Bookends.

Why do you write?

***

I don’t have a handle on what’s happened here, though it’s completely under my control. The Rumors Were True began as a manifestation of envy. I’ve told this story before, but I used to write just to make my friends and family laugh. With some practice, I got to the point where I had a reputation for pulling it off. And as it has happened so many times when I find myself becoming successful with something originally challenging, I bore of it and stop. So it was with writing for a laugh.

I needed a new challenge.

Two years ago, I found PURRTY GUD and I was blown away by his writing. I thought, “here’s a guy that is just better than me. Usually with some work, I can match people at things like this but not him and not now. He’s just better.” I knew I was forever less, so it was a perfect place to begin. And fueled by my feeling that I would never measure up and my jealousy for this talent, I began RWT.

In the beginning, it was very stupid. It was very distant. I’m not sure that someone who started reading at that point would have ever gotten a picture of who I was, other than somewhat snarky and in love with my own diction (you can laugh at that). But slowly I started to write things that were a little more naked and personal, and it was from these things that I received the strongest responses. Soon, the goal of every week was to write something good enough to be included in Grand Rounds and I chased that for months.

At this point, I wanted to be famous. I fell into the trap of obsessing over my statistics. How many people read my last story? Where were they from? How long did they stay? Who thinks my story is good enough that they’re telling people to read it? And so on. Finally, I reached a point where 100 people were coming to read every day and I was very proud. I wrote to a friend of mine, “In one year, 1000 people will come to read me every day.” This is what passed for my goals.

Beginning in August of 2006, I was intoxicated with medical school and the Welcome to Grenada project. I was writing about my love of Anatomy, my research, my introduction to clinical medicine on the islands, and about the islands themselves. Writing the WTG guide began to take over the RWT, and I split it into its own blog with its own management, but already the character of my writing was changing again.

I began writing about what I was thinking. I began reacting to things instead of planning every word. I started writing about Flash Raves, MicroCredit, and I struck a chord with my reaction, “A Lazy Attack on Atheism.” What I wrote was becoming less and less about medicine and more and more about me. It was because I was becoming more comfortable with the thought that strangers could know my secrets and that would be “okay”. It was also because I was running out of ideas, grasping at straws. I thought often about ending RWT.

I tried to suck some water from the well by writing Pancakes Every Morning. I hosted Grand Rounds because I was hungry for some new kind of challenge. Immediately after, I gave everything I had left to The Old Man, which I consider to be the best thing that I have ever written and the only thing I ever did outside of my comfort zone. And after that, I felt done.

I twitted away the next month writing pieces I didn’t care about. I started researching the business and law behind the practice of medicine because it was interesting and I was ignorant. But I was empty. I had nothing left worth writing and I had stopped finding joy in it.

RWT should have died long ago save for the USMLE. I found in writing about that experience a steady supply of “new” and a comfort zone of writing guides for others. Telling someone what to do is an easier thing than writing to evoke a feeling. I was jumping over the lower bar.

And then I found a reason to write again.

I became so engulfed in the material while preparing that I began to see deeper into it than I had before, and I was able to spot conflicts and connections as easily as you would spot marinara on a pressed white shirt. It became clear to me. I discovered this while using the First Aid for the USMLE book, and when I went to find a website that listed its errors, I found not a single one.

And I complained about there not being a source. I have written before about my own guiding principle: The Categorical Imperative. In this case (as in all cases), complaining required action: since I wished someone had already made a list of errors, I could not complain about it unless I was willing to make the thing that I felt was missing. This became my reason for writing: to compile a perfect and complete list of errors. To scour the book as few others had ever done and, in doing so, to know more about everything.

Before I knew it, RWT was no longer a place for my writing: it was a one-stop-shop for USMLE adivce, textbook corrections, and so on. This was more interesting to more people than my stories ever were and I quickly reached an average of 1000 visitors a day. The success was discouraging, and insomuch as my statistics were a progress report, I felt that connection had been completely lost.

And as it has happened so many times when I find myself becoming successful with something originally challenging, I bore of it and stop. So it was with writing about medicine.

Perhaps I set the bar too low or that I chose the wrong metric for success. Whatever the case, it couldn’t have happened at a worse time as I left for Asia and from writing for the next six weeks. Long distance for any weak relationship delivers the final blow. I felt done with writing. In the weeks after returning, my only reason for coming back here was to update and maintain the USMLE portion of this site. Whatever drove me before was gone.

And now as I begin the second half of my medical school career, I find I need something from this space, from whomever has stuck around this long to see if I have anything left to say, that I cannot get. RWT feels ruined by its success. From the First Aid Errors project, I earned the attention and interest of the First Aid Team. Shortly, I will begin working for them. This is fantastic news that I have not been able to share with you until now.

At the same time, I am applying for transfer to US medical schools, and the successes of the Welcome to Grenada Guide and the FA Errors have become selling points on my application. This has made RWT public (as it always was) and has stripped me of any illusions of anonymity. I have never been as diligent about keeping myself anonymous as I could or should have been, but its loss has never been so obvious to me as it is now. At a time where I need this space to be a place for me to be my most honest, where I need the catharisis of venting and a chance to share my frustrations with feeling uncertain about my future and my fears that medicine has facets of it that I feel strongly against, RWT has begun to feel as much a liability as an asset.

I feel watched. I feel known in an uncomfortable way. I feel twisted into self-censure.

I cannot write the way that I need to on RWT anymore. It no longer feels like my journal and a safe for my memories. Now, it feels like a bulletin board of updates and other stale things. I could continue to write here about happy things, about funny things, about critiquing things but I cannot write about sad things, frustrating things, about hating things. I am not Ying or Yang, but the pair, and I worry that this simple thing that is true about all of us could hurt me to show it. I worry about a dishonest portrayal of what life is like.

And now I think it is time for RWT to end. Not deleted (because people still find use in it), or forgotten (it remains the safe for everything that happened to me early on in this new life) or regretted (I learned so much about myself while writing it).

It will end because I was sloppy and couldn’t keep it from mixing with the reasons not to write.

***

Why do you write?

I write to think.
I write to remember.
I write to help others.
I write to stretch and twist and understand new ways of seeing the world.
I write to help people understand me, if for no other reason than to feel understood. To connect.
I write to make you a part of my life so that mine feels larger.
I write for vanity.
I write for the freedom of anonymity.
I write because I need to feel whole and this gets me there.

***

I look back to PURRTY GUD now and I better understand him. He was anonymous to the world as he wrote but his family and friends were all reading. He wrote about it ruining things, about feeling like it was bringing more harm to him than good. When he graduated, he decided to end the blog and start a new one for his residency. It was then that he revealed his name. It wasn’t a few weeks before it completely disappeared. He gave out his email address for those that wanted to know if he was ever writing again and if they could follow him to this new anonymous place.

He hasn’t. I think I get it now.

Grapes and Wine

You start with seeds and their finite potential. You are going to make something great with this field and these seeds. You plant them, water them, love and dote on them. They are nurtured and they sweeten in the sun. And then, when they cannot grow this way any more, you pluck the best.

You take these grapes, throw them into a barrel, and ignore them. You don’t give them sun, activity, or anything familiar. It’s quite a shock to the grapes. You do this for years. And years.

Out pops wine.

Pretty inefficient, but I don’t know how I would fix it. I don’t know that trying to speed it up won’t make for something unpalatable. I guess I just have to deal with the ignoring and waiting until those grapes magically turn themselves into something more.

Pretty much what the third year of medical school has felt like. I haven’t written about it.

Before, my shtick was looking around and sort of cataloging all the interesting things that were happening around me. Not a lot of introspection going on. Nothing to write about inside the barrel that is my hospital. Or there is, but that’s not the story.

The story is the fermenting. My classmates and I are taking on new flavors and textures. A few might be prematurely alcoholic. Others have lost their sweetness. Most rougher for the wear and rarely anyone smoother.

And it is incredible.

I put up a hell of a fight. A nine month spectacle of twisting, thrashing and spitting. On March 5th, 2008, I broke. Emotionally. Mentally. Broke. It was awful. I haven’t written about it because I’m unsure on these new, wobbly legs.

But for the first time I know what language is supposed to do. I know how people reward their physicians. I understand patience. I have experienced the risks and rewards of vulnerability. What is and is not important has been impossibly rearranged in my head. When I look at the decisions I am making now, I don’t recognize them as coming from my past. All of it seems to come from very different stuff.

But then you never could have told me, after I rolled one around in my mouth, that grapes could give way to wine.

Pancakes Every Day Video

A little over a year ago, I was behind in my work and trying to catch up. Procrastinating, I wrote a short blurb about how going to medical school is like having to eat a stack of pancakes every morning. Some people thought it was funny. About 10 months later, a good friend of mine at Saint Louis University Medical School called me up to ask if he could use the concept for a 72-hour film competition. Of course, I said yes.

So he and his friends expanded it, added new portions, and really transformed it into something better than it was before. They pulled off the 7-minute feat in 72 hours, submitted it, and then on the night of the festival came home with FIRST PLACE!

Finally, it’s up on YouTube.   Merry Christmas, everyone!

Med School Metaphor: Pancakes Every Morning (orginal story)

Pancakes Every Day (prize-winning short film)

Anymore

Anymore, it’s hard to write.

It’s been hard to write for months. A lot of that was masked by my time in Asia, but really I didn’t want to write while I was there either. It’s strange to be surprised by yourself over something like this. I have always felt that writing was something that I had to do, but this isn’t the case.

I don’t have to write.

I’ve been thinking about everything that changed. So much of my writing before was driven. No one to have met me these last two years could help but concede that I was driven. Driven by fear of failure, by a desire to prove all the invisible people that thought I was less for being from the Caribbean that they were wrong, driven by competition with my classmates, driven to surprise everyone.

I’ve always taken a great deal of pleasure and satisfaction from RWT. The success of this space (as such a thing can be measured by the hit counter or your thoughtful comments) was always a source of pride. It’s nice to have an audience, especially when you’re convinced that you’re being ignored or dismissed. I’m not claiming that any of this was reasonable, but it was all felt just the same. But this space took a sharp turn in my mind in June and that change was really alarming. It’s part of why I’m stopping, but not the whole of it.

I saw RWT as a liability. I had never been as careful as I should have been with my anonymity, and several people have figured me out (especially those from my new Drexel class). I made it pretty easy, and this was foolish. RWT used to be a place where I pretended to be a writer. I tried to be funny, or shallow, or helpful, but recently I’ve needed this to be a space to vent and be laid bare. As I met with the hospitals in New York, I became incredibly disoriented and upset and I needed a place to scream at the top of my keys.

And then I thought of the people reading this. I thought about the admissions committees of different schools coming to this place and finding a student with light and dark sides, and I imagined them seeing this and rushing to judgment. We all, I think, would prefer to imagine each other as shiny happy shells and to show the rest is to risk the rest. As the days fell from the calendar without word from any of the schools to which I applied, I become more and more convinced that this was happening. True or imagined, the risk was real and I had previously ignored it.

I was stupid to do this.

And yes, I had the stupid argument with myself about “censorship” vs “honesty.” As regulars know, I deleted everything on this blog that was negative. Old posts, new posts, anything that could be seen as criticizing the medical establishment. I decided that transferring was more important to me than all the rest. After all of it, I was still being driven.

So my goal of transferring and keeping best faces forward (I’m a Janus, after all) meant that RWT was becoming less a journal and more a resume. Keeping something that sterile (at least for me) means writing very little worth reading. All of this worry was immediately followed with fantastic news. My worst fears were not realized; I was accepted into Drexel.

What happens to someone that gets what they want? For me, things fall apart. I don’t feel like celebrating (and didn’t when I was accepted). I was happy for the news and shared it with everyone that had been working on an ulcer with me (parents, mostly) but these things are never the way they play on television. The celebration is in the act, not the aftermath. Executing the interview successfully was a celebration. Submitting my application materials and coordinating my recommendations was a celebration. Studying for the USMLE and sitting for the exam was the celebration; the score was just the memento.

RWT has been my celebration of these last two years in the Caribbean and what I went through to get into a US medical school. I’ve gotten my wish and as a result I’m being redefined. My previous hurdles were my previous identity, and anymore I don’t feel like myself. Now I’m just a US medical student about to enter third year and there’s this huge part of me that wants to quit everything and just focus on being a great student. No more research, no more writing, no more side projects and whatnot. I want to lose myself and have a simpler life.

It won’t hold. I’ll find new challenges, find new roles and projects. Soon enough, I’ll have this new identity driven by new hurdles and I’ll want to write again. But if I start again, there’s no sense in repeating old mistakes. Choosing to continue RWT would be the first such mistake. The stakes are only going to get bigger and they drag the risk along with them.

I’ve also become complacent. Originally, I wanted to write and I’ve fallen incredibly short of this. I’ve done a good job of setting the levels academically and straining to clear them, and in this way I’ve accomplished more than I really thought I could have. But in writing, I’m so often running on autopilot. I can think of only one time where I ever challenged myself, and that was with The Old Man. I still think it’s the best thing I’ve ever written, and it kills me that it sits alone in my “creative writing” file. If I plan on chasing the dream of writing something worth reading some day, I’ve got to become unstuck from easy ruts.

Loss of anonymity, loss of drive, a sense that it’s time to start over and to break some bad habits. These are my reasons for ending this chapter in my life.

Finishing the Guide to Transferring and telling you a little bit about Asia are going to be my encores.  It should be good, so stick around.

Thanks for celebrating this with me, topher.

Things to do this week

Things to do this week.

1. Write about the transfer process
2. Write four stories from my trip to Asia (with pictures)
3. Attend orientation at Drexel University and meet my new classmates
4. Explain to everyone why I am going to stop writing here at the Rumors Were True
5. Pack my bags, move to Pittsburgh, and start a new life.

It’s going to be a busy week.

Embarrassment of Riches

Short version: many good things have happened.

Long version:

I took two months to study for the USMLE Step 1, a test that covers the first two years of medical school, and while in Cambodia on my 6 week tour of Southeast Asia, I found out that I scored a 240/99 (the goal I set for myself). While studying for this test, I began editing a review book (First Aid for the USMLE) just for fun and submitting my corrections and suggestions to the authors. They contacted me and asked for my CV, and now I am working for them and credited as an author on the 2008 Edition of the book. During this time, I applied for transfer to several medical schools in the US. Drexel University in Philadelphia invited me for an interview. What follows is the story of that interview and the outcome.

***

Forgive the writing style. For the last week, I’ve been reading The Remains of the Day which is narrated by a proper English butler.

Last Wednesday, Friday, this past Monday and this Wednesday, Drexel invited people to interview for positions in the 2nd and 3rd year. There are 5 spots available for 3rd year and 16 interviewees. There are 4 spots available for 2nd year and 21 interviewees. Of those interviewing for 3rd year, I know six very well. I chose to interview on the last possible day so that 1) I would be remembered best, 2) I would be compared to no one else on my interview day, and 3) to learn as much as I could from people that had gone earlier in the week. This worked out well.

With my little attache case filled with my updated resume, research papers, Welcome to Grenada guide, and a few other things I took the train from NY to Philly, slept the night at a Bed and Breakfast, and headed to the interview. There were eight other students interviewing this day (all for second year). I was the last to arrive before 9am and took the head of the table. I introduced myself to the room, memorized everyone’s name and school, and started the room talking (they were staring at each other when I showed up). I am now always aware that I am being evaluated from the moment I walk in the door and that certain things (like command of a room, ease with strangers) are things that are always on display. Having done this so many times in Asia, I was very comfortable.

My interview went well. I was interviewed by a woman with whom I had spoken once previously on the phone. I had heard from other students that they only had 30 minutes to interview and that it was hard to get their message across in that time. I was aware of this as I shook her hand and sat down.

She then stared at me for four seconds.

“I have some presents for you,” I offered, at which point I opened up my little case and pulled out my updated documents. “This is my updated CV, and I’m very excited about the newest edition. I can’t wait to tell you about it.”

“Ok, then tell me.” I then told her the story of the First Aid Errors, how the job was offered to me, and that I was now a Contractor for Dr. Tao Le to manage the online site for the books. I was glad to have this out in the open early. She then began to ask me pointed questions and the tone of the interview was serious. I got the strong impression that she wanted to flush out people that didn’t know what they were doing with their life as she asked, “Why Drexel? Why Medicine? When did you decide Medicine? What will you be doing in five years? What sort of projects will you do if you come here? Explain to me exactly how your research was conducted.” And so on.

Oh, and my favorite: Why not become a writer?

I did my best to maintain eye contact, avoid looking away, and to sit with back straight and forward from the chair towards her. I have read that this makes you appear more interested and interesting. At every opportunity, I would answer in such a way as to lead the next question and in this way I was able to talk enthusiastically about things for which I had real enthusiasm. This made it easy to smile and hold her attention in a way that drew a smile from her.

And with that, she asked if I had any questions. The night before, I had prepared six questions that sounded specific but were in fact broad and I figured this would cover me, but I ended up not using them. Instead, I asked about very practical things like, “Do Drexel students take advantage of international rotations?” I knew the answer to this, but asked anyway to bring up the fact that I understand the importance of being bilingual and have plans to do a rotation in Ecuador (with Aunt Lucy and Uncle Fred) and that I have already traveled and have stories to tell you that will kill some time and make you think that I am well-rounded and interesting.

I told her about Laos and how much I loved the people. I told her about filthy, filthy Cambodia and the Killing Fields. I told her about the motorcycle trip in Vietnam with Kelly’s heroics, our first stitches, and the pictures that I’d show her if only she’d accept me. The interview ended with her telling me that they would decide later that day (or possibly on Thursday) who would be accepted and that I would know either Thursday or Friday.

So the interview was split very much in two and while I handled myself as well as I could have in the first half, I think we both enjoyed the second half much more. After this, my day was over. I then went down to the bookstore, bought Drexel stationary, and wrote her the following letter.

Dear Mrs. XXX,

As a writer, I depend on stories. There is something extra and hidden between the lines of a good story that would be harder to see if stated simply. You can imagine a much more interesting version of “he went to medical school,” for example. As an applicant, I notice when others have higher scores and I worry that someone might not see my stories tucked between my A’s and B’s. I wanted to thank you for inviting me to interview; it was my chance to show you some of the extra and hidden parts of my life that otherwise might have been missed on paper.

For Drexel, I hope to become a great story.

Sincerely, Me.

I would have mailed it, but as I said, the decision was being made later that day. I left the envelope with her secretary and caught the train back.

***

After working on an ulcer all day Thursday, I was called at 6:00pm. Drexel offered me a spot in their 2009 class and I took it immediately. This weekend, I fly to Las Vegas to give a speech at an Anatomy Research Congress and to share the good news with my mentors there. I’ll be giving the speech, then flying back to New York to pack up my life in Brooklyn and move to Philly.

What a ride.

Thank you, everyone, for taking an interest in my stories over the past two years. The encouragement to continue writing is what opened up so many of the doors that I ended up walking through in medical school. I never could have guessed that they would have taken me here, and I wanted to celebrate this awesome thing with all of you.

Thank you so much,

Topher.
Drexel University Class of 2009.