by Anthony Youn
“I’m serious,” he says.
“Leeches?”
“Be fancy. Call it leech therapy. I’ve done it several times. We bring her to the hospital and attach a bunch of the bloodsuckers right there.” He points to each of Michelle’s nipples. “They suck the old blood out. In a few days, her body will create new blood vessels that will take over for the leeches. Hopefully.” He turns to the OR nurse. “You know the drill. Call an ambulance.”
“Wow,” I say. “Leeches.”
“New technology, my ass. We’re going medieval.”
. . . .
ROMEO ESCORTS MICHELLE to the hospital. I stay behind. I say goodbye to Heather and the rest of the staff, then I run an errand on Melrose Avenue in West Hollywood. By the time I head back toward Beverly Hills, the sun’s starting to set. I drive into the hills, find a spot to park on Mulholland Drive, and watch the lights of the San Fernando Valley flicker on. It looks as if I’m peering down at a second night sky. At around seven, I head to the hospital to check on Michelle.
As I exit the elevator, I hear a scream. A woman stands in the middle of the hallway and points at the floor. She shrieks again and backs up slowly. I jog toward her and see a bloody trail coming out of Michelle’s room. At the end of the trail sits a huge, bloated leech.
“It’s nothing,” I say. “Leech therapy.”
The woman stares at me, horrified, her hands over her mouth.
I push open Michelle’s door and find her lying in bed, sound asleep, the rest of the leeches locked up in a jar somewhere.
Beverly Hills.
Movie stars. Pop icons.
Leeches.
IN THE PARKING lot, still in his scrubs, Romeo leans against my rented Ford Escort. “I couldn’t let you go without saying goodbye.”
“I was going to find you, too. Thank you for everything.”
“You got to see pretty much my whole bag of tricks. And I’m serious. Come back.”
“I’d like that. Hey, I have something for you.” I pop open the back of the Escort, reach in, and hand him a gift-wrapped box. “A little token of my thanks.”
“Get outta town. What did you do?”
Like a kid at Christmas, he rips off the wrapping paper and flings off the cover of the box. He stares inside. His eyes begin to water. He shakes his head and pulls out my present.
A lamp shaped like a naked woman.
He bites his lip. “She’s beautiful.”
“The nipples flash the SOS distress signal.”
He throws his arms around me, locks me in a bear hug. “You feel me.”
“I feel you,” I say, crushed in his embrace.
20
Monkey Time!
Fourth year. January.
And so it begins.
The end.
We interview for residency.
I’ve begun the process over the summer, filling out applications, gathering letters of recommendation, arranging for transcripts and scores. I send out applications in November. In late December I will hear where I’ve been invited to interview in January and February.
If I’m invited to interview.
I have chosen one of the most competitive fields in medicine. I’m told there are 60 openings for plastic-surgery residencies and 250 qualified candidates. Among those I envision a horde of gunners, ass kissers, and overachievers from Johns Hopkins, Stanford, and the Ivy League, causing me debilitating résumé envy. Not to mention frustration and bewilderment at some of the essay questions I have to write. One application—six pages of short-answer essays—closes with this 250-word doozy: If you found Aladdin’s lamp, what three wishes would you make?
First, I would wish to get into your residency. Second, I would wish that you pay all of my expenses and pay off all of my loans. Third, I would wish that the residents and attending doctors I work with not be as stupid as this question.
I put this residency low on my list.
All told, I apply to thirty-five plastic-surgery residency programs and twenty general-surgery residencies as backups. In contrast, Tim applies to five residencies for psychiatry. Why the discrepancy? Two reasons. First, psychiatry is less competitive. Second, I’m paranoid.
Given the odds, a possibility exists that I may get shut out of every plastic-surgery residency. If that happens, I’ll go to Plan B. I’m so determined to become a plastic surgeon that I’m willing to get there through the back door—complete six years of general-surgery hell and then reapply for a plastic-surgery residency. I dread having to go to Plan B.
In January, I receive fifteen interview invitations for general surgery and eight for plastic surgery. I prepare to spend the rest of January and much of February driving and flying around the country to meet the residency program directors and residents who will determine my fate. I take out another loan to cover my expenses. No big deal. Toss another $25,000 into the pot that someday I plan to pay back, hopefully before I move into my assisted-living apartment.
I start by driving to Toledo, Ohio, for a general-surgery interview. I have no interest in either general surgery or Toledo, Ohio, but it will give me an opportunity to practice interviewing. This will be a trial run. I’ll probably schedule at least one more general surgery as a practice. I am all about preparation.
I spend the night before in my hotel room, asking myself dummy questions that I’ve obtained from Shelly the gunner, who’s somehow obtained a list of sample questions that interviewers usually ask. The interview itself will make up only a fraction of a full day of tours, lunches, lectures, and possibly a second interview. I memorize the questions I’ll be asked and prepare how to frame my answers. I work on my poker face as I practice such lies as “I find the field of general surgery absolutely fascinating” and “Why do I want to become a general surgeon? Oh, general surgery is by far the best fit for me. And I love doing trauma.”
After Toledo, I hit Cleveland, spend another entire day pretending that I was born for general surgery. I drive back feeling like a fake. I still have thirteen more general-surgery residencies where I’ve been invited to interview, but I decide to put them off. I’m ready to take on plastic surgery. I’ve heard that some of the interviewers can be quirky—think Romeo Bouley, MD—but at least I won’t be faking my passion.
INTERVIEW ONE.
Cincinnati.
I drive there the day before and again spend the evening in my motel room, grilling myself with questions. I’m more than ready.
I bomb the interview. A boring resident reads a bunch of boring questions off a sheet in front of him. I try to engage him, but he keeps his head buried in his canned questions, and we don’t connect. After the interview, several other candidates and I go on a tour of the hospital where we’d be working. As we stroll down a corridor clustered behind our tour leader, an even more boring general-surgery resident droning on about their cutting-edge facilities, a young resident staggers out of the call room. He looks emaciated, his skin translucent and gray. He shields his eyes from the overhead lighting as if he’s been hibernating and hasn’t seen light in six months. He lurches toward a vending machine. I fall back from the group.
“Hey.”
“Hey,” he says in a reedy voice. “You got change for a five?”
“Allow me. My treat.”
“You must be applying for residency.”
“You saw through me. I’m trying to buy you off.”
He smiles, points to a Snickers. The candy bar thunks into the metal tray.
“So, how do you like it here?” I ask.
“This place is hell.” He chews, savors the taste. “The worst. It sucks.”
“What sucks, exactly?”
“Everything. I haven’t left the hospital in six days. You want me to take you through a typical day?”
“Please.”
“You start rounding at five A.M. You finish by about eight. Then you round with the chief resident until nine. Then you do full rounds with the attending until eleven. Then you operate. By the
time you’re finished in the OR, it’s four, sometimes five. Then you round again.”
He swallows the rest of the Snickers in one bite. He looks at me with sunken, lifeless eyes. “Round, round, round. By the time I finish seeing patients, it’s nearly midnight. Then I start all over again. Round and round. They won’t let me leave. I’m a prisoner. They will not let me leave.”
Okay, so we’ve established the bottom.
I still rank it ahead of all the general-surgery residencies.
THE CITIES, SURGERY centers, and hospitals begin to blur. I start to feel like I’m the ball in a pinball machine.
Then the interviews get weird.
Escape from New York
I spend two grand on an overnight trip to New York, which results in a one-minute interview after a two-hour wait in a hospital located in a burned-out section of the Bronx. Out of cash, I ride the subway from a sketchy subway stop in the North Bronx all the way back to JFK, an hour trip, my briefcase clutched between my clattering knees, my eyes fixed on the floor in fear, avoiding the eyes of the other riders on the car, who look like they’re on their way to a Crips convention.
I put this residency low on my list.
Draw Me
In a midwestern medical center, an interviewer slides a sheet of paper across the desk. “Draw an ear.”
“Sorry, did you say draw an ear?”
“Yes, Mr. Youn. The folds of an ear. And then I’m going to describe a deformity, and you’re going to draw the procedure you would perform to correct it.”
Hand shaking, I begin to sketch.
I put this residency one above Cincinnati on my list.
Tie One On
This interviewer smiles diabolically, waits for an eternity, and says, “Take off your tie.”
I’m getting used to being ambushed, so I undo my tie and pull it off without question.
“Show me how you would do a muscle or a skin flap to re-create a nose. Do it with your tie.”
He chuckles like Freddy Krueger.
I like the creativity this guy shows. I just don’t like the guy. The way things are going, so far this one’s my favorite.
See No Evil
Hands down, the craziest. In California.
An attending surgeon leads me into his office. He stands behind his desk and stares at me. I don’t know whether to sit, so I don’t. I face him, shifting my weight nervously, waiting for him to give me some indication of how to proceed. Finally, he points to a chair. We sit simultaneously. He reaches behind him and places on his desk a sculpture of three monkeys in “See no evil, hear no evil, speak no evil” pose.
He claps his hands. “IT’S MONKEY TIME!” he shouts.
I practically fly out of my chair.
“IT’S MONKEY TIME!” he screams again, then says quietly, “Discuss.” He places a stopwatch next to the monkey sculpture. “You have thirty seconds to impress me . . . Doctor.” He clicks on the stopwatch.
How do I get the hell out of here?
FINALLY, HOME.
Grand Rapids.
Where I began my adventure into plastic surgery six months ago, and where I discovered I wanted to be a plastic surgeon.
The moment I step into the surgery center, I’m greeted like a family member. My interviews feel relaxed, unhurried. The chief of plastic surgery asks me point-blank, no monkey business, “Why do you want to be a plastic surgeon?”
“I like the variety of surgeries that you do,” I say. “I like doing reconstruction where you can really see changes.” I pause. I’ve given this a lot of thought. “I love the immediate gratification,” I say. “I love that you don’t have to wait for lab reports or anything else to see the results of your work. And being a plastic surgeon is very creative, very artistic. I also believe that a plastic surgeon can change a patient’s life.”
I spend the whole day hanging out in Grand Rapids, getting reacquainted. Everyone treats me as if I’m already a resident. I leave with Grand Rapids locked as my top choice. Honestly, it’s my first, second, and third choices.
I have to get in.
“IT’S GOING TO be tough.”
Dr. Karr, a dean of our medical school in Grand Rapids and one of the three people who interviewed me, sighs at the other end of the phone. “They like you, Tony. They like you a lot. But they only have two spots.”
“Really?”
“I know. What can I say? And—” He holds. “They already gave one of the spots to Garth Ellington.”
My stomach flips over. I rub my forehead, lean against the wall in the kitchen on Flower Street. “Ellington, huh?”
“Do you blame them?”
I worked with Garth Ellington for one of the weeks I spent at Grand Rapids. Garth Ellington is thirty-one, married, has two adorable kids, has a black belt in kung fu, is a gourmet cook, does metal sculptures for fun—several of which have been displayed in a New York art gallery—scored off the charts on his Boards, and demonstrates the kind of natural skill as a surgeon that you can’t teach. He’s also one of the nicest guys I’ve ever met. I think of him as a real-life James Bond. No. I don’t blame them.
“What about the other spot? Am I up against like two hundred others?”
“Not that many. Half that.”
“Great.”
“I’m pushing for you, Tony. I’m pushing hard.”
“I appreciate that. Thank you. I really want this.”
“I know you do.”
“So, what do you think of my chances?”
Another pause.
“Touch and go.”
21
Match Madness
Match Day.
The fifteenth of March.
The day we learn which residency program we will attend.
Everyone calls Match Day the single most important event in our four years of medical school. The hype doesn’t do it justice. Match Day determines not just where we’ll be but who we’ll be.
After we complete our interviews (I attend all eight of my plastic-surgery interviews and almost all of my general-surgery interviews), we rank our residency programs in order of preference and submit the list to the National Resident Matching Program. The NRMP compares our list with the list the residency programs submit and then decides if there is a match. To me the process sounds like E-Harmony or JDate, but this is how it’s done. I pray that our top choices match, because if none of our choices do match, we enter a nightmare—the dreaded Scramble. Through desperate phone calls, e-mails, faxes, and calling in every favor we can muster, we literally scramble to land in one of the few residency spots left somewhere—anywhere—across the country. We may enter the Scramble a dermatologist and exit a geriatrician. Or worse. We may find ourselves on the sidelines, an anomaly, an unemployed doctor.
I rank Grand Rapids first. I don’t have a second choice. I rank the two places where I had my least objectionable interviews two and three. I rank Springfield, the hand clinic, fourth; Cincinnati, where I spoke to the zombie resident, second to last; the hospital in the North Bronx, last. While I’ll be devastated if I don’t land the one spot available in Grand Rapids, I’ll understand and accept any of the other plastic-surgery residencies, as miserable as I’ll be at some of them. That’s how much I want to become a plastic surgeon.
The closer we get to Match Day, the less I sleep. The day before, I’m an ornery, fidgety, sleep-deprived wreck. All week Tim has appeared strangely calm and full of clichés, which makes the rest of us want to pummel him. He’s ranked Cornell University first and has received every indication that he’ll get in.
“It’ll be what it’ll be,” he says. “Nothing we can do about it. You have to go with the flow.”
“The ship has sailed,” James says.
“It’s out of our hands,” I say.
“A penny saved is a penny earned,” Ricky says.
“Screw you guys,” Tim says.
The night before the rest of our lives, James abandons us to go to dinner with Daisy, Ricky disap
pears to destinations unknown, and Tim and I decide to take one last stroll across campus. It’s a perfect spring night, brisk, breezy, the air smelling of lilacs. As we walk, images from the last four years blaze through my mind at warp speed, my collection of moments—the horrors of Owen Hall; riding my Huffy across campus, almost sailing over the handlebars after too many beers; orientation; our small group and catching our three-hundred-pound classmate, who has since dropped out; Clark the refrigerator repairman’s unfortunate proposal at the USA Café to Daisy, who’s now engaged to James; Youner, master of the shopping-cart dance; my first look into the bucket of hands; our first night at Flower Street and the ensuing ten thousand knocks on the head I received from the low ceiling leading into the basement; the endless days and nights in the Nerd Room; Dr. Gaw and gross anatomy; clinical skills and my terrifying timed interviews with actor patients; the night I spent with the horrifyingly unfit mother whose pet raccoon feasted on her poor baby’s face; the ten-hour Whipple surgery; “I’M COMING HOME WITH YOU, PRETTY BOY!”; the world of naked-lady lamps and leeches in a Malibu mansion; “Monkey time!” and my other ridiculous residency interviews; and Grand Rapids, the residency I long for, the place that feels like home.
And then I focus on the people, the ones who have touched my life forever—
Tim, Ricky, and James, my three dear friends who helped me resurrect my confidence and locate my true self. It has been my privilege to share my medical-school journey with them. And among my other privileges—I held a newborn baby as he first entered the world; I performed a perfect spinal tap on a small, ill child; I encouraged a man to face death and conquer it; I rocked a sick baby to sleep in my arms until the sun came up. And I felt honored and awed to have learned from the gifts of all the people who donated their bodies for my medical education. Last—and never least—I gazed into the eyes of a beautiful doctor-to-be who did not look away but was able to fall in love with someone as flawed as I.