overcautioning

[overcautioning]

I Aim to Disappoint

Recently, I turned 18. As is to be expected from unstoppable adulthood, I was hit by a tidal wave of existential dread. Throughout my life, I have made an extreme sport out of introspection. I take all the personality tests, and I wear their results like enamel pins on a mental lanyard: INFP, Enneagram 4w5, waterbender, Ravenclaw. I take the psychological tests, too. I know my RAADS-R test score; I memorize laundry lists of symptoms, because I want to know Why am I Like This? and, more tellingly, What Now? I know myself better than anyone else, but I worry I may spend my entire life suppressing her, being instead an arbitrary ideal self. In her 2020 memoir Untamed, Glennon Doyle wrote, "Listen. Every time you’re given a choice between disappointing someone else and disappointing yourself, your duty is to disappoint that someone else. Your job, throughout your entire life, is to disappoint as many people as it takes to avoid disappointing yourself." I do not aim to please. I am unlearning, I think, how to please. I aim to disappoint. And they say that the best way to fulfill your goals is first to articulate them, so I'm going to spend the rest of this entry telling you exactly what disappointing means.

I want to write more.

I expose my truest self through writing. I don't mean typing out contrived blog posts at 6:20 in the morning. I don't mean writing about medicine, either, at least not exclusively that. I don't mean the type of writing confined to hierarchies and assignments and subjects I would never choose. I mean fiction. I mean holing up in my room compiling abridged notes on historical stories. I mean typing out children's books as some kind of wish-fulfillment. I mean the most belligerent, most fundamental writing. The type that scratches an itch. The type that one does because they have no other choice. Not that I have no respect for other types of writing, like nonfiction or poetry or journalism. In fact, I'm interested in growing as a writer, and I know I might find within other fields a similar extension of my heart as I have in fiction. But the difference would be that I'd have to look. I'd have to dive in headfirst and truly, honestly, give them a chance. Fiction, to me, is coming up for air. That's why I know that I would disappoint so many people if, as a practicing medical doctor, I would spend my free time writing. Even more so if I were to blow my hard-earned money on creative writing training, on a Master of Fine Arts or a fellowship in the woods. That would yield raised eyebrows. That would make people ask, What the Hell is She Doing? I look forward to the day where I truly do not give a damn, and I can turn around, flippant and ink-stained, and say, Whatever I Freaking Want. I am going to be a doctor who writes. Watch me.

I don't know if I want to be a surgeon.

Why not just write, if I want to? Why even go through medical school? I stand by what I said in the previous entry: I want to heal kids. I was having a conversation with a friend, recently, about why I'm so set on this, and I think I explained it better then than I ever have before. As a pediatric doctor, I will always be vouching for the children, be that against their parents, or school administrations, or their communities. I will rarely have to defend them against themselves, because children themselves know that they have so much left to know. I want to work in atmospheres of constant hope and wonder, stuffed toys onhand, even if the highest highs have the lowest lows. But here's the thing: I don't know if that means surgery. I want to work with kids as early as possible, not as a two-year fellowship program after six years of general surgery—or any other residency that isn't pediatrics. After all, if my end goal is to work with children, and not to stand at an operating table or tinker with a certain body part, then why should I do anything except that? Then again, something about the constant movement of surgery is still appealing to me. That, and the financial security. Both my obstetrician-gynecologist mother and corporate lawyer father see clinical work as just that, as a "just", as something lacking. If I become a pediatrician, how will I ever earn enough to buy a house? I would be foregoing years of drilling about financial security, not to mention my mother's unsubtle nudging towards OB-GYN. What a waste, they would say. And my answer would be, what would I be wasting? I'm not dextrous like my brother, who spends his afternoons putting together 4000-piece Lego sets. I freeze under pressure; I sometimes explode. All that I would be wasting would be the part of me that likes surgery and has invested time into rotating in it. Pediatric surgery? Still viable, I suppose. As before, the question of specialties remains non-urgent to me. In my goal to disappoint, however, I hope that if I choose a surgical field, if will be because it is as dear to me as fiction is. I hope that it will be because there is no other path to take.

I want kids, but I don't think I want a husband.

I like kids. That much should be clear by now. It's no surprise, then, that I want my own. I want four, but of course any child at all would be a blessing. I want to bear them biologically, because I have read about the adoption industry being traumatic, and I want to be involved in every step of raising them. I think I would practice Montessori parenting. I want to raise intelligent, independent individuals. They would never have to fear about disappointing me, because I would dedicate myself to nurturing their talents. They would never, ever, feel like they have to hide themselves. Here's a secret: I want a family, but I don't think I want it with a man. I don't think I like men at all. You know, I don't. I don't like men. I'm a lesbian. You have no idea how much it physically pains me to type that out. I want to erase it, backspace, backtrack, burn it. I have always had a creeping suspicion that someone who knows me will find this blog, but only after typing that do I feel genuine fear about the consequences of being discovered. If you know me, and I know it will be obvious, please don't tell anyone. Please. I've been out as bisexual for many years, but this is something else entirely. Please let me tell people on my own terms. Disappointment, I think, would not even begin to underscore how people would feel if they found out. I know that because I don't even have to choose between disappointing others or myself, because I would disappoint myself either way. My children would never be allowed in Catholic schools. I would strive to create only love in our house, but they would be judged by everyone outside it. We all would be. And what of my partner? How would we ever legitimize our bond, if same-sex marriage is still illegal in my country by then? How would I ever explain this to my parents? To my extended family? I can name at least two aunts and uncles who would cut me off forever. To all of them, I would say I'm sorry. I don't think I can say anything else. I read somewhere that accepting you like girls and accepting that you don't like men are completely different experiences, and I could not agree more. What about all the crushes I used to have on guys? It's so hard to accept that those were never crushes, that it's uncommon to sometimes feel apathetic about the people you like. What about the guys I find attractive? It's so hard to accept that aesthetic attraction is just that. Everything is just so hard to accept. My sexuality feels to me like an internal train wreck. I don't know how I'll get through this. I'll get through this. I'll date women. I'll get married abroad if I have to. I'll shield my children from a cruel world, and I'll pray, pray, pray, that it's kinder to them than it will be to me. God, I'll pray that it's kind to both of us. I just want to be myself.

What now?

I don't know what now. The conclusions are always the hardest parts to write in my entries. All I know for sure is that I'm 18, and I have my whole life ahead of me. I hope I stop living it inhibited. I want to look back at this entry when I'm 28, and realize that hey, it wasn't all that bad.

[overcautioning]

Rotational Reflections

Last week, I completed a surgical immersion program in a local private hospital. Think Fox Foundation: high-end, frequented by expatriates and rich politicians. In contrast, I will be completing my medical training in my country’s flagship government hospital, which, despite its congestion, is slated to receive yet another budget cut this year. I’m in my dream program, and I truly would never choose another school over this one. Still, for five days, I bore witness to another world—or maybe, one that I’ll find myself in once I enter private practice.

But why surgery?

My mother is an obstetrician-gynecologist. My entire life, I have been nudged towards OB-GYN, to the point that I think I could convince anyone to choose it (One: You will always have patients. Two: It is so fulfilling to start a family. Three, though this one is exclusive to fellow OB-GYN brethren: You can inherit my practice.). However, I completed my immersion program in general surgery. On some level, I think I just wanted to see something new; on another, I think I just wanted to convince myself that I could be something other than an OB-GYN. I find myself often recalling how in preschool, I had to fill up a worksheet that asked what I wanted to be when I grew up. I wrote, in blunt pencil, “an obstetritian like my Mommy.”  Some part of me is still haunted by my five-year-old self.

As I circled the wards during my rotation, I would find myself wondering how much of my life is paternalized. I like to think of myself as this independent, free-thinking individual, but I’ve made safe choices for as long as I can remember. I attended the grade school five minutes away from home; I went to the same high school as my mom and my brother; I followed said brother to the same medical program in the school where our mom teaches, where we’ve visited since our childhood. I’m a textbook legacy. I imagine my choices captured in a fishing net, bound by the limits of what my family knows and supports. General surgery is at one of the farthest corners of that net. Indeed, the entire time I was rotating, my mom was nudging me to switch to OB-GYN.

There’s a train of thought that I use to console myself: it doesn’t matter if all my choices are paternalized, because they’re still mine. Hence, maybe the life I’m leading is to some extent what my parents want, but to the fullest extent it’s what I want as well. Whether that’s specifically surgery, I don’t know yet, but I know that having big shoes to fill will never mean that I have to fill them in the exact way as my mom, or the many doctors in my extended family, did. I’ll repeat that over and over to myself until I can take it to heart. 

“Even when you’re a consultant,” said one of the consultants I met during my rotation, “the comparisons never stop.” All the more reason, then, not to let the comparisons stop me.

Here’s what I know is me.

I want to work with kids.

I don’t think I can fully articulate why. I saw two lap choles, a robot-assisted prosthatectomy, a right lobe thyroidectomy, a sleeve gastrectomy, a left breast mass excision, and several more procedures I could only glance at in passing. Still, the entire time I was rotating, I kept holding out hope that I would see a pediatric surgical case. The closest that I got was, ironically, when my mom invited my friend and I to assist her on a cesarean section. I suctioned blood while she cut the patient’s uterus, layer by layer, and when the baby was pulled out and laid on his mom’s stomach, I stared at him in awe. I kept on wanting to look his way while the pediatrician checked on him, but I had to keep my eyes on the surgical field. Hence, I held the retractor when it was handed to me. Otherwise, I kept suctioning.

“It’s different,” said the resident who sat me and my friend down at Starbucks. “We only have three pediatric surgeons in the hospital, and only two of them are active consultants. You might think it’s like operating on a small adult, but it’s not. Everything about it is different: the protocols, the principles, everything. You have to rely on what the parents say, because the kids can’t describe their own problems.”

Maybe that’s why I want to work with kids: I want to advocate for patients who can’t advocate for themselves. I want to be there for people who haven’t been able to experience the world. I explained it during my medical school interview as just this: children are so young. They have their whole lives ahead; often, they compose the lives of their loved ones. One of the greatest manifestations of the problem of evil, I find, is that tragedy sometimes strikes the young.

Being in a medical program already, my next major life concern is what specialty I’ll enter. I tell everyone I meet that I’m not sure—and it’s true, because I have years to go before my actual specialty rotations—but I’m sure about kids. I think I was sure before I entered the immersion program. All the immersion program crystallized for me was the possibility of become a pediatric surgeon, which to me seems like the clearest career path I’ve had in a while. I have yet to decide, though, if it’s the one that I want. I know I like the instant gratification of surgery. I like the quick decision-making. I enjoy working with a team. I like how straightforward the entire process is: you ask why a problem exists, and then you solve it, just like that. You amputate a foot besieged by diabetes mellitus, instead of tending for months to its smelly wound. However, I’m far better with my words than my hands, and under pressure, I sometimes freeze up. There’s a train of thought I use to console myself for that too: I have time to learn.

If I went into pediatric surgery, what kind of surgery would it be? General, to supplement my aptitude for digestive and hepatobiliary anatomy? Oncologic, to push my desire for restoring childrens’ lives to its maximum? There are so many decisions to make, and my brain twists itself in knots trying to make them all right now. I was the kid who, in seventh grade, was creating full-blown college lists and planning all her high school extracurriculars. At the same time, I was the kid who, in twelfth grade, didn’t fulfill any of her plans, but led a high school life just as fruitful.

I spend so much time thinking even if I know how pointless it is. I won’t know, until I do.

Until next time!

[overcautioning]

I Hope Nobody Reads This

I am seventeen. I’ll be starting medicine at university in a few months. I’ve always wanted to become a doctor, but now that my training is nearing, I sometimes find myself daunted.

What impact will I leave on the world?

I think of healing as an act of restoration more than anything, to a baseline level of health. Some people in need of healing have reached this level before; others haven’t, but it looks the same for all. You want to be healthy enough to dream, and more than that, to act fully and totally towards that dream. You want to be healthy enough to be alive; then, you want to be healthy enough to live. I used to wonder about the impact I’ll leave on the world, but I know now, more than ever, that I want to give people their lives.

I’m not trying to be profound. No, maybe I am, a little bit. Talk of life and death does lend itself to verbosity.

I have a vague idea of what giving people their lives looks like, but I have so much to learn. Hence, I created this blog to write about my reflections on life, both as a medical student and a teenager (I have only two years left of teenhood, but I am intent on maximizing those: the lockdown took far too much). There will be no such thing as upload schedules, because I’ll only write whenever my internal life-processing capacity is at its limit. Getting words down, I have found, helps their ideas seem far less overwhelming.

I admit it’s embarrassing that this might be read by people who aren’t me, but I know that I need to document my life somehow. Plus, I’m an introvert. Maybe writing in this blog will help be more comfortable being vulnerable.

Welcome to Overcautioning.

I hope not to see you next time.