loop, infinite

The platitude about the “meaning” of “it all” that people keep repeating is the one that says life is a road to some kind of destination. Traveling this road is achievement. Reaching the destination is success.

The destination is important for its own sake, and the road is important because it represents “the path” that you “choose.” The “journey,” people say, is in many ways more “rewarding” than the destination.

I think this rhetoric has appeared in roughly every commencement address ever given at every high school graduation in America. I think it’s supposed to be inspirational, and maybe in some cases it is. But this stuff doesn’t inspire me. I can’t make sense of the metaphor. I can’t see how the road is different from the destination.

The reason I’ve had so much trouble in med school (aside from the whole thing about me not actually wanting to be a fucking doctor at all – more on this later) is because I can’t “visualize” that “destination.” I don’t see a “goal” there.

People are mainly able to “get through” med school because they are capable of seeing it as a kind of highway that has a beginning and an end. They drive down this highway and then achieve their desired objective: doctordom.

The med program I’m in is a six-year program. That is how people refer to it colloquially. They don’t call it “that med school at UMKC.” They call it “the six-year program.” That is this school’s selling point.

The normal (I guess “traditional”) way to “become a doctor” is by graduating high school and then going to college, where you take a bunch of science classes and whatnot. You have to do really well in these classes. Then you take the MCAT. I don’t know or care what the fuck “MCAT” stands for (nor do I know what the test is like, because I’ve never taken it – more on this later). I just know that the MCAT is the test you take to get into med school. You have to do really well on this test.

Once you have taken the MCAT, you apply to various American med schools. If you’re lucky, at least one will accept you, and you will then go to that school and begin your “medical training.”

If you aren’t accepted anywhere, that’s not as big of a deal as it might seem, because then you just apply to a med school in a third-world country in the Caribbean. They’ll take anyone, and you’ll get the same M.D. in the end.

Whatever school you go to, your “medical training” will last four years. The first two years, you’ll take classes and shit. The second two years, you’ll be on “clinical rotations.” Then you’ll graduate. Then you’ll go spend a few more years in residency.

The net result: you will have used well over a decade of your life to drive yourself into debt and prepare yourself for a boring job that you have to perform while wearing a lab coat that makes you look like an asshole.

You will make a good living, true: enough to buy yourself an asshole house and an asshole car. Every year you’ll give the American Medical Association some of your money, and every year the American Medical Association will donate much of that same money to the Republican party. This is how doctors “help” people. I’m really going off on a tangent here. I need to rein this bitterness in.

The “six-year program” at UMKC is compressed. It allows you to get your undergraduate degree in two years, instead of four. After those two years, you don’t have to take the MCAT. You just immediately spend four more years doing med school shit, and then you graduate. So this “saves” you “time.”

“Saving time” is the only real reason to come here. The “six-year” aspect of this six-year program is a gimmick; it is designed to fool people into thinking that attending a shitty (and needlessly expensive) med school in Kansas City is a good idea. Man, I can feel another bitter tangent coming on. I need to stop this.

The gimmick works. The idea of a six-year program is incredibly exciting to a lot of people. It would be fair to say that most of these people are Indian.

“In India,” my father has always told me, “medical school is just five years long. And you go right after high school. And you don’t do this . . . undergrad thing they do in America. You just go right through. Medical school. That’s how it should be.”

He’s right. That is an advantage of the six-year program: if you’re 1) very “goal-oriented” and if you 2) “know” that “medicine” is what you want to “do” with “your life,” you come here, because yeah, it does let you cut out a lot of bullshit. If you truly see undergrad as a waste of time, then the six-year program is probably “a good fit” for you.

Here’s another, much more sinister advantage of the six-year program: if you’re 1) unlucky enough to be of Indian descent and if you 2) really give no shit whatsoever about “medicine,” then you’re an even better candidate than the go-getter.

This is because your parents, knowing intuitively that you lack the work ethic to get into med school via “the traditional route,” will decide that you should come here when you’re still twelve years old. They will give you no actual choice in the matter. Their hope will be that you’ll get slipstreamed into the “tightly structured” curriculum and end up a doctor before you even know what the hell happened.

It’s a tunnel. Six years. At the end, you are a doctor. What could be simpler?

To the typical Indian, “becoming a doctor” is the most important, most respectable thing you could possibly do with your life. This is particularly true of Indians who are, themselves, not doctors. They view doctorhood through an idealized lens that’s not so much rose-colored as it is fluorescent pink.

I’m exaggerating, but not much, when I say that my dad (who is not a doctor) sees doctors as veritable demigods and/or shamans who never have to worry about anything. I think he imagines that they make, on average, fifty billion dollars a year. I think he imagines that they work, on average, half an hour a week.

Or maybe not. Maybe I have no idea what he imagines. There’s such a cultural chasm between us. I don’t think my dad and I have ever understood much about each other.

When I go home, my dad always tells me, “Just try to think of it this way – you only have x years left,” where x is the number of years of med school I have left until I graduate.

But what then? That’s not the destination. There is no destination. After I have the M.D., what does that mean? There’s residency. There’s working off all the debt I’ve incurred. It’ll be a pain. It won’t be worth it. It’s not like I ever saw anything worthwhile in medicine to begin with.

There are only two reasons people become doctors: either because they really “want” to “help people,” or because they’re Indian. I know there’s some overlap between those two categories, but for me there isn’t any. I’m in the second group, not the first one.

Don’t get me wrong: I like the idea, in the abstract, of “helping people.” That really does not mean I want to be a doctor.

Maybe I’m overthinking this. Maybe most Indians in medicine don’t give that much consideration to why they’re doing what they’re doing, and maybe they’re better off for it. Because if you take away the cultural pressure, what the hell is left? Is there any real desire there? Or are you just doing this thing because it’s front of you, and because you were told you should do it?

Why do you measure your life this way? Is it because you want to, or is it because that’s how your parents see things? If I were to drop out of med school now, then go write a Pulitzer-winning novel and tell my dad about it, he would, I think, be none too impressed. He would still think of me as “a failure” in “my life” for dropping out. Hell, he thinks of me as “a failure” anyway, and I haven’t even dropped out.

A while back, he told my sister, who is four years younger than me and will probably become a doctor someday, that she should study hard in high school in order to not be “a failure in [her] life” like “[her] brother.” He said this while I was in earshot. He knew I was in earshot.

My sense is that if you’re a father you should probably not say shit like this around your son because he’ll remember it forever, and he’ll resent you for it, even if he doesn’t want to. I have no control over my own feelings.

“You don’t want to be a failure in your life.” That was how my dad put it when I was in high school and was trying to figure out what to do about college. “You have,” he said, “a choice. You can go to UMKC’s six-year program, or you can be a failure in your life and starve to death in the gutter.”

This was not a real choice. I pointed that out then. He denied it. I point it out now, and he still denies it. My mom chimes in and says, “Well, really, it’s completely your fault if you don’t like med school because you’re the one who told us you wanted to do it,” but that doesn’t make any sense.

If you put a gun to a dude’s head, ask him a question, tell him to answer it in a particular way, and then threaten to shoot him if he doesn’t, then that dude will give you the answer you want, but he’ll also remember the gun. He will not forget it.

You can’t come by years later and pretend the gun wasn’t loaded, or that it was a toy gun, or that it never existed. You can’t do that. There is a word for that, and the word is “fucking disingenuous.” Wait, that’s two words. Okay, the word is “disingenuous.”

My resentment isn’t healthy, or good, or normal, yet I can’t get rid of it. I will hang on to my resentment, my insecurities, my neuroses forever. Nothing will change because the road is the destination. I already am where I’ll end up.

People spend their whole lives striving to achieve bullshit, and all the striving changes them. It changes the destination too, turns it into something else. People struggle, for years, to get where they think they want to be. Then they get there, and realize 1) that they were always there, and 2) that they actually don’t want to be there at all.

It would be funny if it weren’t so fucked-up and depressing and terrifying. An accomplishment doesn’t mean anything. You’re always the same person. You can’t separate your “struggle” from your “reward.” There is no difference.