For the rest of my life

This week I had an epiphany of sorts, and I am excited, proud and terrified to say that I think I know what I want to do with the rest of my life. During my third year, I was hoping that one rotation would stand out above the rest, and that I could say with confidence that I loved that specialty and that I wanted to continue in that field for the next 30 years. And since I was leaning towards Internal Medicine, I was really hoping that the specialty I would instantly know I loved would be that. However, Internal came and went, and no such lightbulb went off, which made me a little panicked. I definitely liked IM, and now that I'm pretty much done with the year I know that I liked IM the best out of all my rotations by a decently sized margin. But also, my IM rotation started out roughly, with the most difficult patient I've encountered all year, and the end of my 5 year relationship that took me by surprise. Time heals all wounds though, and the patient left, and I slowly healed away, and I came to really like the complexity of all that is Internal Medicine, though the hours of course, are quite long, second perhaps to only surgery.

But Internal medicine is a broad, broad specialty. And I knew I wanted to subspecialize but I didn't know in what. Pretty much everything filters through internal, so I figured I could take the next couple of years to figure out what specifically I wanted to do. What I determined through the rest of my clerkships this year though, is that I like working with my hands. I like doing procedures: suturing, freezing/shaving off warts, blood draws. Things I never thought I could do. So I knew that whatever I go into, I have to work with my hands. Enter this past week, when I was doing pediatric cardiology. I was always intrested in cardio, but I was leaning away from it because I just don't understand the subject well. On my exam, it singlehandedly dropped my score, and was the only subject that was scrunched waaay to the left of average. It's made me a little wary of pursuing the subject, since I seem to have developed a mental block to the subject, and especially because it's one of the more competitive subspecialties. But I realized how much I like piecing together the heart conditions and listening/discovering murmurs and extra heart sounds. On Internal med I'm proud to say I was attentive enough to discover murmurs that other residents missed. So long story short, I think, at least tentatively right now, that I am going to pursue Interventional Cardiology. It's sort of scary to think of the long road ahead if I decide to go ahead with that (3 years residency+3 years cardiology+1 year interventional cardiology), but the more I think about it, the more excited I get. Which I'm taking to be an encouraging sign. It's got procedures, the critical thinking, and the instant gratification of helping someone right away (interventional cardiologists are who put catheters into patients with heart attacks, etc) that I loved about surgery. So all in all, it's a rough road ahead, but...at least it'll be interesting.