The True Believer

2021

I graduated from Michigan State School of Medicine in 2021 after completing an undergraduate degree in Biology at Aquinas College in my home town of Grand Rapids. I remember telling my mother when I was at AC, I was getting a Biology degree as a backup. If I didn't get into med school, I could teach high school biology. In the long days and sleepless nights since coming to the farm, I have often wondered if that would have been a better road to take.

             Two roads diverged in a wood, and I - 

             I took the one less traveled by,

             And that has made all the difference.

 Yep, that dude Frost knew what he was talking about.

My degrees came at a cost of about three hundred thousand dollars. That doesn't sound like much in 2045 dollars, but back then, before the financial meltdown in the early 30's, that was a lot. Point of reference: a cup of real coffee, not the synthetic shit, was two bucks! One tenth what it costs today, if you can find it. 

My strategy for paying the debt off and building a rewarding and lucrative medical career was simple: Avoid Primary Care. Before the passage of universal health care, some specialties earned significantly more than others.  (Note:  An unintended consequence of making health care affordable for all was to make practicing any field of medicine significantly less profitable, and thus the present doctor shortage. It's Econ 101 at work.) This was all driven by what pencil pushers and actuarial accountants at insurance companies thought the service was worth. Primary care was the area the insurance companies tightened down the hardest and consequently, it was the lowest paying. Granted a primary care physician still made good coin compared to just about any other profession but it boiled down to getting an ever decreasing piddly amount per patient. Most general practitioners made their boat payments by seeing as many patients as possible per day, conveyor belt style. Sucks for the patients. Sucks for the doctor. Not for me.

I knew my Step 2 scores would rule me out for dermo, surgery, neuro and some of the other highly competitive specialties that paid the big bucks. My plan was to focus on Emergency Med. Not generally looked on as glamorous but it paid well and for the most part the hours were tolerable. I applied to over one hundred EM residency programs across the US. (Funny to remember now, I applied to two residency programs in Miami and one in Fort Myers, Florida. With the current state of sea level rise, I'd need an air tank, fins and goggles to work there now. Hah!)  As a backup, I also applied to half a dozen Obstetrics and Gynecology programs. The OBGyn field was so dominated by women, I figured I might qualify as a diversity candidate.

Surprise, surprise! That scrawny 'Stankewicz' kid from St Adalbert's was accepted as a OBGyn resident at the University of Mississippi Medical Center in Jackson! After I got over the shock of not matching to an EM program, I was elated I matched to a quality program and I wouldn't wind up in a primary care residency. Another road not traveled.

Residency for any physician is brutal. Long hours, intense pressure, and crappy pay don't make for fond memories. But my 3 years in Jackson were some of my happiest years. Correction: 2 1/2 of my happiest years. You see, as a male in a predominately female medical specialty serving only women, I was unique. An outlier you might say. The fact that I'm over six feet tall with a shoe size of thirteen only made it appear more so. It made for some awkward moments – getting kicked out of the delivery room being the main one. In hospitals before universal health, insurance ruled. If an expectant mother had insurance, she could refuse to allow me in there. Even if mom was too much in the throes of labor to care, some dads said no to another man spying his wife's va-jj. But if the hospital was eating the bill, you got whoever was on the floor. So, I learned quickly to check the charts in delivery for LWS (low wallet syndrome) at the beginning of my shifts. Maternity calls from the ER were my specialty, the majority of those being indigent. I had the naïve notion early on in Jackson that I could ingratiate myself with the EM doc's and offer to pull a few shifts, kind of a back-door EM residency. I still remember the EM resident coordinator's laugh when I suggested it. Washington has nothing on the politics practiced in hospitals, then or now.