Why I Play

October 5, 2011

It’s been a rough week. A few days ago, my wife found out that she matched for her neonatology fellowship in St. Louis, MO. She’s excited, because she really likes the program and it’s a great opportunity. Unfortunately, St. Louis isn’t the ideal city for us. I’m fairly certain that emergency medicine is what I want to do with the rest of my life, and there are no osteopathic (D.O.) emergency medicine residencies in Missouri. There are a couple allopathic (M.D.) programs, but I would need to do a traditional rotating internship (TRI) year first to strengthen my application. There is one TRI program in St. Louis, but it’s a risky proposition for a number of reasons that I won’t get into here. Suffice it to say, I’ve been feeling very helpless. It seems like no matter what I do, or how much I want to succeed, whatever happens ultimately isn’t even up to me or Emily. It’s very unsettling.

******

People often ask me why I play so many video games. Granted, I used to play much more than I do now, but I still turn on my DS or PSP for at least a few minutes each night before I go to sleep. Growing up, I used video games as my escape. If life was getting stressful or if I just wanted to procrastinate for a little while, I’d pop in a Zelda game and suddenly be a million miles away in Hyrule, swinging a sword or playing an ocarina.

But video games are more than escapism. During the most tumultuous times of my life, video games have been therapy. When I feel like I have no control over the things that matter most, video games offer a place where I can feel helpful. Useful. Needed. I’m saving a princess from captivity, a species from annihilation, or world from destruction. The helplessness I felt before is gone and I feel empowered to do something good. Even if that good is for fictional characters, it resonates. When I’m done playing, the feeling of empowerment stays, even if only for a week. A few days. A moment. It builds confidence. It battles depression. It inspires.

Sony just launched a new ad campaign called LongLivePlay. The video below sums up the feeling I’ve tried to convey here. It’s more effective if you’re familiar with the characters, but it gets the point across either way.

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Match Game

January 19, 2011

When I started this blog a few years ago, I had no idea what I was doing. At the time, I was deciding between careers in medicine and video game journalism. Two fields that couldn’t possibly have less to do with each other, but ones that (as you can see from the layout of this page) share my affection fairly evenly.

So you can imagine my surprise when a lovely woman from Medscape contacted me through this site and asked if I’d like to write for a new blog she was starting. Match Game is a student blog focusing on choosing a residency program and the match process. Admittedly, I know very little about the match. My wife went through it a few years ago when she was choosing her pediatrics residency, but that experience is the extent of my knowledge on the subject. I do, however, have quite a bit to say about choosing a specialty. So we’ll see where that goes.

My first post is available here. I tried making the introductory post light and humorous. Here’s an excerpt:

It’s a scary prospect. The whole match process is a cloudy mess that you really don’t know much about until you start thinking about what residency program you’d like to apply to. If you’re anything like me, you spend your third year just trying to stay afloat on rotations, figuring out what you want to do with the rest of your life, and desperately trying not to screw up the rest of anyone else’s in the process.

Medscape is a sister site to WebMD that is particularly useful for medical students. Along with eMedicine, the trio of sites provide droves of information, medical references, and student perspectives that I’ve valued for some time now. It’s an honor to be asked to contribute to Medscape, and I’m really looking forward to hearing what people have to say about Match Game. If you have any feedback or suggestions for topics, please let me know.

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Posted by brianfishman

Halfway There

June 22, 2010

The last lecture of my second year of medical school was over a month ago, and I’ve been on my third year rotations for almost three weeks now. But I couldn’t really relax and take a break from studying until this week when I took Step 1 of my COMLEX medical licensing boards. I was originally scheduled to take the exam on May 28, two days before my wedding. As it turns out, people who are in the final stages of planning a wedding don’t really have too much spare time to study. So I postponed the exam until June 21.

In the meantime, on May 30, I married the love of my life, my high school sweetheart, and my best friend. Nine years ago, when I was a senior in high school, our two families booked a Spring Break cruise vacation to the Western Caribbean. I met Emily on the Enchantment of the Seas, asked her to my senior prom the following week, and we’ve been together ever since. The wedding was amazing. We all had a good laugh at the reception when the head waiter came to my table to confirm that I was a vegetarian. Literally three minutes later, he brought me a steak dinner. Little mishaps aside, I think everything went very well.

The next morning, on 4 hours of sleep, Emily and I boarded a flight to our honeymoon. Nine years after meeting there, we took a cruise back to the Western Caribbean and visited the same ports. We were in Grand Cayman for my 27th birthday and spent the day lounging on Seven Mile Beach. The next day, in Cozumel, we took a catamaran cruise to swim and snorkel. It was the same excursion we did on the first cruise and every bit as fun.

I started my third year rotations the day after we got back from the honeymoon. During the day, I alternate between rounding on inpatient service and following a hematologist/oncologist at his office. At night, I studied as much as I could for the exam. Now that the test is over, I can finally focus on my rotations during the day (more on that later) and relaxing, catching up on video games, and working on the new house at night. It still keeps me busy, but it’s nothing compared to two years of sitting in lecture for 9 hours a day. Only two years of medical school left. Halfway there.

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Motivation

April 25, 2010

Every so often, when the endless hours of studying and lack of sleep start to catch up with me, it becomes difficult to find motivation to keep studying. Getting bogged down in the detailed symptoms of this disease or the inexplicable physiology of that syndrome makes it easy to lose sight of the big picture – of why I applied to medical school in the first place. It’s during these times that I take a 2 hour break from studying for the night and pop in my favorite movie.

During my junior of college, I had the privilege of meeting Patch Adams. He came to speak at my school, and, to be completely honest, I can’t even remember what the subject of his talk that day was. What I do remember is that he came out on stage wearing his trademark clown suit (pictured left) and made the entire audience laugh for a few hours. When I met him afterward to sign his book, I asked him what his recommendations were for a student who was thinking about going into medicine. It was fairly loud in the room and I couldn’t quite make out what he said, but above his signature he wrote ‘Follow Your Dreams.’ Cheesy, yes. But meaningful when coming from the right person.

There’s a scene toward the end of the movie where Patch is pleading for his right to graduate from medical school. The dialogue is, again, cheesy. But it’s an amazing philosophy and a great reminder of why I applied to medical school in the first place.

Patch: At what point in history did a doctor become more than a trusted and learned friend who visited and treated the ill? Now, you ask me if I have been practicing medicine. Well, if this means opening your door to those in need, those in pain, caring for them, listening to them, applying a cold cloth until a fever breaks; if this is practicing medicine, if this is treating a patient, then I am guilty as charged, sir.

Dean: Did you consider the ramifications of your actions? What if one of your patients had died?

Patch: What’s wrong with death, sir? What are we so mortally afraid of? Why can’t we treat death with a certain amount of humanity, and dignity, and decency, and god forbid maybe even humor. Death is not the enemy, gentlemen. If we’re going to fight a disease, let’s fight one of the most terrible diseases of all – indifference. Now, I’ve sat in your schools and heard people lecture on transference and professional distance. Transference is inevitable, sir. Every human being has an impact on another. Why don’t we want that in a patient-doctor relationship? That’s why I’ve listened to your teachings and I believe they’re wrong. A doctor’s mission should be not just to prevent death, but also to improve the quality of life. That’s why you treat a disease – you win, you lose. You treat a person -  I guarantee you’ll win no matter what the outcome.

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Camaraderie

January 7, 2010

It’s no secret to anyone who knows me that I didn’t particularly care for my undergraduate experience. While I think I received a good education and met some great people, the extremely competitive environment bred a cutthroat attitude among the students. Because most courses were graded on a curve, other students had to perform poorly in order for you to do well. A certain amount of healthy competition is fine, but the survival-of-the-fittest atmosphere at my university went above and beyond.

When I started medical school, I thought this kind of pettiness was behind me. And for the most part, it is. Everyone is working toward the same goal, and while your class rank is certainly important when applying for residencies, letter grades and GPA aren’t nearly as worrisome. Regardless of how well everyone does, the valedictorian and the person with the lowest class rank will both still become doctors.

One of the grading policies that helped relax the students and give us a small cushion when we didn’t do as well on an exam as we’d like was the decision to drop test questions that performed poorly. At least two or three times on every test, a question would unintentionally be worded badly, contain a typo, or simply have more than one correct answer. These questions were either double-keyed or dropped, giving credit to students who got them right. As long as you were a decent guesser, you could usually count on an extra point or two on every exam.

However, today we were informed that, due to student complaints, professors would no longer be dropping questions with credit but rather removing the question from the exam entirely. So instead of an extra point or two, a poorly worded question makes it easier to do badly by lowering the total number of questions on the exam. Granted, we’re dealing with very small point values and the change isn’t likely to affect most grades or overall GPAs. But I cannot fathom why a fellow student would complain about a policy like this. The only possible benefit it could serve would be to raise his or her class rank a few points at the expense of the rest of the class.

If I had a choice between a doctor who performed well academically vs. one who barely made it through school, I’d obviously choose the one who got all A’s. But if those A’s come at the expense of common decency, I’d start looking for a third option.

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