Unwound

March 29, 2009 at 8:28 am | Posted in Uncategorized | Leave a comment

(this post was written on New Year’s Day, 2009)

Woohoo! Happy New Year everyone!

2008 wasn’t too bad, overall. Nothing particularly horrible happened, although it was disappointing not to find a PGY-2 spot. I did finally wake up from the nightmare that was the second half of fourth year, and put my life back together. And decided that people can damn well reap what they sow, and I have every right to be pissed off that my career would so easily be derailed over the supposed interest–nowhere in evidence from my perspective–of someone who’s notoriously a player when it comes to relationships.

It still makes me angry when I really think about it. But sometime early in 2008 that constant, visceral fury I’d felt for most of 2007 dissipated. I wonder now if anyone had any idea that it was there. I express more anger now, mostly because I know it will blow over and be gone. But back then I was concerned that if I let go of it, my anger would far exceed the provocation.

Yeah, so I entered internship with the kind of visceral anger it takes most interns the whole year to build up to. And as the year went on, I actually grew happier rather than more beaten down. You can see it in my blog entries. Toward the latter half of the year, they become markedly more humorous and irreverent, and less tightly wound and defensive.

Update

March 27, 2009 at 7:13 am | Posted in neurosurgery | 1 Comment

For those of you who haven’t been following along in the comments section (which is where all the action has been these last two weeks), I am still looking for a job. I’ve applied to almost everything neurosurgery-related that’s out there right now (1 more app to send today).

But it’s an employer’s market right now, so I must keep my pharmacy overlords happy until I find a neurosurgery fellowship or PGY-2.

The rent, it burns…

Please help

March 20, 2009 at 1:31 pm | Posted in neurosurgery | 10 Comments

I’m going to lay out my situation here, because it’s pretty dire. Obviously it could be worse. If there’s anything I’ve learned in life, it’s that it can always be worse. Nonetheless:

1. Didn’t match

2. Wasn’t able to find anything in the scramble (one program did offer me a spot, then dithered around about sending me a contract, and finally told me all their spots were gone). Then again, I’m not sure that’s the way to go, and I don’t want to sign a contract and then reneg.

I know, I know, this is a bad time to get all squeamish about screwing other people over to look out for #1. But there are just some things I can’t seem to make myself do. Like go into a field I find uninteresting, but that pays really well and is easier to get into. Trust me, I’m mentally cursing myself over my inability to get over this mental block. But honestly, in a choice between that and defaulting, I’m not sure which is worse.

3. My temp assignment ends Sunday, and there’s not much other temp work out there right now to take up the slack.

4. I am the only person in my family who’s even employed right now. My mom is retired and I’m paying some of her bills. Fortunately she’s no longer in the Medicare donut hole like last fall, but at some point this year she will be again. My dad lives in an assisted living home, which my brother pays for. However, he is a corporate attorney who was just laid off by his company. He was incredibly good at his job, and has in past saved his employers millions of dollars, so I’m sure they’ll be sorry next time they’re up against any attorney who actually knows his stuff. Nonetheless, he has no income and it’s a tough job market.

5. I have about three times the average student loan debt. Tulane’s student insurance was awful, so my medical expenses had to be included in my cost-of-attendance calculation. This is also why I was working as a pharmacist throughout the preclinical years, and why my finances (and my health) were in such dire straits by the end of 4th year. I had spent every cent I had trying to match in neurosurgery. I can live on a pittance of a salary, as long as I have good medical insurance, and can defer my loans. Otherwise my loan payments are in the range of 6-7K/month. I have zero consumer debt, just the student loans. But I can’t pay them on a primary care income. Period.

I don’t actually care about the money, where neurosurgery is concerned. I care a little bit, with regard to vascular surgery. Everything else just feels like prostitution; I’d be doing it for the money, and no amount of it would ever really be enough to compensate. It would a sad thing for my patients, and for medicine, if I went that route instead of doing something I love. And it would be utterly stupid to train in some field I don’t even like, that doesn’t even pay well enough for me to repay my loans.

6. For some reason, I’ve been completely unsuccessful at getting any kind of job in neurosurgery. I’m consistently told that my qualifications are excellent and that I’m a strong candidate whose application, though it does have blemishes, does not contain anything that should keep me from getting a position. And yet, time and time again I’m not the person chosen, and no one will give me anything more than platitudes when I ask for feedback about where I fall short in comparison. It just doesn’t ring true anymore. There’s something not right about it, I can feel it.

7. I am FAR less interested in my love life than I am in solving the above problems. Those things must be dealt with first. So don’t anyone talk to me about men right now.

——-

So that’s where things stand. I like to work hard, I’m easy to get along with, my neurosurgical operative skills are as good as they could be with the amount of experience I’ve had. I manage patients well. And I just want the opportunity to prove myself in neurosurgery, and no one will give me even the slightest chance.

This is just a bad dream, right?

March 17, 2009 at 12:30 pm | Posted in neurosurgery | 7 Comments

It’s official. I should just go to sleep, and wake up again tomorrow. I’ve been awake since about 5am yesterday. And yet I’m not tired. Or if I am, I’m too numb to feel it.

Cheapskate rationalizes an iPhone

March 17, 2009 at 1:11 am | Posted in Uncategorized | 4 Comments

Well, I’ve prepared all I can for tomorrow. The scramble packet has been assembled and scanned into a file that I can either fax or email. I have three phones–two for outgoing calls and one for incoming calls. Two internet fax numbers–one outgoing, one incoming, and I’ve uploaded all the documents I might possibly need to send out into their autofax function. And one faculty member who’s offered to speak to PDs on my behalf, and whom I can reach tomorrow.

I can’t think of anything more to do. Ugh! All that money I spent on interviews…to have it come to nothing is just crushing.

But I have managed to find somewhat of a silver lining in all of this. Thin and fragile as it is. I’ve been looking for an excuse to upgrade to an iPhone since the 3Gs came out last June, and this whole scramble business has provided an excellent one: I needed two more temporary phone lines. So I bought a Go Phone for super cheap, that I’ll cancel as soon as I’m done, and upgraded my regular account to a family plan for $10 extra dollars a month to get a second line on it, used my old phone for the new line, and moved my real number onto the iPhone. All told, it’ll cost me $80/month. Which is still cheaper than most people are paying for a single line iPhone account. And since I don’t have a land line, that’s still a pretty reasonable amount to pay for phone service.

Yay me. But it goes without saying that I’d gladly trade the iPhone to be matched right now.

Please please please let something come through for me tomorrow.

Did I Match?

March 16, 2009 at 9:24 am | Posted in neurosurgery | 8 Comments

No, I did not. If someone out there knows why, please tell me.

Tick tock

March 14, 2009 at 8:55 pm | Posted in neurosurgery | Leave a comment

Less than 48 hours till we find out if we matched. Options for how to spend the time:
a) drink heavily, do something stupid, worry about that instead
b) alternating Benadryl/Ambien till 9am monday.
c) curl up in the fetal position and moan
d) blog incessantly but don’t post any of it

D is clearly the most pathetic, so D it is.

House of cards, chapter 3

March 11, 2009 at 7:12 pm | Posted in Uncategorized | Leave a comment

The thing speaks for itself.

Dominoes

March 6, 2009 at 3:03 pm | Posted in pharmacy | 1 Comment

It’s been a horrible few days in the pharmacy where I work. As a community hospital, it relies on people and insurance companies to actually pay their bills for its operating income. And with the economy as it is, people aren’t doing that. So in the week I was off, dramatic cutbacks were instituted across every department, and about 85 people were laid off. Including the director of pharmacy, as I found out last night. He’s been asked to take the position I’m currently covering, and if he does, I go back to the general staffing pool at my agency as of the next posted schedule.

The thing is, the staffing pool is not the place you want to be right now. I get the impression that they’re struggling to keep people working, and don’t really have the hours to support the people they have, much less one more. So it’s time for a backup plan.

As usual, I have more than one idea simmering right now. A cursory inspection of the job boards shows that there are still plenty of jobs out there to be had in pharmacy. So my problem is simply finding the right one. It would be better to stay in the Seattle area and find something temporary here if I can. But in 14 days I’ll know where I’m going for the next 5-7 years and it might make more sense to transfer my license to that state and move there early. Or alternatively to put my stuff in storage and stay with my family in Texas, and work there temporarily until I’ve saved enough for moving expenses.

I’ll know better on Monday how urgently I need to find a new pharmacy gig. But there are some things I can set in motion today, so I’m going to get busy on that.

Nerves

March 4, 2009 at 6:12 pm | Posted in neurosurgery | Leave a comment

O-kay! The dread has officially set in. Today for the first time I felt a twinge or two in the pit of my stomach over the possibility of not matching.

Perhaps it was the kindly email from the NRMP titled “Scramble Advisory,” that did it. Even though I know everyone gets that email, and it means nothing at all about my own match results to have gotten it, it still sets off the fight-or-flight reaction. Reading it only made things worse. I sat there and considered the logistics of scrambling from my living room, and whether I would even want to take part in it at all. Why scramble into another internship that I’d most likely have to repeat the following year if I finally found a spot in next year’s match? Does that even make sense?

Instead, though, I reined in my thoughts and reminded myself how unlikely it is to fall entirely off a 15 program rank list, even as an independent applicant. Plus I’m not usually someone whose personality sabotages her application to that extent. So given the range of programs on my list, surely somebody ranked me in a position where I’ll match.

But the waiting. It’s getting to me.

House of cards, chapter 2

March 3, 2009 at 9:36 am | Posted in Uncategorized | Leave a comment

The Bank of England has written a fairly lucid and accessible explanation of the current global banking crisis. It’s worth noting that, while leverage ratios did increase worldwide, the largest increase was at U.S. banks, which may have been serving as a worldwide safety net in prior downturns. Also noteworthy is the fact that home equity lending represented nearly 50% of losses at U.S. banks, compared to 10% plus or minus 4% at UK and European banks.

House of cards

March 3, 2009 at 6:59 am | Posted in Uncategorized | Leave a comment

People have been speculating how low the Dow Jones Index will go. The University of Google served up this handy chart, showing its historical value all the way back to 1900 (click on the chart to enlarge it so it’s actually readable).

Note the logarithmic scale. Contraction seems to be logarithmic, just as expansion is an exponential function. But that’s neither here nor there. The question is, when will it stop. And here’s my prediction:

5500.

I didn’t just pull that number out of thin air. I picked it because that’s where the Dow was in 1996, before the housing bubble started ballooning. At that point, it was just called a housing “boom” because construction was up and everyone considered it a legitimate effect of the general economic prosperity of the time.

But I bought a condo in 2000, and by that point there were already lots of crazy loan programs out there, ready to sign you onto a sketchy ARM loan you could only afford if the interest stayed ridiculously low, with a separate loan for the down-payment you also hadn’t saved enough for. People were nervous even then about the prospect of buying too late in the “bubble” and getting caught with their financial pants down when they tried to sell.

As for me, I went with the slightly less sketchy option of purchasing a foreclosed home directly from the bank, and using my conventional loan preapproval from my own bank to negotiate a better rate with no down-payment in exchange for taking out a conventional loan from the bank that owned the property instead. I sold it two years later for 150% of what I had paid. I was moving to Seattle and didn’t think I’d ever be living in Houston again.

Little did I know. Man, it would have been nice to still have that place post-Katrina.

Anyway, my point is that I think the Dow will fall all the way to its pre-housing-bubble value before it recovers. Granted, mine is a very unsophisticated analysis. But the housing collapse is what’s driving this turndown, and I think it’ll keep going until the house of cards is entirely flat.

Stranger than fiction

March 1, 2009 at 11:32 pm | Posted in Uncategorized | Leave a comment

I’ve seen this on a few blogs, and decided to post it here because:
a) I’m a lemming
b) I have 18 more days to kill, and
c) It’s funny.

How To Make Guys Like You

Also, it reminded me of conversation I had several times with my mom, back in high school.

Mom: Pay attention to those nerdy boys. You may not like them now, but someday they’ll be the ones you want to marry.

Me: {eye roll} Maybe so, but they also won’t be so socially retarded by that point. Right now, however…(so heartless)

Mom: Yes, but if you latch on to one now, he’ll be rich someday, and totally devoted to you because you paid attention to him when no one else would.

Me: No, that just means that when he divorces me to marry the hot young trophy wife, I’ll be rich. (heartless AND cynical)

Mom: There are worse things in life than being rich and single. (FTW)

I confess, though, what I was really thinking was “who said I don’t like the nerdy boys?” But that’s no way to pick a fight with your mom.

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