Malaise

I have settled into a 6 day hangover that began Tue night and has had no intoxicating percipitant. It continues unabated. How i dislike everything.

What could be the cause? I have taken almost 9 years of advanced education and training and done what the modern well-to do intellect does far too naturally--repeatedly ramming this education at the excessive dissection of my own neuroses. Is it the cold weather? am i hypothyroid? Is it a subclinical sinus infection? a dopamine failure? Perhaps i have been too inattentive to self reflection? A shortage of quiet meditation? Am i paralyzed by choice in the modern ennui of post industrial capitalism? Is my mental hygeine insufficient? And so goes the differential diagnosis of the incompletely trained young physician and meta-physician.

In my lucid moments i suspect i have merely run out of the shrill and hysterical enthusiasm that kept me afloat for the several weeks of surgery following the soul sucking devastation that is commonly known as the USMLE step 1 exam. Surgery and inpatient medicine furthermore was a great novelty. Plenty of dopamine to keep one afloat. The outpatient medicine scene i had wrongly assumed to familiar and thus easier. Although i do not arrive home in stuperous exhaustion every day, i maintain baseline level of anxiety that is mostly associated with a constant confusion as to where i am supposed to be at any given moment.

Its true, there is no 3 hours of excruciating rounds. No feigning interest in the 43rd hernia surgery you've seen and still don't get as its just a lot of flimsy layers being poked at and wasn't cooper's ligament in the boobs or something? So now i have arrived in the exotic lands of outpatient medicine and the time has come to open my soul to a new land, a new people, to patients who are not obtunded under anesthesia and have rich and complicated lives outside of the clinic, usually involving eating too much, smoking too much, etc.

Whatever the etiology of my malaise, the self-medication has remained worrisomely the same since age 14 - eating, internet, a bowl and someimes a passage or two of Bertrand Russell.

It is in these moments that the road ahead seems despairingly long. The thought of being a doctor, being organized, caring about other people, having responsibility, having any job at all, seems pointless and horrible and wouldn't i rather be...what? balancing a bowl of cereal on my gut and watching cartoons with lewd humor?

Such despair is often moderately improved with a well titrated dose of caffeine, usually with a little creme. At that point i am assured that i would indeed like to have a job, a meaningful, interesting one that affords me whatever minimal illusion that i am Part of Something Bigger, and making things on sum better rather than worse, one that i would like to be Very Good At, and always inspired to Do Even Better, and one with a steady income to boot, so as to allow funding for said bowl of cereal.