Things have been anti-climactic since my test last month.  I had plans to write about it during the afterglow of victory.  It would have been all fighting game action, entitled MEDIKAL KOMBAT or TEST YOUR MIGHT (test, get it?), with me standing victorious, a pulsating heart in one hand and a seizing spine in the other.

But… I don’t know.  The test was hard.  After hundreds of study-hours, it was still that hard.  The time was really tight.  I didn’t have the greatest feeling coming out of it, and even worse, I won’t get the results for months.  So I was hesitant to start anything new in case, you know, I have to start studying for the next one.  Last year’s stats said 90% of people pass; one out of ten fails.  There were ten of us in that fingerprint-scanned closed-circuit monitored room.  Was I the dumbest?

If I had (have) to study for it all over again, I’ll spend the last several months just doing test questions, no source material.  The test part is such a game.

The next day was work as usual, making up the days I took off.  I understood why doctors don’t celebrate or mention their recertification exam.  They’re afraid that more people will know when they failed later on.

But, unlike the automotive plants in Detroit, the medical assembly line continues on.  One of my first patients back was an old man with rectal bleeding.  The medical mantra is never assume rectal bleeding is from hemorrhoids (the most common cause).  You don’t want to miss a colon cancer or inflammatory bowel disease.  His turned out to have ischemic colitis.

“Will it happen again?” he asked me.

“Probably not, but if it does, you may need surgery next time,” I answered.

Not the kind of answer that would be on a test, but that’s the real world for you.  Sometimes you have to choose the thing that has the least chance of killing you the quickest.  Sometimes that’s a gray zone too.

Another one that stood out was a 20-ish girl with severe abdominal pain and a rash.  One of the PA’s instantly diagnosed her rash as contact dermatitis.  His cocky answer still pisses me off to this day because: 1) it wasn’t his field of knowledge (unless bullshit is a field of knowledge), 2) I was right in the middle of talking to her – my patient, and 3) a young Caucasian girl with abdominal pain, rash, and childhood diabetes should make you at least consider celiac disease (which WAS his field) before blowing her off.  I have all that boards studying to thank for that last diagnosis.  So yeah it did make me a better doctor, if somewhat less tolerant of ignorant blowhards.  When she was discharged, she insisted on giving me a hug too (even though she didn’t have celiac disease), so thanks again American Board of Internal Medicine.

When I finally got some time off this week, I actually accomplished a lot of the things on my TO DO AFTER (my teset) LIST.  Played the hell out of Fallout New Vegas of course (Level Maxxed).  I visited my brother and little niece for a day (+100 Karma Points).  I played chess and Halo Reach with Sun Su (+10 Energy Weapons skill).  Started reading a new book (Fallout related stories).  Watched Charlie Brown cartoons with Ooseung (so that’s where she gets those grunts from).  Fixed our DLP television from turning off every two minutes (ACHIEVEMENT UNLOCKED!).  Watched more K-pop videos (+10 K-pop knowledge).  Started a new Corean language book and audio CDs (my old one had cassettes).  Went to Corean church and enjoyed it (Save vs. Fire of Damnation = successful!).  Exercised more (+1 Strength).  Slept more (+1 Sanity).

So even though my life feels like it’s on hold while waiting for my exam results, I’m getting used to the fact that maybe it isn’t.

Then this week, I started having pains in my ass, literally.  And two days later, I saw blood dripping down while I was.  Sitting.  On.  The toilet.

My blood.

So, yeah.  You never know what’s next.

Maybe I should have gone with the whole medikal kombat fight scene.

To be continued.