Structured Program

I think I'd be lost without this community, without my psychologically minded sister, and without help from Alan. And Bear, of course.

I do try to take personal time to play. I love to sing; I sing all the time when I'm not busy. I walk in the park, trying to take in the natural beauty.

Not trying to sabotage myself but I feel like I'm fighting a losing battle with that little voice of criticism and "failure" in my head. Alan and I have worked on that a little so far. I like thinking clean; there are moments when it hits me how absurd all this worrying is. An uphill battle. Staying rooted in the moment is a challenge for me.

Still working on it.

 

Well if it helps, this is my battle too. It's trying to change a way of thinking that's been rooted for a very (in my case) long time. But one day at a time - someone once used that term, is the way to work out of it.

BG

 

Glad we're in this together.

 

Just an update. Things going on in my life. Don't really expect anyone to read this lengthy post (this is more like blogging for my own sake) but if someone is good enough to do so, comments are, as per usual, welcome. Night Float sucks. I should be sleeping at 4:45 AM but instead I'm waiting for admissions.

Recent events: continuing to exercise (weights and running) even though my shoulders hurt like hell. Working on self-love. Mom may move out per my request, but the "kicking her out" aspect of it makes me feel horribly guilty. Working with Alan Gordon--Skype problems fixed. Moving on with my life as much as possible--learning that it's really not THAT horribly scary approaching women.

Oh, and that "yellow sheet issue" seems to be pretty much resolved, although I'm not sure how, because I have been offered a contract for the second year of residency. Which prompted the following journal entry:

 

"What to do with the rest of my life? I don't know how to feel about my contract. I haven't signed it since I got it. What have I learned from this year and a journey of the mind, body, and spirit? I could live the unexamined life, but that's not me. On the other hand, I spend a lot of time agonizing over what the "right" thing to do is when there aren't supposed to be rights and wrongs in life. Should I sign my contract? A few short months ago, I couldn't stand being here. Even now, with rare exceptions, I can't stand doing admissions. I hate them. When I feel an admission coming down the pike, I feel a slow burn of anger and viciousness building inside of me. Lord knows there's a LOT of bullshit 2nd years put up with. Lord knows I'm petrified of teaching med students and PGY-1's. How did I get to this juncture? I've been so unfocused on Medicine since getting here. I've been so focused on TMS and pain and psychology and movies and guns and girls that I haven't mastered ANY of medicine. Am I really supposed to think I can survive PGY-2 when I don't even know HOW I've survived PGY-1? In a month or so, I'm gonna NOT be an intern anymore. I have ACHIEVED my own goal since being robbed of my PGY-1 year at Stony Brook. I've done journal after journal of writing and I STILL don't know if I WANT to be a doctor. I don't! I'm not trying to be difficult. I just DON'T know what being a successful resident means to me. I can't make this decision. What do I work towards when/if I sign this contract? Money isn't enough for me; I need meaning in my life. This, and I cannot even decide what FUN activity to do for June vacation.

I've worked for this goal for so long that I've lost sight of who I am, what I want, and what I stand for in life. Ever since 2008 or so, I've worked tirelessly to get back to WHERE I AM NOW without thinking what the outcomes would be if 1. I didn't get licensable, or 2. what I would do if I actually DID. I worked so hard against so much ambivalence that I never stopped to think about WHAT HAPPENS if I don't match--and I developed TMS. Then I spent all this time worrying about WHAT HAPPENS if I can't get rid of this TMS/chronic pain that this first year of residency has been an absolute TORTURE of not JUST the pain, but admission after fucking admission after fucking admission. Then I get my contract renewed for PGY-2 year and then I need to figure out what this means for my TMS and for my future. I still have chronic TMS. The only difference is, for a few weeks now I've (at least tried) to give up an attachment to outcomes. I'm feeling very "meta" now. I've given up on the notion that my chronic pain will ever go away, and now I have new life choices to make. I can live with chronic pain. I don't WANT to--does anyone?--but I CAN do it. As I realized last night, doing so means that I need to weather the same frustrations and daily annoyances that everyone else does...and then TMS on top of it. Can I live with chronic pain? Sure. It may mean that I'm committing to a life of quite some bitterness and anger in so doing, because I feel like I never had a choice in developing it or not--the TMS kicked in automatically. And now I'm left with that behind the 8-ball feeling again. Accepting chronic pain won't be easy. Even these several weeks, it hasn't been. If I sign that contract, does that mean I've processed my inner qualms and misgivings about being a doctor and I'm contentedly signing up for another year that WILL NOT BE EASY? I DO NOT KNOW. I need to do that "Pro's" and "Con's" list.

...Or conversely, does TMS exist because I have so many psychological wounds and "complexes" based on Tayloe [Loftus], based on Langenberg, on Dr. Marx, on Schwartz, on Nsouli's predicting I wouldn't finish intern year...that are now OVER and DONE because I HAVE finished (almost) my intern year of blood, sweat, and tears?

...In plain terms...do I hate and loathe residency/admissions/being a doctor because I loathe residency/admissions/being a doctor (as I profess ALL THE TIME to Ma, to Ba, to anyone)...or do I just hate being a doctor because for SOOOOOOOOOO long, I haven't been able to get where I am NOW?
Herein lies a choice...in many ways more urgent than the one denied me in 1998.

If I sign, it means, on some level perhaps subconscious, mute and tacit, that I accept this paradigm where I am going to continue my medical training. Although I'd love to be an actor/singer/dancer/playwright/comedian/dramatist, if I don't break away and follow my heart NOW, will I ever? Will I regret it later? TMS be damned, I need to make "the right" choice <no pressure there, eh?>

I just cannot believe I got through my intern year essentially "coasting." Can I even run a code? Can I manage a medical service? Can I manage interns and med students?

Well, at least one thing's for certain. Deadline's June 4th, 2012 to submit this thing. Since I'm on vacation that week, means I need to decide by end of next week if I decide to agree and submit this thing. And unlike 1/11, when my idle Internet perusings led me to disaster, at least I am thinking about this BEFORE the fact...and not feeling like an edict has been handed down from on high: "THOU SHALT NOT MATCH DESPITE YOUR WORK."

I guess I need to revel in accomplishment for a bit. No revelations from on high, and try to avoid this MASSIVE pressure I'm imposing on myself (so TMS). Just JOY that I've accomplished this mission that I've wanted so long (which joy is incredibly hard for me).

'This chip, they did to me. I couldn't help it. But the soul, I got on my own. For you.' ---Spike to Buffy.

Any wonder why "Ensouled_Vampyr" is my handle?

'You think you have insight because your soul's drenched in blood? You don't know me. You don't even know you.' ---Buffy to Spike. "

 

"The Doctor and the Soul" and "Man's Search for Meaning", Viktor Frankl.

I hate this. For so many years, it was get through to the next step, because it would otherwise be 8 years, 10 years, 13 years, 15 years wasted if I didn't. Now I'm in a position to actually choose, for no one else other than ME, and I don't know what decision is "right".

'I fought for so long, for redemption, for a reward, and finally just to beat the other guy, but I never got it.' ---Angel.

 

Shanshu:

First of all congratulations! That is a huge accomplishment. And you're right. You aren't celebrating the way you should be. This is "what you wanted" so badly back on Page One. Now you have doubts. But I think it's a good thing. Your understanding of TMS and your life journey are starting to come together. So now what? And it seems all this is coming together at the same time. Hmmmm - don't you just LOVE life?

Time after time I see you leaning towards your true desire in life. To be an actor. You are young. You could make the change. And we don't know yet whether or not this would affect your TMS symptoms. But one thing is clear to me:

You are pursuing this career in medicine because of your parents. And booting your mom - is a good thing. No guilt! You need to have your own space and your own life. And btw, "girls and guns" don't go well together. So maybe a movie? More on that later.

Crossroads are always hard. You wanted nothing more than what you've been offered. Yet you have had a mental shift, whether it be from Alan Gordon or simply all the reading you've done. I know you wrote out your "Job Manifesto" so you could think more clearly. I think I see the best solution - but it's not my life. Wouldn't it be great if I or any of us could solve this for you?

The key to this very short time we have on the planet is to be happy. Will it work to continue in this profession without your mom there? Will it help to walk away for awhile - or forever? These are questions I can't answer for you. But a couple things stand out.

1) you need to have a little celebration that you are holding a contract - even if you never sign it.

2) Keep writing about where your heart and soul truly lie. You know the answer already, (I think) but are nervous about this change. Why not? You are a really smart guy and the world is open to you. Not just that hospital.

And girls love smart guys. As long as they are packin' heat.

I'm still reading!

BG

 

SOOOOOOO much pressure I'm putting on myself on this MD or not-MD decision. Plus I think I'm conflating my potential TMS cure with making the "right" life decision. I could still very well be an unhappy, struggling artist-cum-waiter with chronic pain. I like material goods and financial security as much as anyone. That would be a battle to obtain following my muse.

I suppose I could always see patients part time in two years and become a song and dance man in my spare time. I just really don't know. Don't hate patient care 100%, don't know if I have the balls to try Theatre. Darn my successful high school friend for awakening my latent desires to perform!!!! Darn my med school friends for actually suggesting I have any talent at all for't!!! It'd be easier if I didn't see my own potential for both Medicine and the performing arts!!!

 

People in the community suggest that it's possible to cure TMS without rocking the boat too, too much. People who hate their jobs can be cured of their TMS. I really do think it's NOT MD Phil that's the problem, it's the Critical Phil and the Frustrated Phil and the Insecure Phil and the Unhappy Phil.

 

OK then:

You are really coming to grips with the "issue". You brought up over and over that you could still have TMS if you were to become an actor/singer. You're right. This is what we refer to as: Your Decision. Only you know if you would like to finish out as a doctor or make a change. It's not up to your parents. It's not up to Alan Gordon or any of us. This is yours alone. Not to make you feel lonely - but only you truly know what will make you happy. And it sounds like you already have a handle on what is causing your TMS - and I think you have the right answers.

 

Just a short post this time.

Despite the training I've had, ironically enough, other people (including you, Beach-Girl, way back when) nailed it more easily than I do.

TMS runs on fear, AND it's also a moving target (the more you push against it, the more your outcome moves away from you). I've been struggling to articulate just what it is ABOUT the fear for a while (you others may have "gotten it" much quicker). But I think I've finally nailed it in recent days: just what exactly constitutes this fear for me? For me...it's a deep, dark, profound sense of NOT FEELING SAFE IN MY OWN BODY. It's not the pain. It's not the tension, and it's not even the random clicks and pops. It's the NOT FEELING SAFE. So I'm trying to tackle that head on. Alan Gordon has me working on old hurts and traumas that my limbic system, amygdala and right brain have latched onto. Turning a fear jag into a livid, righteous anger (at my own brain) for making Phil-childe feel SO SMALL and HELPLESS (sadly enough, like family members in my past have) is incredibly EMPOWERING, and it BLASTS AWAY all the panicky fear that I've just described.

This may just be generalized anxiety as you pointed out awhile ago, Beach-Girl, but it helps somewhat. I'm going to get there. I'm going to get there when I get there, and I have to try to stop PUSHING TMS away, but I will get there. The TMS explanation of anxiety is the same as the TMS explanation of obsessiveness (which is another part of it).

Anyway...it's vacation week, and I'm going to Allegheny National Forest tomorrow, and damn it all, I'm going to have FUN!!!!

 

You can do with that fabulous break. Keep thinking that 'you are going to get there'. We create new patterns when we believe in what we are creating. We are 'on line' developers because we make 'us' as we go.

Let me say that I identify with you about hurts and traumas in the past. I am sure we have a chorus line of people in this website that can sing a similar song. I believe that psycho-emotional pain can go both ways (1) to arrest our development and leave us with a sense that 'we are not safe' and thus halting our opportunities to be out there, open and free to absorb the nourishment so necessary for growth and development; and (2) to amplify our horizons to the point that we can never be the same. We are on the right journey and from here on there is only one way, it is onwards and upwards Shanshu. This is where you are now, so ride with us on this beautiful star! .

Enjoy your break in health, happiness and safety.

 

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Shanshu you can do with that fabulous break. Keep thinking that 'you are going to get there' in the company of many who walk a similar journey. We create new patterns when we believe in what we are creating. We are 'on line' developers because we make 'us' as we go. And I agree with you that this is a fabulous and beautiful community and thus a great and safe place to be.

Let me say that I identify with you about hurts and traumas in the past and about not feeling safe. I am sure we have a chorus line of people in this website that can sing a similar song. I believe that psycho-emotional pain goes both ways. When we are helpless (specially as children) it arrest our development and leave us with a sense that 'we are not safe' and thus halts our opportunities to be open and free and to absorb the nourishment so necessary for personal growth and development. But when we are adults and we face honestly, the painful memories in addition to what has become 'our issues in our tissues' (TMS) then there is an amazing miracle happening. We unlearn the toxic pain but it is not without certain degree of healing pain. Taking responsibility for our well being can be both a joy but taxing. Nevertheless the experience is nothing short of amplifying. It opens our horizons to the point that we can never be the same. We learn to be safe in the love that we create for the self and in the love expressed by others via their care and experiences. We learn to trust ourselves because we are 'safe' within. We are on the right journey and from here on there is only one way, it is onwards and upwards Shanshu. This is where you are now, so ride with us on this beautiful star! .

Enjoy your break in health, happiness and safety.

 

You sound so good dude. Have a great trip. You most certainly deserve it.

BG

 

"6/6

Denial. Anger. Bargaining. Acceptance? Compare/contrast "empowerment wolf."

Back from my 2-day vacation trip with Ma to Allegheny; Buffalo NY. Drove boat today for first time--very cool. Also no TMS symptoms (including obsessive thoughts) really at all. Totally enthused. Painful symptoms tonight when in Buffalo--no fear, mentally at peace; "if this is it this is it; if this be life this be life". Compare/contrast last night at hotel waiting 1 1/2 hours for dinner--lots of jaw tension/neck pain, lots of subvocalized fear, doubt, obsessiveness, anxiety, "will this be forever." Then sleeping off the jaw tension/neck pain with a "fuck it" attitude.

Fuck it. Fuck it indeed. Moving on with life. Flirting. Socializing. Drinking bubble tea."

Sooooooo done with suffering. Empowerment wolf.

 

Hi Shanshu. Glad to read that you enjoyed your break.

Don't forget to journal your hotel waiting 1 1/2 hours for dinner

Wishes for love, peace and health

 

I think what was interesting about the two days was the stark contrast between being frustrated waiting 1 1/2 hours at the restaurant bar for my dinner and having quite possibly the worst symptoms I've had in a while, and the very next day on the boat, where I didn't even for a SECOND think about TMS at all (I think many of you TMS old-timers will agree it's the mental aspects of TMS sometimes, and the pain aspects less, that are most troublesome. "Will I get better or won't I", etc).

Today:

"I don't think it's easy for me to look forward into the future and just "accept" the reality of chronic pain in one fell swoop. I think true acceptance of such a noxious outcome is one that I'll have to be dragged kicking and screaming down the path. But look, I gotta accept it because it's real and it's HERE. The more I push against the reality of what IS reality, the more inner tension I generate. Like trying to make a brick wall go away by pushing it with both hands.
Be with the reality of the present."

 

There's a line in Monte Hueftle's book along the lines of, "Your problem is that you don't know your symptoms are temporary." SOOOO true. Now I'm asking myself, I'm pushing against the TMS soooo hard to make sure it is temporary. What happens if it isn't? Try to swallow that harsh pill all at once, and it might induce a very real depression (who wants to live a lifetime with chronic pain?) Yet what if it isn't temporary? How do I, in the MOMENT, make sure that life is a life worth living supposing it isn't temporary? By what means do I put meaning in my life? I wish I was back on the boat. That was a beautiful moment. The challenge is to find beautiful things and beautiful moments in life regardless of pain, and in so doing, relieve suffering.