. I am in LA instead of sitting in front of a computer screen at a prometric testing in portland because this exam is only given in a few testing centers in the country, and this was the closest (and the one in a city that I had friends to visit). The Clinical Skills exam is a "hands-on exam that tests the examinee's clinical communication skills through his or her ability to gather information from standardized patients, perform a physical examination, communicate the findings to the patient, and write a student note." In other words I will spend 8 hours tomorrow interviewing and performing physical exams on patient actors who are highly trained not only to portray specific medical conditions, but then to judge me on my every move. My every move will also be videotaped for review by a professional physician judge at a later date.

And since I graduate from medical school in literally 5 days, I sure hope I pass.

Being tested on your interactions with "standardized patients" brings up all sorts of interesting issues. Simple things like greeting a person become part of a complicated assessment of your professionalism, emapthy, and cultural sensitivity.

For example, according to the study guide book that I have been occasionally looking at:
- "Remain consistently aware of words you are using during this and all phases of the interview; it is often disquieting to patients if physicians use too informal or personal statements, e.g., "How are you?" or "I am pleased to meet you."
- "If a patient offers to shake your hand, returning the gesture is often appropriate. For cultural reaasons, it is better to not offer the handshake because not all patients are comfortable with this form of greeting."

Or how about this:
- " If the patient becomes teary... gently gaze at the patient with a compassionate expression in your eyes. It is permissible to convey supportiveness by resting your hand for one second gently on the patient's shoulder or upper arm (not the leg or hand, and do not pat)."

One mississippi... and release. Empathy officially given and recieved. Check.

This whole testing process is so interesting. Obviously there are certain qualities that everyone looks for in their doctor - but these qualities are very hard to test for in a standardized manner. But the USMLE is giving it a go.

It is safe to say that this is a very unique time in my life. And by unique I do mean stressful and crazy and emotionally, mentally, and physically demanding in a total-life-upheaval kind of way. But its also a pretty amazing and important and exciting transition in my life, when I stop to think about it.

Things accomplished in past two months:
- finished last class in medical school
- went to australia
- managed to return from australia without crashing onto a deserted jungle island
- purchased car for first time ever- enormous white 1993 toyota camry wagon, aka "Gigantor."
- packed new car full of belongings and drove it to minnesota (aided by little bro and the admiral)
- reunited with family and friends
- looked for and found apartment in new home town of minneapolis
- looked for and found local co-op, dive bar, coffee shop/art house, ice cream shop, thrift store, and hippy organic juice bar and herbal tea emporium
- purchased new couch at aforementioned thrift store and lugged it up three flights of stairs (aided so graciously by mom and bud)
- purchased incredible table and chair set and assembled bed
- studied on the flight from minneapolis to LA

Things to accomplish in next week:
- take and pass USMLE Step 2 CK exam
- finish program for AOA induction ceremony
- write graduation speech (I really really need to get on this one)
- plan graduation party
- graduate from medical school
- pack up remaineder of random stuff strewn about half-empty apartment
- say goodbye to everyone that I know and love in portland
- try not to sob too hard on the plane back to minneapolis

Sounds do-able, right?