is it time for a change in career?

I remembered tonight (in the midst of ER chaos, sitting next to Dr. D. at the desk as he wrote out a prescription for Percocet while muttering, "idiots, they're all fucking idiots, all of them, and all they want is narcotics") that my ideal, when I started medical school, was to be one of those enviably flexible brilliant people who switch careers every ten years or so, and move on once they have achieved greatness in one field to achieving greatness in a totally different field. i graduated from medical school in 2002, which means that if i am going to pull this off, a) i have to achieve greatness in medicine in fairly short order and b) that I should start thinking now about what career number two is going to be. Having sent two people with appendicitis home from the ER in the last twenty four hours, my track record is not looking so good for the former, and i am completely blanking on my options for the latter. What I really need is something that I can be good at that doesn't require much additional formal training, because the very idea of going back to school makes my eyeballs ache. Mural painting sounds like fun. If someone wanted to pay me to be a tango dancing student, I'd totally go for that. The pisser about medicine is that just when you have an inkling of confidence in your own competence, you have a disaster, or a patient that you don't know what to do with, and your professional self-worth is knocked right back down to zero again. and it's not like there's even a good correlation between your mistakes/triumphs and the public recognition of your mistakes/triumphs; one of the nurses was really impressed with me last night for being able to instantly find fetal heart tones on a woman who was sixteen weeks' pregnant, after the nurse had been searching all over this woman's abdomen, and kept saying, wow, that's amazing, you just found them, just like that, (when in fact the truth is that there's really only one place you're ever going to find fetal heart tones on a sixteen-weeker, and i just stuck the doppler there). on the flip side, i got a lot of shit for sending home a guy with an appendicitis, when i don't think i actually did anything _wrong_: he looked completely fine, his pain had resolved by the time he came back from the CT scanner, he didn't have a fever, and (this is the kicker) i talked to the surgeon and the surgeon said, send him home and have him come back for a recheck in the morning. and yet everyone's rolling their eyes at what an idiot _i_ was. urgh. you win some, you lose some, but it's never the ones that you think you are going to win or lose.

anyway. c'est time for bed. tomorrow is my first four mile run in the half-marathon training program. we'll see if i can run four miles without falling over.