Conventional Wisdom from Hot Urologist: More Than a Board Score

Months and months ago, I walked into the same Starbucks on City Avenue at 6:15, just prior to giving a pap smear for the first time to a volunteer patient (true story, god bless that women's soul, amongst other things).  It would be the day I first encountered unnaturally hot, super thick-blonde-haired urologist from Einstein.  I didn't know his name (now I do), but we talked for a moment. He was in his fifth year of urology residency, something I learned later was a polite way of saying "chief resident" without shoving it in your face, like when people say they "go to college in Boston" but we both know what that means.
H.U.: "Are you a third year?"
VW: sheepishly (<<<----not entirely sheepishly, I just like the opportunity to use that word), "uh, I will be if I make it through this year."  Two can play at this 'guess my actual position on the medicine totem pole' game.   Actually mine was pretty obvious.  The short coat always gives it away, and I'm pretty sure I need to pack on 10 lbs and lose the makeup before I start to look like a resident.
H.U.: "Second year's rough. Boards.  It gets way better though; everyone tells you that and it doesn't really mean anything but you'll see."
VW: "Cool, I'll hold you to that when I come work for you."  wtf?  God VERONICA YOU ARE SO CREEPY RELAX.


Fast forward half a year, and hot urologist was right, after boards it DID get a lot easier. In a way not unlike the Kubler-Ross model of grief, I went through five stages, give or take.

1. Denial:  I don't buy it.  There's no way an 8.5 hour exam can be all about endocrine and Calcium.  There's no way.  They have to have been secretly asking about chronic myelogenous leukemia or polycythemia vera.  They wouldn't make an all endocrine test.  That's crazy.  No.

2. Anger: WHO MAKES A USMLE ENTIRELY DEDICATED TO ENDOCRINE.  WHY DID I EVEN STUDY ANYTHING ABOUT VAGINAL BLEEDING. HELLO, WHERE WAS ALL THE MICRO?  DO WE JUST NOT CARE ABOUT STAPH NOW?  YEA, EVERYONE, JUST SO YOU KNOW WE DON'T GIVE A RATS BEHIND ABOUT ANYTHING REMOTELY APPLICABLE TO MODERN DAY MEDICINE, OK. This is the worst.  I hate everything.

3. Bargaining: "Hey God, it's me, Veronica again.  I swear, I will literally join the convent and dedicate my life to you if you somehow make the Prometric testing center explode without human casualty during this exam and accidentally rig the system to give me >240."

4. Depression:  so little sleeping, so much ice cream, lots of nervous "hope I'm a doctor, hopefully, ha ha" jokes.

5. Acceptance:
Anyone else: "How was USMLE/COMLEX?"
Me: "Awful, I wanted to die.  Nothing you prepare for is on there. But in general pretty okay!"

I digress.  So here I am, post-boards, pre-score, but emphatically, post-boards, waiting for my latte that is probably the reason I have a hard time budgeting my student loans, and through the doors saunters in Mr. Hot Urologist Long Coat. But before the costume even gives it away, I think, God, that guy looks familiar, and I go through the mental forensic profiling match I keep in my head.
1) That guy is from Tinder.  NO. (It was a dark time when I became newly single). We don't like Tinder.
2) That guy is Hot Urologist.
3) Dude, Hot Urologist is on Tinder.  Yikes.

I'm sure he sees this moving montage/algorithm on my face as clear as day, so I take my thoughts elsewhere.  I read creepy like white on rice. Anything, think of anything.  Uh, puppies.  Campylobacter. Trisomy 18.  Scrubs Season 5 and how disappointing it was.  Laundry I didn't put in the dryer.  What am I going to eat in 6 hours----

H.U.: "Today's my last day of residency."
VW: "Exciting!  Good for you."  It worked. He's not on to you.
H.U.: "Second year, right?"
VW: "Actually, third year.  I made it out alive.  Well, [cue the self-deprecating defensive humor], I guess it depends.  I just took my boards."
H.U.: "Awesome, they're no joke.  What do you want to do?"
VW: "I guess it depends on my score."

And as you might have guessed it, the crux of the moral is manifest here.
Hot urologist vigorously shakes his head; I can tell he's bordering upon a "tsk, tsk" and finger-wagging.
"I didn't ask what you got, that doesn't matter.  What do you WANT to do?"

And before I begin my diatribe to explain that, yes, in fact, I believe my score dictates a lot of what I can and can't do, I also give myself some pause.  A lot of what I "can" or, perhaps better put, am academically qualified to do is premised upon a score.  But Hot Urologist is right, it's not the only thing, and while it's the most standardized way, it isn't the only way.  So I answer him truthfully.

"I want to do Internal Medicine.  I like adult medicine.  I like a little bit of continuity of care, but I'm afraid I might not see as...'ill' as I'd like with just Family, although I considered that too.  Honestly, gun to my head and I had to decide today, I want to be a hospitalist. It's my dream.  It's what I want."

H.U.: "You poor bastard, you'll be worked to the bone until you die/retire.  Good for you.  It's not just your scores, don't let anyone tell you that.  I'm telling you that.  Good luck."

And part of me hopes he's truly right.  Not just because his frankness makes hot urologist even more mysteriously attractive, and not just because I feel it's a fallback excuse for substandard performance, should I not get my target score (read: passing.  In case you haven't noticed over the past two years, a lot of my targets tend to gravitate towards making sure I don't fail).  Mainly, I hope he's right because, in much the same fashion I deliberately chose to apply to and attend as Osteopathic College of Medicine, one that preaches and practices looking at the "whole" patient instead of just pigeon-holing their problems into symptomology (made that word up, don't try to google it) and differential diagnoses, I wanted to be looked at wholly, and thoroughly, and completely too.  I want to be seen as competent, which hopefully is substantiated by my boards, but irrespective of those, I want my future attendings and residency programs to see me as Dr. Williams, the resident who is so bothered by not knowing the why  of your presentation that I'll let my OCD take me to the depths of Harrison's at home and I'll look it up until I can teach you all about acute appendicitis.  I want them to know I am a trained painter who loves portraits, because of the attention to detail that is required, and because I genuinely feel art and it's application on a painted canvas is a way of telling a story about someone, and I am so interested in everyone's story.  I want them to know I run miles and miles not because I ever give two hoots about my weight, but because I do all of my thinking and problem sorting when I run, and I believes humans were meant to move.  And most importantly, I want them to know that, although medicine was a dream realized a little later than most of my peers, I still, every day, want to be doing it.  I want them to know that I would sleep in a car 5 summers over and over again.  I would remediate physics, again, for the third time, to be here. I would overdraft my account by 20 dollars and cry into the Washington Mutual phone again and again and beg for a fee waiver just to pay for another AACOMAS application. I would fail Dermatology in medical school again, study for 1 week straight while everyone was already on spring break, and never have a sense of bitterness about it, just because it meant I could keep going, and now, I know Derm like nobody's business.

That, hot urologist, is what I want you, and all attendings just like you, to know.  I hope you're right, but really, I hope you don't even need to be.