Chapter 8
SURVEILLANCE STATE
Away rotations, sub-internships, or audition rotations all mean the same thing to once bright-eyed and bushy-tailed premeds.
The ‘aways’ are month-long rotations in sought-after locations apart from a medical student’s ‘home hospital,’ ideal opportunities to impress a new group of attendings and match at a prestigious institution.
THANATOS
Away rotations were a mistake. I can’t do this.
Another half-eaten, artificially sweet protein bar plummets to the floor as I collapse into my Heirbnb, utterly spent from 4/4 sub-Is.
My feet ache from walking home without a car. Sweat drenches my back. Even the wild macaws flying overhead mock me, screaming human insults above as I slog home every night.
Bitch! Fuck! Cunts!
Palm trees crash into my window while I’m trying to sleep. The broiling sun burns, leaving red, itchy tracks across my fair skin. Even the appeal of meeting new students has long faded, replaced by my simmering exhaustion.
What are they doing back home, while I’m melting here?
My back collides with the wall, crumbling down the scratchy paneling while I stare at the AI-generated paintings that ‘decorate’ this old maid suite. Poorly printed imitations of Napoleon stare back, vacant eyes meeting my paper-thin scrubs and papier-maché resilience.
November should mean frozen lattes and tiny snowdrops. Rumbling football games and tins stuffed with cookies. I should be watching the snow fall on my decrepit, haphazardly built medical school, not squinting through the diaphanous prime of a new beachside hospital.
Fuck, I miss Rusty! What’s happening to me?
BrokeDash is too overpriced for me to eat.
The minuscule fridge, barely bigger than a mixing bowl, can’t hold more than one meal at a time.
And the microwave, sans a turning dish, is somehow the only black hole in this state that can’t heat.
I’m so tired of inhaling processed protein, fighting off the sweltering humidity, and choking down caffeine while a dimly lit screen glares at me.
I’m overthinking every interaction, doomscrolling away my critical thinking, letting my head pulse and numb from mindless social media instead of succumbing to my own self-doubt.
On auditions, we get assigned a new attending every day, sometimes every half-day, so that the entire residency voting committee can assess you, one by one. It’s the all-day, never-ending interview.
One wrong move, and you’re off the rank list.
My head lifts from near-fetal position, thoughts whirling past every single decision I could have made incorrectly.
Did I smile at the nurses enough? Was my clinical knowledge up to par? Did my stumbling feet slow down the emergency C-section?
I missed a question today. One of the attendings asked me what the dome of the bladder was, and I said the trigone. The trigone??
What was I thinking?
If I don’t end up matching because of this—
I slowly sink back to the floor, grabbing my protein bar and staring at it with disdain. It looks disgusting. But I refuse to lose $50 on delivery, especially after I lost $10 on overpriced hospital food for lunch. And I need to eat. Even if it pains me.
I inhale the protein laced with sugar.
Nasty.
But I can’t starve, even if that would be easier. I have people to impress tomorrow.
And I have $300,000 in debt to pay off. As a biology major with no lab exposure thanks to the pandemic, I’d be lucky to get any job, let alone one that pays above minimum wage.
How much is the monthly debt payment on $300,000? I ask my phone.
Sirus’ chipper voice answers.
On a 10-year plan, the monthly debt payment for a $300,000 loan is $2,000…
I choke and throw away the protein bar. I can’t fuck this up.
I don’t even bother reading the following articles about how the new administration will change student loan repayments. I can’t make it through today if I don’t focus.
I crawl over to the kitchen table I’m using as a desk, pulling up a textbook with the plan of studying until I fall asleep. Basic anatomy first, then reviewing the OR schedule tomorrow, and then endless pimping questions until I pass out.
It’s now or never. 27 years of working, and it all comes down to match day.1
Just one more week of my last stretch of sub-Is. And then interviews for 3 months straight over my ‘winter break.’
No rest for the weary.
Like a fool, I check my messages.
Nothing. Not even a ClockTok or a VainstaGram from my friends.
The ache in my chest doubles. I know Esther’s busy growing a child, and Hyacinth is struggling through her pathology sub-I, but this garage apartment feels extra lonely with just me and my emotions tumbling through it.
I get obsessive when there’s nobody but myself checking my thoughts and nothing but my aging face to look at in the mirror.
When the sun sets at 5 P.M., and it feels like midnight because I’ll be up again at 4 in the morning.
When I’m lost in the cycle of dissecting every single interaction, catastrophizing about how every mistake I made led to here, and reminiscing on how every person who’s shaped me is no longer in my life.
The shadows flickering with the setting sun are as close as I have to friends, ghosts from my past appearing in every reflection of my face in the mirror across from me.
The eyeliner I learned from my best friend in high school.
The sunscreen my aunt lent me, which I’ve been using in various forms for years to pretend it’ll halt the passage of time.
The frantic blinking and crippling self-esteem issues from every man who’s stuck around for other women, but not me.
The brain I wield with every memory from every friend who told me I was so smart, that they were so jealous of me, that I’ll never have to worry because everything will always work out for me.
But I am worried now.
Over the years, my exhaustion has kept me from reaching out, leaving me as alone as I deserve to feel.
I’m just not smart enough to stop panicking, and not lovable enough to keep anyone who once had an interest in me around.
TO GENUINE AND REAL
Percy
Are you guys alive? How are we doing?
Five long, dreary minutes pass before I set the phone down. I can’t expect them to respond right away. Not when all of us are busy with our own lives now.
Twisting my hair up, the shadows on the mantle morph like the coal-black shadows of my new friend’s hair, and I reluctantly message my last choice of companionship.
Percy
How are you holding up? Completing your homework? Smiling at your PAs? Trying to learn about your co-residents’ hobbies and kids?
I wait another ten minutes, tracing the wood dents on the floor, until he responds.
Kane
You should be studying
Away rotations are not a joke. Fucking focus.
Embarrassment hit me like a brick, especially with my textbook glaring at me from under my phone, and I quickly delete the chat.
I should have known better. Expecting comfort from a man?
I wasn’t expecting him to be so harsh, and I especially wasn’t expecting my head to feel so hot, my eyes to water so quickly, my throat to thicken so fast.
I swallow hard, blinking back my emotions.
Instead of processing them, I check my email again. No interview invites yet.
Then I skip to the OB/GYN spreadsheet. Besides some gunners arguing over whether “malignant” programs provide better training or not, it’s just wave after wave of applicants bragging about their new interview invites.
Of which I have none yet.
I should have expected this, given that I’m from a low-tier medical school with minimal research, but I can’t help but be disappointed.
Especially when some of these programs aren’t even good!
I mean, the OB/GYN applicant Diskchat was traumatizing enough…
Cliquey, stereotype-filled program with a PD that cries every time she gets criticism…
Residents have to work all 52 weeks of the year, no breaks…
Medical students here get sent to a kiddy corner while the residents shit-talk everyone, attendings, nurses, and PD included…
And even they don’t want me?
Am I going to have to leave my self-worth in a cornfield to match?
Am I going to match at all when the worst of the worst are still ghosting me?
I can’t even blow my current rotation.
Aloha states need good OB/GYNs, too.
My ‘interview’ is every single day on it, and I’m terrified of torpedoing my reputation before I get a real chance.
Tears prick my eyes, but I swipe them away, shaking my head. Just one more shift. And then the next. And the next.
It’s been 50 hours and counting. And it’s only Thursday.
I still have my 24-hour shift tomorrow…
What if I do all of this, and it’s not enough?
What if I’m never enough?
I continue flipping through social media apps, absent-mindedly chasing dopamine in a lame attempt to self-soothe.
If I can’t feel my feelings, then I don’t give them the power to affect me.
Distract, dopamine, and deceive myself into feeling nothing at all.
First on ClockTok, a raspy male voice:
Hey, as a premed. Does anyone think there should be a base standard of fitness for future doctors? I mean, shouldn’t we all be living by example? Today I saw a MEDICAL STUDENT with the biggest pot belly, I mean she had to be huge!
The video cuts to Esther, smiling during her pediatrics rotation as she coos at a newborn.
I almost drop the phone in shock.
Fucking asshole.
I guess nobody is safe from criticism, even literally perfect human beings who are pregnant.
I report the video for harassment and move on to TownCrierThreads, scrolling through the first few worthless platitudes: love yourself!! Your career will never leave you!!
Because I, the enlightened feminist, am supposed to ignore the common sense that my career will never love me back, either.
Beneath them are even worse, the cynics:
ILoveBeinganAttending: HOT TAKE: Medical students shouldn’t exist in the hospital setting.
They should all train in their schools and be prohibited from breathing the same air as MY patients.
I mean, I’m a busy woman; everybody knows that each medical student added to my service adds 3X the work for me!
SurgeonBaddie: These students are SOMETHING ELSE. Always late, never read up on patients, constantly worried about studying for exams over patient care?? What happened to the profession of medicine?
BoomerProud: Back in my day, we lived in the hospital. There was no such thing as “work-life balance.” What happened to born in the hospital, die in the hospital?
I.am.an.Interleukin: I agree, some of the medical students from my school would rather rot on social media than study medicine.
I grunt out a frustrated sigh and skip to Y Chromosome:
GymBrotoOrthoBro: I never realized how… annoying medical students are?
Why are you asking me questions? Don’t you have the internet?
Also, why are there so many girls?? Don’t you worry about your fertility?
Now is the time to be freezing eggs, not chase me around the hospital at the ass crack of dawn…
Alphamaxxingdoc: What’s weirder is that there are men in nursing now, too. What happened to male thinkers and women listeners?
Gross. I swap back to r/Redpillit instead.
R/FedUpMedStudent: I HATE being compared to other medical students. Does anyone else think their class is fake and unbearable? I mean, especially the ones who want to be OB/GYNs. Have you *ever* met such a miserable group of toxic, diabolical mean girls??
propofolpusher: This is why my only friends are outside of medicine. If I had to deal with these delusional bitches any longer than absolutely necessary, I’d lose the last of my brain cells.
gunnerproud: There’s this one girl in my class who I’m convinced is sleeping her way to the top.
Without spilling too many details, she literally just jumped from dating the valedictorian to a program director’s son.
We had to kick her out of the group chat because literally nobody takes her seriously anymore.
bonewizardsriseup: lol guess studying for STEP 2 wasn’t worth it huh?
gunnerproud: her boyfriend literally just got her a CAR. Like, in public. For no reason.
anonymouscunt: I guess that’s one solution for a diversity admit. Why bother doing aways and studying hard when there’s always whore solution #1:spreading your legs?
And with that closing note, I throw my phone across the room, gather my ‘whore’ self in my arms, and descend back into darkness.
1 Narrator’s notes: Match Day is when medical students find out where they’re going for residency. During the fourth year, they submit applications, receive interview invites, and then put their lives on the line for 4-8 hours for the most important interviews of their lives each interview day.
Their match is where they’re going to live. It’s their professional reputation. Where and if they match their desired specialty makes them them, lest they wasted the last four years of their life, their master’s before that, any preceding gap years, and college.
In other words, it’s all or nothing.