As promised, more background

So if you've read my first two posts, you know that a) I'm an ER resident and b) I wasn't supposed to be a doctor in the first place.

As promised, here's more of the story of how I got here.

I quit grad school four weeks into it (a true Gemini, fickle to the end) and moved back to Chicago. After working with asshole litigators who were turning me into an asshole but telling me not to be an asshole, I decided to try and figure out a career that would keep me from being an asshole (medicine is certainly not that career path, but that's a whole other story). Really, it's just not in my nature to be a jerk (most of the time).

The truth is, I'd probably love law school; I'd just hate life afterwards.

Anyways, three things happened as the planets aligned that made me think very seriously about medicine as a career:

1) I kind of dicked over a dead kid. And his family.

Before you level your judgment, let me explain. I'm not going straight to hell, I'm at least going to spend some time in limbo probably for this. I was just a cog in the legal machine at the time (that's my defense and I'm sticking to it). You see, I was spending countless days and hours helping to work defense on a case in which unnamed plaintiffs were suing an unnamed corporate pharmaceutical monolith for knowingly allowing tainted blood products to be used for transfusions on hemophiliac children. A class action suit ensued, and I worked with lawyers well into the evenings to explore ways to get out of this one. And we did -- on a technicality. I won't bore you with the details (read: I can't divulge, I still fear retribution), but the court tossed it out. Completely. Scot-free. OJ-Simpsonesque, if you will. "If you didn't file your complaint in time, it ain't a crime." (I never really said anything stupidly brazen that appealed to the least common denominator like that; and I haven't forgotten that Johnny Cochrane died of a brain tumor.) Dozens of families and parents were emotionally stunned. So was I -- I really was not expecting that outcome.

About two weeks later, I received a handwritten letter. It wasn't addressed to me specifically at this firm, but on some level it was. One of the fathers of one of the children who died from AIDS-related complications from tainted blood said this:

"You bastards. I got nothing. Nothing but a dead 12-year old kid. Me and my wife don't even have enough money now to give him a proper burial. He's in a goddamn wooden box without a tombstone."

Ouch. Re-read that letter and really let it sink in.

Call me a wuss (I am), call me gay (I am), call me soft (I am), but what can I say? I cried. I am the crying type. I cry from watching Little House on the Prarie re-runs (except when Nellie Olsen gets her due). I can't watch Animal Cops because I cry when I see abused dogs. This really was a watershed moment for me. I'm not a terribly good person, but I don't think I'm all that bad either. One of my close lawyer friends with whom I was working on that case wrote one of my reccommendation letters for med school. And partially based on this case, she said, "I think Brian would be a great lawyer, but I can tell you without hesitation that it requires a certain ability to be at times distant and cold, to remove all emotions from a situation for a long time and potentially psychically damage others. And I just don't think Brian has that in him."


2) My attempt at karmic re-adjustment.

This is the second of three sequential events that led me to medicine.

A few months after closing up that case (I asked not to be involved in the appeal), I found myself with an inordinate amount of free time. I worked till 6pm and had most weekends free. After having wasted enough of those evenings and weekends in bars, I decided to give back a little and volunteer.

It will probably come as no surprise to you that I ended up volunteering at an AIDS hospice.

There is a place in Chicago I learned about that gives housing and food to people with end-stage AIDS. Most of the residents there had long been disavowed and disowned by their families and most friends. Through bad luck or bad attemps at maintaining proper medication schedules, they had developed resistance to the current life-saving regimens of anti-HIV drugs that make HIV almost a manageable chronic condition. So they went to this agency to live and die with dignity.

My role as volunteer there was to assist in preparing meals and generally keeping them company. I could play Texas Hold 'Em with the best of 'em, but as far as the cooking, well, let's just say the volunteer coordinator decided to place less of an emphasis on that role for me. (I was restricted to bringing bowls of cereal with milk on the side.).

And I loved it. I liked working with the patients, I liked listening to their stories, and in turn, they enjoyed my presence. And yes, I did like the way it made me feel.

One thing bothered me very much, however; it was that I did not understand their disease. The concepts of T-cells and protease inhibitors, immunosuppression, and even the basics of cell-regulated immunity and compromise were completely lost on me. I was fascinated by the science behind the disease and wanted to learn as much as I could about it. I was, after all, a total science nerd in high school (and I mean real nerd: braces, headgear, thick glasses, slacks-not-denim) before I became a humanities nut in college.

Then the third thing happened:


3) I ran into my old friend Jane.

Jane was a senior in college when I was a freshman. She was an English major who was going into publishing, and we met -- actually I don't exactly remember where or when -- some random function in college. Jane was a quirky gal with a deadpan sense of humor and a funky fashion flair -- in short, your typical faghag. Like two brown dwarfs (the stars, that is), we gravitated towards one another and began orbiting. Actually, we weren't able to spend THAT much time together since it was the end of the school year, and soon she graduated and we lost touch.

Several years later, I ran into Jane on the streets of Chicago (actually knowing her, I think it was a gay bar), and we caught up.

"What are you doing these days, Jane?" I queried. "Editing Vogue yet?"

"Not really," she said. "I'd still do that, yes, but I'm in the people business right now."

"Doing what?"

"Medical school."

"Huh?" I truly had lost touch with her. "I thought you were an English major. I never had you pegged as one of those hypercompetitive premeds."

"I wasn't," she said. "I did a post-baccalaureate premed program."

I had no idea such a thing existed. After a long conversation, I found out one only needed four classes to get into med school: biology, chemistry, physics and organic chemistry. I thought long and hard about this one, believe me. Here were my options at the time (actually these aren't so unique, you'll discover most of you have similar options):

a) continue working in a dead-end job and live paycheck to paycheck;
b) go to law school (three years and you make a pretty good buck)
c) go to business school (TWO years and you make a pretty good buck)
d) do a post-bacc pre-med program in two years at night, use your weekends to do required laboratory work for those classes, then four years of med school, then several more years in residency, then begin to make a pretty good buck that tends to decrease in linear fashion with more federal, state and private regulations.

Guess which one I chose?

Even though we're all taught to pick "C" when faced with an unknown, I decided after a lot of thinking (really, a lot of it) to try the med school thing. When I told my parents about this plan, I think they finally forgave me for dropping out of Yale. "Can you do THIS for more than four weeks?" they asked. An understandable question on their part.

So in two backbreaking years that required me to give up nights and weekends (most of them) previously devoted to alcohol, I immersed myself in those Big Four Classes. I endured the wandering eyes and competitive spirit (actually it was a crushing spirit) of competitive pre-meds, only this time it was during night classes when claws could be more easily bared under the cover of darkness. And who was I kidding? The only science class I took in undergrad was Highlights of Astronomy, and that was my worst grade in all four years.

I know -- this is exactly what you want to hear from your doctor, right?

Once a nerd, however, always a nerd. Science came back quite easily to me (maybe because I'm half-Asian?) and all was fine. The premed coursework is just something you have to get through -- I didn't like chemistry, I didn't like biology even, and I certainly didn't like physics. In fact, the only physics I currently have to know is the principle of gravity -- when someone ingests poison, you force charcoal in them, flip them over, back again and stand out of the way when they hurl black goo in projectile fashion. Organic chemistry, however, was something I totally got into -- weird, I know. But it was like a beautiful symphony -- you just figure out where the electrons go and everything else in the reaction falls into place. That's the only premed class that made sense to me.

When all was said and done, I got into a few med schools and decided to attend The University of Chicago.