Ding Dong! The Wicked Witch is Dead!

"Ding dong! The Wicked Witch is dead!"

I sang these lyrics on April 21, 2011 in the afternoon, after my last day with OR responsibilities. The Surgery Wicked Witch was dead!

And I found myself continuing to sing these lyrics into the next day, the last day official day of Surgery and of third year, both happening to be my on 28th birthday. (Happy Birthday to me!)

"She's gone where goblins go, below-below-below. Yo-ho, let's open up and sing and ring the bells out."

I sang these lyrics in my mind as I continued to celebrate all good things happening on Friday, during lunch with friends, during a walk in the park around the MFA, while sitting on the lawn of the Quad at HMS greeting fellow classmates, "Congratulations! You've made it!" And I soon realized it was also the Third-Year Wicked Witch being dead too.

Though I found myself elated that what is supposed to be the second hardest year of medical training (after intern year) as well as the toughest rotation of that year was over, I was saddened that my elation was not out of a sense of accomplishment, but out of a joy of escaping the wicked witches, a joy of it just being over.

Don't get me wrong. Third year and surgery are tough, and one would be crazy to want to go through it all over again. I'm not crazy. But isn't it intrinsically sad that after the first time I'm allowed to be truly a part of patients' care, after the first time I can act like a doctor, that all I can celebrate is its' end?

To be fair, of course, it's everything else about third year and surgery, everything other than the patients, that made me want to escape. I guess I'm just saddened to realize that a gift as special as being able to take care of patients can be couched in attitudes and workplaces so toxic as to make me be happy to run away from it all, all the way, in fact, to a Master's in Education for a year.

I guess that's just the way it is? Maybe we can change it one day? Ack, too heavy of a topic for me to think about right now as I try to cram for Step 2 of the boards that I'll be taking in just a week and a half. Ignorance is bliss, for now.

But one thing's for sure; no matter how dire I view medical education to be, third year and surgery are still over for me!

Coroner: "As the Coroner I must aver, I thoroughly examined her. And she's not only merely dead, but she's really most sincerely dead."

Mayor: "Then this is a day of Independence for all the munchkins and their descendents."

(Wise) Barrister: "If any."

Mayor: "Yes, let the joyeous news be spread! The Wicked old Witch at last is dead!"

One Day More

I have stolen a small bit of my time on-call this beautiful 63F Saturday to blog about a moment fresh in my mind. This morning, I was walking to the hospital at 5:30AM, when it was still 36F and before the sun even thought about rising. I was happily thinking that today is my last call day. (That's right, it's finally my last call day, not just for surgery but for third year!) Unexpectedly, I starting to sing a song in my head.

"One day more! Another day, another destiny. This never-ending road to Calvary."

"Really?" I thought to myself. "Is this day that momentous, requiring so dramatic a song to pop into my head as the one sung in Les Miserables before the French Revolution?" (And why do I know all the lyrics to this epic song? I can't remember risk factors for certain surgical diseases after being on a surgery clerkship for 10 weeks now, but I can remember the lyrics and tune of a song I haven't heard in years.) Even with this sort of perspective, I still couldn't help but keep singing the song in my head.

"Tomorrow we'll be far away. Tomorrow is the judgement day. Tomorrow we'll discover what our God in Heaven has in store! One more dawn! One more day! One day more!"

By the end of the song in my head, I had gotten so into it that I was on a march towards the hospital. I was ready to grab the call day by the cahones, ready to start a revolution. This was it. This IS it.

But after rounding with the team for 5 hours before jumping into a long consult, I realized I wasn't really that close to the end; surgery managed to beat down my spirit, again. I still have a full 8 days of being in the OR for surgery, a day for the dreaded shelf exam, and another day for an oral exam. And I have a summer full of clinical coursework, including a sub-I that will include many a call night. So really, not even close.

But tomorrow morning, when I walk out of hospital having spent my last night in the hospital for all of surgery, for all of third year, and if my sub-I has a nightfloat system, for all of medical school, I will feel an incredible sense of accomplishment and a relief that I've made it through third year (most of it). I won't care that I still have a way to go. I'll just be exhausted and happily marching home victoriously to the tune of Jean Valjean.

Addendum: Just got out of call night after 27 hours up. Tough hand to be dealt on the last one, and truth be told I was angry on the walk home. But now that I'm in my PJs sitting in my sunny living room, I realize that overnight call is over, finally over. Can't get me now, call.