Over the last couple of days I have been doing a lot of personal reflection. When I am in this phase, a person cannot possibly pick a worse time to get into an argument with me, because I lose any inhibition of using my intellect to cut people down.
When I first started my career in firefighting, I was told by both those in and outside the industry I was way too smart to be a firefighter. I didn’t really like that too much and really lashed out against those who took that position. In retrospect, I have to admit most of them were probably right. A few years later, after some pretty big career setbacks, I was told I was too smart to be a paramedic. Like most paramedics, I was proud of my accomplishment. I thought I had learned a lot. I thought I actually made a difference. I was confronted with not only the limits of the career, but also a growing body of scientific evidence demonstrating what I had been doing and believing in for quite a while was either not beneficial or outright harmful. So I rationalized I had done the best I could with what I knew at the time and resolved to be better.
Eventually, I can only say with the obviousness of the truth staring me in the face every day at work, and generally making me feel miserable, I followed the advice of some trusted friends and colleagues and signed up for some classes at the local University to pursue going to medical school. As fate would have it, during this time I got married to a wonderful lady from a foreign country, and believing that I was capable of facing any challenge; in order for her to be closer to her friends and family as I spent countless hours in medical school, as well as assuaging her depression over the absolutely horrendous treatment she was being subject to as an immigrant to the US, I made a decision to go to medical school in Poland.
I was made aware there was a stigma about “foreign medical graduates”, but I honestly figured with my background, career history, personal connections, and hard work, I could overcome such an obstacle. Unfortunately for me, I seriously underestimated the obstacle. Perhaps out of my own ignorance, but I must be afforded the benefit there was some purposeful disinformation. You see, there is not a “stigma” about foreign medical graduates, there is an outright discrimination against them. I considered it a bit of hubris, and even a bit of a racket the US medical system was running. You pay to go to a US school, you get a desirable US residency spot. If you do not pay your “protection money” then you can choose from the reject positions. I felt greatly betrayed. By my “friends” who claimed it was “harder” when in fact it was like saying “if you do not go to the US medical schools then we discriminate against you as if you were a woman or a black person in the 1800s.” Physicians I had taught for, worked with daily, encouraged me to go to medical school, and had nothing but praise for me suddenly would not take my calls or would not meet with me. One I particularly looked up to even related to me in private the reason they did not accept “foreigners” was because “we could not speak English well enough to communicate.” I pointed out that not only was I a natural born US citizen, I had lived in the US my whole life, went to US schools including university, and even worked in US medicine in some capacity both in and out of the hospital for 15 years. (If I do not speak English well enough, who does?) I was told it didn’t matter, that was the excuse used to avoid a discrimination suit; I went to a foreign medical school so forever more I was a “foreigner.”
But I have never been so easily defeated. I doubled down on what I believed to be the key to success; hard work. I struggled to read entire medical texts while friends and colleagues were getting outstanding grades reading USMLE study guides. I started work on my PhD during my clinical years in medical school, while being a new parent, often researching and studying some 80+ hours a week. I was always tired. I was always behind. I was always angry. But I had a mission.
Soon after I came to terms with the fact that if I was going to have a successful career in medicine, it would not be in the USA. I did not like it, but I accepted it. My mission had not changed; I had to be the best, but not for a desirable residency spot; for me. I would know more, be able to do more, and in every aspect out perform any doctor ever educated in the USA. I would demonstrate without doubt or equal, “foreigners” were not only equal, but better. To that I hold.
Unfortunately, there have been some complications. One I didn’t consider was not everyone is as driven as I am. So the very same effort I was making to be better than my US colleagues was also alienating me from my “foreign” ones. It was also affecting my peer group. It created a major disconnect in my life. All of the doctors I was spending time with or conversing with were not “new” doctors; they were professors, senior doctors, department heads. It didn’t really occur to me this was not endearing me to my colleagues who seemed to think I was either a kiss ass or “punching way above my weight” simply conversing with them. In my mind I was simply doing what I had always done, try to do my best. Solve the problems of my superiors. Learn from those who know more. After all it stands to reason, if you want to be the best, you have to learn from the best right?
I started noticing a familiar pattern to my fire and EMS days. I was “too smart.” I had heard at work that when I received my PhD I was entitled to a raise. So when I officially got my paper, I matter-of-factly walked into the human resources office at the hospital, handed the lady (an absolutely outstanding woman who went well above and beyond anything expected of her to help me with all of my problems of being a foreigner in the hospital; who I must regretfully report met an untimely death) my new documents and asked “so how much more do I get?”
The reply was not what I expected. She said she didn’t know and would have to call a lawyer. Having to call a lawyer is never a good sign, especially when it comes to pay. Apparently not only was I the first English speaking PhD graduate at my university, I was the first at the hospital to have a PhD before internship was finished. I was later told the lawyer had to call the ministry and I was the first in living memory to achieve such a feat. I didn’t care. I wanted 2 things. 1. My money (the equal of $20 USD a month). 2. To get on with the next step of being the best in trauma/vascular surgery and intensive medicine. So far I have had to settle for the money. Career advancement this year has not been going well. I may be overstating, but it has been nothing short of a fucking disaster as far as I am concerned. (Maybe others do not agree)
In order to assuage my feelings of failure and inadequacy, I thought it might help to try and give something back to the Fire and EMS community which I credit as being the number 1 factor in my success in life. Sometimes I just never learn…
These were industries that never saw any value in me. The harder I worked, the more I tried, the less I was wanted. The grand ending to my fire career was being accused of being gay. I am not gay, I never was gay, I could not imagine not being attracted to women, I cannot see what women or men see in men. We’re ugly. We smell bad. Aside from work we really don’t contribute much. We cause a lot of problems. But I digress… The fire service was so… I don’t even know the word to use… Base? In their thinking and beliefs the accusation took hold and my life became a living hell. Friends were no longer friends. Supporters would not talk to me anymore. The hazing I took bordered on torture. I thought if I just worked on it harder, I could convince people it wasn’t true and believed they would welcome me back. I had completely neglected the fact that all of the comments of “you’re too smart to do this job” may have been a subtle hint because I was smart I was not overly welcome to begin with. Looking back, I think my response of “when your life is on the line don’t you want the smartest person you can find coming to help?” was not endearing. One of my mentors (I would go as far as to say idol) who wouldn’t publically speak to me anymore offered in secret that “the fire service isn’t for smart people, it is the last decent blue collar job for white men who wouldn’t do well in college.
With that, I packed my bags, vowed never to return, and got a job in EMS. That was met with an almost similar response from the rank and file as well as some in management, and eventually I found my way to the hospital, where finally, my paramedic career was a success. At least as much success as the lowest level provider in the place entrusted with responsibilities well beyond my credentials afforded. But I didn’t mind. Everyone was friendly; I had real friends at work, most even appreciated smart people. I think there might have been a rumor I was gay that crept up, but nobody seemed to care, so I just pretended it didn’t exist. So far, that was the best time in my life and the best job I ever had. With friends that have lasted over distance and time.
When I was putting together my official dissertation defense CV, I was told I should include awards I had won. I told my promotor that was not possible because they would not all fit in the space required. I have trophies and ribbons going all the way back to little league baseball, with accolades for everything I have done in between. (In the days when only the 1st place team got trophies, the losers did not get ice-cream, ships were wood and men were iron.) I also explained that I did not believe in presenting my awards of yesterday because the true measure of greatness is what we do today. I keep them in a drawer. Diplomas in a folder next to them collecting dust. I notice some people actually frame that kind of stuff and put it on their walls. For me, all of those were just obstacles. I had to go to medical school to be a doctor to practice independently, using my judgment instead of rules and “guidelines.” I had to get a PhD in order to change medical practice as I saw reasonable. Considering none of my awards or credentials has gotten me what I really want, they seem more like failures than achievements. I would describe it as a failed experiment for the hypothesis of success.
Still I play the game. At least I think I am in the running. I can picture the trophy. I didn’t come to play, I came to win. There is no coach. There is no playbook. There is nobody to copy. The further I advance the more distant I feel from everyone. I get mad when people question my dedication or my motives. I get mad when people question my intellect or insights. Having suffered so much socially and professionally for being “smart” I really get pissed off to no end when people tell me I am stupid. Being stupid seems like it should be easy, but I just can’t figure out how to do it. Those people (I confess sometimes I doubt they are people and closer to the evolutionary link to common ancestors) seem so happy. They seem so knowledgeable and sure. They celebrate like they won something. I am still fighting like hell trying not to lose.
I didn’t get a trophy today. I’m not feeling very feisty. But I have to quit writing this and slog on now. I have to finally buckle down and force myself to finish the process of getting rid of my US passport. (It is a difficult act for some reason I cannot explain, despite being branded an undesirable foreigner.) Ironically I also have to schedule a test for my proficiency with the English language to apply for a job in yet another country. Perhaps I will get a trophy tomorrow. Luck is not as reliable as skill, but I’ll take it all the same.