September 1st, 208

The first time in a while that I am posting when I am not completely depressed.  

Earlier tonight I felt like getting down "on paper" some of my thoughts and feelings.  

I am reading Operation Shylock by Philip Roth and like it a lot.  Roth is so courageous as he opens himself up to the world and says "this is me, this is what I think and fell"  He is definitely one of my favorite writers.  As I read the book I realized that Everything is Illuminated is a kind of cheap copycat of Operation Shylock.  The same is true about Andy Kaufmann's move.  I can't remember the name.  That is another thing.  Lately I cannot concentrate or remember things like I used to.  It may be from the heavy pot smoking, but I am not sure.  For some reason I think it might be from the sheeps brain I ate with Brian that one time at Canary.  

Getting back to Operation Shylock, I wonder if that book is just an imitation of something else.  One possibility is Woody Allen's "The Kugelmass" episode.  Anyway, this notion of story within a story made me think of adding that "trick" into my play.  I could write about me trying to write the play as it is being performed.  But what would that add.  

Oh and about that play.  I think it is good and could be good and could be my big break.  Still it is just one good idea.  Why is it that some creative efforts become plays or movies or great books and establish the artist.  Other, equally creative efforts become an episode of Mad Men or an obscure play that no one appreciates.

I cannot concentrate.  I cannot focus on one task for any significant amount of time.  I read about how multitasking reduces your IQ.  I may be an example of that.  By trying to do too many things at once I lose my peak performance ability for all tasks.  Starting tomorrow.  No starting now I am going to focus on the one task I am doing and not think about the rest of the day.  

I feel anxious.  I know why.  I got a call from Greg D about a patient with cardiace tamponade.  Tomorrow we will do a pericardiocentesis.  This is something I have not done and more than that I don't know much about cardiac tamponade.  I am supposed to be an Echo maven, but cannot even tell you the basics.  There is anxiety about be faced with a situation that will expose me as a fraud.  

I need to slow down.  Take things one step at a time.

Mad men is a great show.  I like it so much.  At the same time it has gotten under my skin.  The sense of frustration, sadness, hiding of secrets, fear of failure, pressure of responsibilities that lies just below the surface of the slick sets, smoking of cigarettes, and heavy drinking is so effective that it makes me anxious and unsettled.

Exercise helps me so much.  Today after the run I felt so much more capable of dealing with everything.  I need more of it.  The best time of my life was when I was participating in sports all the time.  I think that the great physical activity kept my mood better.  I did not have a choice back then.  Now I think to much about how I am going to choose to spend my free time.  Is it worth it spend a whole afternoon playing pick up basketball?  Rollerblading?  Getting involved in a soccer league?  Setting up a time to play tennis?  The answer is yes, but I do not always feel that way and try to get the most of my time with a quick run or work-out in the apartment.  Kind of effective.  Still, I am again trying to make a commitment to more exercise.

Work scares me b/c I am not confident in my clinical skills, my social skills to deal with the other attendings, and the office where Dick and Jane (and Donna) are doing some crazy things to run the office as efficiently as possible.  For now I am the good little employee, but when we conflict or clash it will be interesting to see what happens.  I cannot decide if this is the right situation for me.  I probably will stay on and try to become a partner if for no other reason than inertia.  The smart thing to do (and I think I am going to do it) is look around for another job (probably in NJ) just to see what else is out there, but also to use as leverage for this situation.

I want to live life to the fullest.  Carpe Diem.  But those are just words.  For a while I had this amazing energy and motivation to do things.  Now I am back in the usual rut of not wanting to do anything after work except watch TV and surf the internet.  I do the bare minimum of required things to get by.  Stay up late.  Have a late snack (tonight pistachios) and then do the whole thing over again.

At work I am always rushed and careless.  Again tomorrow I will try to slow things down.  I think I have to accept working later or else things will never change.  Will any of those internal medicine guys start referring to me?  Hospitalists?  Right now I have no respect.

Tomorrow I will try my best.  Compete with myself to live life.