Anxiolysis

I do not like to be anxious. I push things out of my head to deal with later (this is called suppression - one of the mature defense mechanisms, which probably contributes to the high frustration threshold I mentioned yesterday), and this exasperates Nicole to no end; not only does looming uncertainty increase her anxiety much sooner than it does mine, but talking and discussing the uncertainty, in an attempt to make things more concrete diminishes her anxiety, while it increases mine. When there are issues to be dealt with, I know that they have to be dealt with - I don't ignore them, but it takes some time for me to get to the place where I want to devote mental time to it, and am willing to submit to the inevitable tide of anxiety.

Right now, the anxiety centers around finding housing in NYC. There was a brief period last week in which it looked like we might be able to stay and complete the remainder of our clerkships here in Miami. It sounded awesome, but only the deal for psychiatry was signed; I could stay an extra six weeks down here - but when I found out that our landlord had already rented out the apartment (I had, after all, given him the date we'd be finished), it was like God telling me to go to NYC. Also, since the vast majority of landlords require a minimum 6 month lease, chopping into that just to stay here for a while sounds like a bad idea. I have no concerns about whether or not we'll find housing; it's just that it'd be nice to get decent housing, and I've learned that if I procrastinate too long, I'll be taking what's left, rather than having my pick. This seems to be the most pressing concern right now (taking precious time away from clinical musculoskeletal disorders).

More anxiety? Money. I don't worry about it for now; I worry about it for later - I've joked before about how Sallie Mae owns my soul, and I never quiet forget that I'm going to have to repay every dollar I spend with interest. Since that's not quite defined by any specific deadline (except for the repayment start date, which is, at this point, deferred for years to come), it doesn't spark anything more than little nagging blips of anxiety. Housing is expensive. Books are Expensive. Transportation is expensive. Food is expensive. And tuition? Don't even get me started. Add to that the rumbling Medicare thunderclouds on the horizon of medical reimbursement - the cuts keep coming, and it sounds like more and more doctors are becoming disillusioned with the whole business, occasionally recommending that interested folks consider other careers, and less frequently leaving medicine altogether.

What else? Board exams. I rocked my first set in November, and I'd like to keep up the momentum - the way I'm scheduled, I not only have all of my cores lined up back-to-back, but I have a few months between the end of my academic requirements and graduation; wiggle room. I'd previously considered taking that time to work and begin repaying loans, but it might be a better idea if I took some serious time off to study and locked in some great scores, perhaps even taking the USMLE step III before graduation, so I didn't have to worry about it during my first year of residency, like most US med students.

Hot on the heels of that nagging little "anxiom" (my sarcastic neologism for a a bit of anxiety-inducing uncertainty) is the unsureness of whether or not I'm learning what I need to know. On the island, they told us which books to use and gave us the lecture slides - you either knew them or your didn't. Here I'm preparing to be tested on some information, but I'm on my own as to where I get my version. Harrison's Princples of Internal Medicine is an exhaustive and exhausting reference - I'll never get through any topic in a timely manner. So I use Davidson's Principles and Practice of Medicine, because it's shorter, supplementing it with Step Up to Medicine - but are these good enough? Am I learning what I need to be on the wards, as I madly scribble down every word that proceeds forth from the mouth of the Attending? Am I practicing my physical exam skills properly - were those really rales, or just harsh lung sounds? Should we do a CXR or HRCT?

So I'm anxious about whether or not I'm acquiring the appropriate skills to be responsible for someone's care, but I'm also sometimes anxious about whether or not I'm growing up to be a competent adult - my very wording demonstrates that I don't feel like I'm there yet.

You know what, though? These Anxioms will never go away - never will there be a time when I have no cares whatsoever. I'll get a great job and a nice place to live, but by then I'll find myself beset by another, more pressing consortium of concenrs - the offspring of the anxsioms that trouble me now. Generations of worries will harry the various stages of my life, and so I guess I'd better get used to it...and get back to looking for housing in NYC; anxiolysis.