“What did you do when you passed your recert exam?” I asked my colleague.

“I cried.”

I take my medicine boards recertification exam in two days.  The fail rate from a couple years ago was around 24%.  This from doctors who have been practicing for ten years and passed the exam ten years ago.  Most docs don’t talk about it, they just shake their heads and say, “I am so glad that is over” or “I am so glad I don’t have to take that for a few years” or “I … I grandfathered out of it (for the older ones).”  I know one person who is a fine hospitalist who failed it three times (a foreign medical graduate for what it’s worth).

I’ve been hitting the books harder for this one than I did ten years ago, at least as much as full-time work, day-night shifts, and family can allow.  Studying was pretty much my career until I was 26.  I did it before and I can do it again – I just didn’t have ten years of adult responsibilities back then.  I don’t want to come out of that test feeling like it went all wrong (although most people feel that way anyways).  I don’t want to just skim by the pass cut-off either.  I want to beat it to a bloody pulp for making me come back in the first place.

Twelve months, nearly 600 hours of studying, 1500 questions and answers…  just two more days until I hopefully can put the exam behind me (for now).  It will be such a relief not to have this weight over my head at the beginning and end of every day, every weekend, every vacation.  Not waking up at three in the “morning” due to anxiety trying to remember some detail I just read.  It will be nice not having to tell the kids “No, I can’t play with you right now” again.  Has it made me a better doctor?  I guess I have to say yeah, although in practical use, I’m not sure if it will affect more than 1-2% of my daily hospital work, if that.  But at least I might sound feel smarter.

Has it made me a little more bitter about the whole doctor thing?  A little bit, yeah.  It’s not that I’m not up for challenge and sacrifice but you kind of think that after ten years of challenge and sacrifice through pre-med, medschool, and residency, that at least you’ll have the luxury of choosing your own challenges.  These days, with a family, kids, and relatives you hardly see, certain things gain a lot more importance than putting another feather in your cap that you don’t really want.

Anyways, I’ll be as happy as an epileptic with gelastic (laughing) seizures by Thursday night, so whatever.  Hopefully that will last even after I make up all the work days I moved to clear this week.

Next time, I’ll start studying two years ahead instead of just one, just to lessen the stress load.  Another colleague said he’s taking his a year early, “just in case.”  That sounds like a good idea.  So I’ve got seven years before I do it all over again.  If I’m lucky.

Like the surgeon saying goes, “It’s better to be lucky than good.”

Enough commentary, I’ve made a list of what I plan to do with a free mind and free time after Thursday.

________________

THINGS TO DO AFTER MY EXAM

Visit my brother & his family

Play Pokemon Battle, chess, Villains & Vigilantes, Halo Reach, Dungeons & Dragons, Car Wars, Halo board game with Sun Su (like I promised)

Read some post-apocalyptic books I have stored up

Get my game on (Fallout New Vegas)

Draw again

Write more

Princess day with the girl

Bring back the expression “It’s been real.”

Clean out that spoiled milk smell in my car

Find out why our TV keeps shutting off every 2 minutes

Exercise more

Sleep more

See dentist – my back teeth are getting sensitive

Take kids to the bank to open “their own savings account”

Go to Corean language class with the kids at church

Study Corean language again

I might get back into K-pop if I find more videos like this one (I *lesbians* Miss A !! — *Scott Pilgrim reference)

Work on a Kung Lao (Mortal Kombat) costume

Not worry so much about how I’m spending my time

I’m still studying for my medical boards recertification which is in three weeks.  I’m re-reviewing material I’ve mostly forgotten since the beginning of the year, like spent spells in a wizard’s repertoire.  [Warning!  Nerd alert!  Geek overload!]  Per 1st edition Dungeon & Dragon rules, one has to memorize that stuff over and over again.  It gets easier with time and experience though (a Staff of the Magi wouldn’t hurt either).

It’s taking its toll on my constitution.  Lately, I wake up with medical facts bouncing around in my head from the night before.   Sometimes I can’t sleep and my heart races [intermittent fast heart rate, hypertension, flushing = pheochromocytoma].   This afternoon my throat was on fire.  [Reflux -> Barrett's esophagus -> esophageal cancer.]  That’s what I get for eating after a midnight shift and crashing.  [High grade esophagus dysplasia = needs esophagectomy.]  My head was pounding too.  The differential diagnosis includes:

1) too little sleep,

2) too much stress,

3) too much studying,

4) too much caffeine or

5) not enough caffeine.

Coming down with a cough too.  [Dry cough + aches + bad X-ray + pharyngitis = mycoplasma or chamydophila.]  Yesterday I woke up just in time to pick the kids up at school.

My eyes were sore from lack of sleep [eye pain = optic neuritis = sign of early multiple sclerosis], but I spied Sun Su walking down the school steps.  He seemed so much older with his bag slung over his shoulder.  [Winged scapula = thoracic nerve injury.]  Little Ooseung followed at his side, her chin up to face a world slightly bigger than she is.  [Inability to look down = progressive supranuclear palsy.]

I acquiesced to their request to go on the playground.  Brain and body were too fatigued to resist.  My mood has become dark with the number of times I’ve had to tell them, “No, I can’t, I have to study,” these past couple months.  Supreme knowledge is a demanding, vengeful, and costly pursuit, isn’t it, Raistlin?  ["Gold" skin and pupils + psychiatric illness + weakened heart and liver = Wilson's Disease.]

Musical notes drifted strangely through the breezy air as my son led the trek to the playground.  [Auditory hallucinations = schizophrenia or stroke in temporal lobe.]  An afterschool child was playing on a mounted tube instrument like a novice bard.  Sun Su precariously climbed to the top of the monkey bar dome and smiled at me.

“Careful,” I said.  [Traumatic hyperextension of neck = Hangman's fracture, C-2 vertebra = death.]

Ooseung eyed the sandbox next to us, but then she ran over to the swings instead.  I was relieved.  [Sandbox = animal feces = tapeworm, intestinal parasite.]

“Look, Baby, a squirrel!”  Sun Su scouted, pointing at nothing that I could see.  [Rabies = rare in squirrels.]

“YAAAAAHHH!!  SQUIRRRRRELLL!!” she yelled out with berserker rage as she chased it down for dear life.

I shadowed my party of halflings into the woodlands behind the school.  “Adventure!” Sun Su exclaimed as he rangerly maneuvered around branches and slippery slopes.  Hmm, I didn’t teach him that word.  Treasure abounded – a bottle cap, a Baskin Robbins cup, a rotting apple with ants, a basketball, and a box of Cheez-its.

Our little leader scavenged two sticks strong enough to break other sticks among the fallen branches and trees.  He gave the big one to his little sister and engaged a sapling tree in swordplay, stopping only to point out another squirrel.  “SQUIRRELL!!  A BIG ONE!  A BIG ONE!!”  Ooseung went on the rampage again.  While ducking branches with soft earth underfoot, I felt a cool kiss on the cheek from what must have been a wind fairy.  I remembered these half-real, half-imaginary worlds from childhood.

Then I heard the sound of a child crying, not mine.  He was standing alone against the back wall of the school farther away.

“Do you know that kid?” I asked Sun Su.

“No.  Don’t go,” he cautioned.

I walked a little closer, but stayed a fair distance away so as not to scare the boy, “Hey!  Are you okay?  Are you lost?”

He stopped and looked at me.  “No.  I’m okay.”

“Are you sure?” I yelled back, before he disappeared around the corner.

“Let’s see what’s going on over there,” I told my young ranger and tiny barbarian.

We walked down a natural tunnel with webby school windows on one side and overarching trees on the other.  (Of course my iPhone batteries were dead at this point – hence, no pics here.)

“I hear voices,” I said.  Ooseung gripped my hand.  I looked around the corner.

It was another playground filled with more kids and several moms.  The crying boy was there too, playing, no hint of crying.  I suspect he was probably sent to The Wall in the first place by his mom (or a teacher) for misbehaving on the playground.  I forgot they used to do that back in elementary school.

“Appah, there’s no more squirrels!  UHNG!” Ooseung made her usual angry grunt.

“They’re probably all hiding from a little girl with a giant voice who says YAHHH!”

My little girl giggled,

“I just wanted to pet their soft fur.”

“Ready to go home?”

“Yeah,” then she boomed out, “SUN SU, WE’RE GOING !!”  Just like her ummah.  Sun Su emerged from his woods exploration with a disappointed sigh,

“Aww, do we have to?”

Back to reality and my spell books.

[Stimulation of oxytocin and vasopressin, psychological attachment, warmth = LOVE.]

I am studying to the point of nauseating myself.  Seriously, I feel a little like hurling at this moment.  That is all.

“Hi Mr. Brown,” I said as I entered my new patient’s room.  The old man sat in a chair looking out at the construction crew tearing down the old hospital wing.

“Doctor Brown,” the old man corrected.

“Oh, right, I read that,” I slid a chair in front of him, “How are you feeling today?”

As he began his long-winded answer, I briefly wondered what kind of person demands to be addressed as doctor outside of their role at work.  Would I be like that someday?  I seriously doubted it.  I don’t care for the attention, positive or negative.  Plus it just puts people’s guards up.  Being understated and underestimated are advantages.

I sized him up by his doctor lingo.  He mispronounced a few of the newer medicine and test names.  He knew a few things but he wasn’t a practicing physician anymore, that’s for sure.   He didn’t do what I do.

Eventually his answer wandered into relevance.

“Just a little chest pain this morning.  A little diarrhea.”

“Well, the surgeons want to hold off on your heart bypass until the colitis is under control,” I informed.

“I agree.  This body can only take so much.  Seventy-eight years.  Longer than most I guess,” he shook his head, “I used to throw around 100-pound bags when I was a kid.  Now I can’t carry a grocery bag to the door.  I didn’t have any problems until I turned sixty-five.”

Retirement age.

“Now I’m on over a dozen pills.  Four of my heart vessels are blocked.  On prednisone for the past eight years.  This may be my last week on this earth.”

“We hope not,” I smiled.

He asked where I trained, how long, sized me up.  He told me about his days in pediatrics.

“You got kids?”

“Four and six – no, ages six and eight, girl and boy,” I corrected myself, surprised at losing track.

“Ah, you’re just beginning then.  Still got time,” he replied.

“Yeah, they’re fun.”

“Enjoy it.  I worked HARD,” he paused for a moment as I imagined him in the old-school workaholic hey-days of medicine, “I took a few good vacations, but … I always planned on my Golden Years.  These aren’t golden.”

“So I’ve heard,” I replied.

“They’re the Iron Years,” he said.

“I like that,” I nodded, thinking that I’ve got to write this stuff down.

“I had my fifty-year medical school reunion.  We visited our old anatomy lab.  Saw the cadavers.  Smelled the formaldehyde.  Brought back memories.  You get to look at life in a long way.”

Memories of my own came back, probably much like his.  There are only so many ways you can skin a body.  When I was just being born, he was my age now.  I looked at him, soberly, my professionally amiable doctor mask off for a moment, physician to physician.  His eyes were as black as mine.

“Things you waited to do, you can’t do, because your body’s falling apart.  Do them while you still can.  It’s the cycle.  Someday that cadaver in anatomy lab is going to be you.  Filled with formaldehyde.”

I stood up and smiled but this time had nothing to say.

“I’m not suicidal.  Not yet.  I can’t leave my wife like that.  But I am … pretty blue.”

“Hang in there, okay?  I’ll be back tomorrow.  Maybe the surgeons will let us both know what the plan is by then, haha.  We can make you better,” I said.

“We hope.  What’s your name again?”

“Dr. Scott.”

“Sorry, you don’t need me to preach to you, Dr. Scott,” he tapped a Bible on the table.

“No, not at all.  It was very … informative.  I’m looking forward to talking to you tomorrow.”

Doctor.

“Four… five ….”

“What are you doing over there?”  Sun Su asked from over his bed.

“Sit ups,” I answered, “Seven….”

“Why don’t you go to sleep like me?”

“It’s not my bedtime and you asked me to stay in your room. You need to start going to sleep by yourself, young sir.”

“Noooo.  Don’t go.”

“Fine.  Nine….  Aren’t you excited?  First day of school tomorrow.”

“Maybe a little.”

“First day of school is fun!  New things to learn.  New desks, books, teachers.  Everyone’s so nice.”

“Why do we have to go to school so much?  It’s like half of our life.”

“So you get smarter and learn new things.  And understand new things.  So you get a good job and do things you want to do.  Otherwise you’ll grow up all wild like an animal and not know anything.”

“What if I got sick and missed school for three days?”

“Then you’d make up the work when you get back.”

“What if I missed school for three years?”

“Then all your friends would be smarter than you and you’d have to go in the little kids class.  Don’t get any ideas.”

“Hmph.”

“Seven-hundred and eight.  Seven-hundred and nine.”

“All you do is work, study, eat, exercise.  What else do you do, appah?”

“Games, well, not that much lately.  I play with you guys too,” I added.

“Not that much anymore, appah,” my boy corrected me.

I stopped.  Flat and floored.

“I know, Sun Su.  I just have to study a lot until my test next month.  October 21.  After that, I won’t have to study.  We’ll play a lot more after that, okay?  I’m almost done.”

“…”

“APPAH!  When are you coming to my room?!” my little girl called from her room across the hall.

“Be right there, Baby,” I answered.

“I have to tuck Ooseung in.  You’ll have a lot of fun tomorrow.  I love you.  Go to sleep,” I kissed him on the forehead.

“I can’t sleep.  The crickets… they’re… bothering … me….”

Then he was out.

I walked over to my little girl’s room.  She was in her bed, lying crooked as usual, smiling at me upside-down in the dark like a Cheshire cat.

“I can’t wait to go to school tomorrow!”