Future troubles

I've been having a difficult time considering what I will do with the rest of my life. I tried to put it off by applying for a public health fellowship; unfortunately, I was not selected and now I've got to go ahead with my 4th year of medical school. Not a drag, but not ideal for my at the moment.

Reading "Thinking in Pictures" by Temple Grandin, an autistic woman that designs tubes and chutes to transport cattle in meat plants and ranches, has helped within the last five minutes. I listen to Grandin talk about the great things that she gets to do as part of her job. She gets to design, she gets to learn systems for transporting animals, handling animals and slaughtering animals, she gets to work outside, she gets to be visual, she gets to do research and write articles, and most importantly for her, she gets to work with cows.

I'm realizing now the multifacetedness of any job. It can involve so much. Really. And maybe, that's just that you can make your job do what you want--at least Grandin has found the secret. A woman who can barely pick up social cues and who barely understands social interactions has figured out society enough to have her ideal job.

So the question is: how do I incorporate what I want to do? And more importantly, what is it I want to do? Number one, I want to be good. I want to diagnose. I want to find out what is acutely wrong with someone. I want to be right. Therefore, I need to see sick people. Well, that's not entirely true. If I were a family medicine doctor, I could always find something to diagnose, even with a perfectly healthy patient. I could encourage living healthily, or finding love, or staying productive, or fricking recycling or reusing or whatever to make the world a better place.

But what I really want to do is work with people that are dying. And alternatively, work with people that may live and not die. I'm not sure why. Perhaps because getting into medicine was inspired by my understanding the importance of life? Because I'm fascinated with the spiritual art of dying? Because I believe that dying should be more of an emphasis for humans? Because I want to perform doctor assisted suicide? These are, in fact, viable reasons, although I don't know that any one of them is completely true.

I would like it to be okay for me to cry in front of a patient. I would like to be able to do so. And simultaneously, I would like the responsibility to remain strong for a person in their most desperate time. And I make this sound so romantic and wonderful (to mine ears, at least), and then I also become floored at the thought of performing surgery on a patient to remove their tumor. That would be so fantastic: to remove a tumor and help a person live longer. But recently I've been bothered with the idea of sustainability--I know it should be an important part of my future, but I also want to do something that floors me every day.

I sure wish I had another year to think about this.