High hopes

He was just a kid when his father sat him down at the kitchen table. What do you want to be when you grow up son, he asked.

I want to be a doctor just like you dad, he said. 

His father was a well-liked family physician in their town. 

Grew up playing sports with the neighborhood kids. Spent summers at the local pool. Goofing around and riding their bikes to the local ice cream shop. 

He grew up liking the Cowboys because his father was a big fan of Roger Staubach. And he loved his dad so he was a big Cowboys ;

fan too. 

Got a paper route when he turned thirteen. Stocked the shelves at the local grocery and saved up and bought himself a weight set when he turned fifteen. Pumped iron in their musty middle class basement. Devoured his mothers homemade cooking, got big and strong. Until she had to start making more food. Pasta Sundays were his favorite. 

He grew up to be big and strong; shoulders like hubcaps, abs like a flattened turtle shell. Dark hair thick and curly like movie stars. In high school, he played linebacker and running back – he was a star of the team. Got drunk for the first time on his old man’s Schlitz. He kissed the cute cheerleader. Took her to the Springsteen concert. Asked her to the prom. Picked her up in his dad’s pickup. Lost his virginity that night in his friends house drunk on 3-2 beer. 

Went to college. Decided he wanted to be a doctor like his dad, his idol. Enrolled in the state school, premed classes. Had work ethic like men of a past generation in steel factories. His father taught him these blue collar values. He earned straight As that semester and landed on the Dean’s List. His dad proudly brandished this letter on the refrigerator. Throughout his college years he continued to maintain an exceptional GPA while exploring the social scene. He made friends. They’d tailgate for the university football games. Moved into a campus house. Hosted parties with kegs. On off nights he delivered pizzas for beer money. Picked up a position in a research lab studying cholesterol in mice. Made the type of memories he could share with his kids one day — when they were old enough to hear them. 

Took his mcat and scored very highly. Got accepted into 3 medical schools. Chose to attend the school where his father earned his MD many years before. 

I’m proud of you son, his father said. 

These words were the pinnacle of his life. Beyond making captain of the football team and bedding his crush and all of that – this was everything. He spent long hours in lecture halls and libraries. Reading his textbooks and reviewing his notes until his eyes couldn’t take any more. 

Caught the surgery bug. Felt like it was what he was born to do. It will be hard, his father said, the hours will be long and the training will be tough. 

I can do it dad, he said. I will do it. 

He thought of his fathers hard work. and his immigrant father before him working 15 hours in a steel mill to provide beef and potatoes. He was born with this grit. No challenge was too great. 

Began intern year. Lived and breathed surgery. Spent so many nights napping in the twin call room bed. Eating slop cafeteria food. No time to work out. No time to sleep: go go go. But he kept his head down and chin up. Just like his football coaches taught him. Just like his father taught him.  

One day he was in the elevator. And like god planned this stuff — this beautiful woman was in the elevator. He asked her out. Flame ignited. She brought him dinners and lunches to the hospital when she could. Dates at the hospital cafeteria. Went hiking and camping and kayaking on his rare golden weekends. 

They got married and had two beautiful children. Big house with a swimming pool and all. 

You did it man.  


He drove home with a bottle of cheap whiskey in his hand, taking pulls at the red lights. He drove the car in the driveway, parked in the garage. Closed the garage door. Kept the car running.  Pulled a picture of his kids from his wallet and put it in front of the odometer. 

He ran the car and fell asleep. For the last time.

This is a true story.

Rest In Peace, doc — you were a human.  Everyone had great things to say about you. 

The grass was greener.

What if I get fired

What if I get fired. What could I do:

1. Reapply to other residencies, a different field, something. Sensible. Actually no I can’t run it back a third time.

2. Make and sell drugs Walter white style. Hated Ochem lab, my drugs would suck and I would get executed with my body dumped in a denny’s dumpster. 

3. Onlyfans. Get no subscribers. Humiliating. 

4. Start a band. Completely fail. Become guy who plays Journey covers at beach bar to old people on vacation. 

5. Impregnate really rich girl, like, heiress rich. Stay at home dad, throw the ball with the kids, fine tune my cooking skills. Please? Haha.

6. Med spa. Botox, filler, the works. Hire hot girls to market for me. This is plausible. 

7. Move to like, Costa Rica, live in modest shack of an apartment. Bartend. Invest soul in Taoism. Take up surfing. Become Paul Rudd in Forgetting Sarah Marshall. I can do this.

8. This. 

9. Get a girl, any girl, with a good job pregnant before they realize I’m a loser. For years I’ve been warned about getting a girl pregnant and the ramifications. Well: uno reverse. 

10. Start using anabolic steroids, take my physique to the next level, claim natty, curate my Instagram, take motivational gym videos, become fitness influencer, peddle useless supplements. Profit?

11. Start bartending again. Become degenerate. Indulge in a life of unchecked hedonism. Realize at 40 I’m a loser and need to check in for a long stay at the Betty Ford Center. 

12. Invent new dating app that’s slightly better than tinder and hinge or whatever. I have ideas. But I haven’t the slightest fucking clue how people create apps. 

13. Move in with mom. I can deal with her nagging me about taking out a the trash for the delicious food. 

14. Move in with dad. We could watch football on Sundays while he tells me what an idiot I am. He’s not wrong. 

15. Beg on the street corner. Use cardboard cutout sign with my ERAS pic to guilt people into giving me money.  

16. Teach like physiology or something at local college. I like teaching so this could work. But die perennially renting with 200 grand in debt and the shame of being an almost-yet-failed doctor.

17. Consulting. Every r/residency redditor’s pseudo wet dream. Well I hate computers and numbers and I need to be threatened to respond to work emails so scratch that.

18. Career in research at public university (LMAO)

19. Work on one of those oil rigs for 6 months a year for six figures. Become reason they have to reset calendar to “0 days since last accident”.

20. Go to fortune teller who unirocally tells me great fortunes will abound at the right time. Listlessly drift through life waiting for my ray of sunshine, my moment. 20 years down the road realize I got scammed. Can you believe it.

21. Buy the best bottle of single malt I can afford. Drink it on the beach. Listen to my favorite music. Wait until three in the morning then see how far out I can swim.

22. Join a gang. Make a hilarious yet untimely joke and get executed.

23. Get an MBA and parlay it with my medical degree into becoming a hospital administrator. If you can’t beat ‘em, join em. Right.

24. Buy one way ticket to like, Colombia or Thailand. Show up with nothing. Figure it out. Pretty rock n roll if you ask me.

25. Start testosterone clinic for forty and fifty-somethings with money who want an edge. Str8 cash homie.

26. Hey uh yeah how bout I just keep my job? Wouldn’t that be something.

Dating in Residency: Where to Find GF

Went home to visit family and friends. Buddy invites me to his daughter’s first birthday party and I’m like: Jesus, how long have I been gone. He invited me to his wedding but I couldn’t get the time off to fly home for it. So I forgot he was even married. Now he has a daughter and I’m just — oblivious.

Then my mom, she makes me dinner and we’re hanging out and she not-so-subtly starts rambling about how her friend Terri’s son who is my age got married two years ago and his wife is pregnant. Yeah I get it mom you want grandchildren.

Reflect on my own life. Hook ups and dates and talking stages until I fade out and move onto the next. Fun? Sure. But any human can admit it’s empty after a certain point. And I’m always third or fifth or seventh wheeling my coresidents with their spouses. Deep down I want to feel something again.

But I mean… I don’t go out much. I spend most time in the hospital and I already pseudo-dated one nurse at my hospital. That ended and became awkward. Swore I’d never swim in that river again. The gym, forget it. And dating apps — they feel like a butter knife slowly cutting off my limbs.

So what then.


The asteroid

Millions of years ago the asteroid hit. Enormous mesozoic beasts roamed the earth, foraging for sustenance, mating, exploring the precivilized earth. one day they looked up and saw flaming space rock Chicxulub in the Yucatán peninsula. Oh shit, they thought.

Devastating blow to the earth’s ecology. Smoldering ash and brimstone flew across the skies. Fiery hell rained from the heavens. Killed lots of dinosaurs.

But not all of them. many lived.



May 2018

There’s a spider inhabiting the dark crevices of my brain.  A poisonous spider.  A black widow.  Retreats to its nest during the day to let me function.  Idly resting until it’s feeding time, when I brush my teeth and turn out the lights and put my phone away and try to sleep.  That’s when it comes out.  Encases my brain in its sticky web like an insect.  Retracts its fangs, venom dripping from the tips like the saliva of a basset hound, sinks them into the flesh.  Injects the poison.  

What if I blow it. 

What if I don’t get the score I want – the score I need.  What if the test is remarkably different from the prep materials I’ve been using, memorizing, devouring.  What if my brain doesn’t work.  What would happen?  The neurotoxins rapidly hijack my nervous system.  

Let’s imagine.


Part 4: Rorschach Test

April 2018

Sunlight drifted through the open window and crisp spring air breezed through the screen. A cardinal sat perched on a nearby tree branch, its radiant red feathers artistically contrasting the newborn spring greens, glowing in the April sun. It was the first cardinal spotting of the year. I marveled at the creature as it centrifugally hopped along the branch of the elderly sycamore. Speckled eggs nestled comfortably in a messy swarm of twigs, soon to break with the new life of hatchlings. It paused for a moment, providing me the perfect opportunity to capture the cherry of nature. I zoomed in on the majestic bird and snapped a photo. Too blurry. Stealthily creeping closer to the window for a better vantage point, I focused the camera for the perfect shot with the shallow breaths and the steady aim of a sniper. The bird was in perfect focus, surrounded by vibrant greenery with the sun’s light saturating every last feather and leaf.

My phone rang. 

It flew away. 


Part 3: Get a Life

March 2018

I think I’m going to wear the grey cardigan you got me for Christmas, she said. With jeans and a black tank. And the black wedges too.

Babe, please – no, I replied.  It’s way too big.  You should’ve returned it.  It’s not even a cardigan on you; it’s more like a robe.  You look like a goddamn Jedi knight in it.  Like Obi Wan Kenobi.

Who’s Obi Wan Kenobi?

Jesus chr… Never mind, I muttered while shaking my head and staring at my computer screen.  Just wear something else.

But it’s comfy and I think it’s cute and you it reminds me of you.  Plus, you’re not even here, so I have no one to impress. 

Exactly, I’m not even there, so you don’t have to wear it to prove to me that you like it. How about the white Velvet Underground tee shirt?  The one with the red lips. 

Ugh, fine. I just picked up some new red lipstick I can wear to match it, she said. That might be cute.

Yeah, okay, now we’re talking. Do that and send me a picture so I can see how good you look. It’s been too damn long.

I know, babe. But just think – two more weeks of studying hard until you’ll be done with this exam. Then we’ve got all weekend to celebrate. You’re gonna have me, Michael, Cory, Dante, and Anthony coming down to visit ya. But most importantly, me, the love of your life.

I can’t wait, I replied.


Part 2: black lagoon

In the black of the night, I was sitting in the driver’s seat, guiding a small sedan along a serpentine one-lane suburban road. A dense fog lingered above the ground. Headlights illuminated the path before me. There were no other vehicles on the road. There was no music playing. The steering wheel, dashboard, center console; all unfamiliar. This wasn’t my car. As I approached a bend, I slowed the vehicle and gazed to my left. There was a small ranch house. Tire marks ripped through the grass. The tracks leading up to a bare coniferous tree split in two. A bouquet of flowers at its base. My attention returned to the empty road as silence floated through the air. I drove further before looking to my left again. Two black horses were walking in the oncoming lane.


Part 1: missed calls

November 2017

You woke up, eyes heavy. Vision blurred. Brain fuzzy. A soul full of laughter and joy.

Look at the clock: jesus christ it’s almost noon. How did you sleep this late, on a couch nonetheless. It’s medical school and you’re tired and on vacation visiting friends. You deserve this. You are at Shaliek’s apartment. Best friend from college. He’s in law school now. Cozied up on the couch with her on the eighth floor of this grungy building. This is exactly where you needed to be. Surrounded by friends and laughter. This is what you’ve been longing for.

You reach around for your phone – the coffee table, between the couch cushions, not there. Slip and wiggle your hand under her. Feel the rubber case and cold glass of the screen. Yank it from beneath her butt. Press that button on the side. So many notifications overlying a background of happy days. Who could want this much from you on a Saturday morning.

Mom: six missed calls, messages saying “call me, please”.

Missed calls from your brothers.

Dozens missed calls from various friends.

What gives.


hey man

June 2022

I’m sorry I didn’t come to your birthday weekend. I’m sorry I bailed on your family’s party in the winter too. I really am sorry. I’d say I’m sorry about not acknowledging you birthday when we originally met, but your birthday is the first of July. An atrocious birthday — we were all just tepid little interns on our first day.

You were an intern doing a transitional year internship before fleeing to greener pastures in the world of anesthesia. Life was.., idk, predetermined. I was an unmatched lost boy trying to figure out what the hell I was going to do with my life. We started intern year in the ICU together. We did our first intubations, lines, etcetera as doctors together. You took a picture to commemorate this. We joked around and wrote our notes together. We’d go on long walks around the hospital on slow afternoons to just goof around and vent and bond. Funny thing is, I scored like fifty points higher than you on Step 1 yet you were the better intern, the better doctor. You made me want to be smarter. I still remember how torn up you were when your thirty-something patient was put on ECMO and eventually died. We did chest compressions and watched people die together.