“Why does that exempt you?”
“Where would the University get somebody for an indefinite time period, dedicated to this department, and who knows they will be abruptly terminated as soon as a permanent replacement is hired? For me, it doesn’t matter if she tells me tomorrow that she doesn’t need me anymore. So, I think she settled for a disposable, uncertified, warm body.”
“But you don’t seem to feel that way, from all outward appearances.”
“No. I want to do a good job, I want to fill the needs of the department, but I don’t want a career. In a year, I imagine I will be out of energy again, and it will be time to quit.”
“I didn’t perceive you had that view.”
“Let’s get back to board examinations. What happened?”
“I was weak in gynecologic oncology. What she scolded me about was that I didn’t pass the obstetric module.”
“Uh-oh,” Peggy repeated as eyebrows rose.
Brian continued. “On the first go-around, I did pass the obstetric module, but I was weak in gynecologic oncology.”
“Cancer was never my favorite either. I can understand that if you focused on obstetrics, you likely let some of your cancer knowledge slip. You can bone up on that a little. There are practice tests with answers on the national website that you can use, with lists of recommended reading.”
“I only have one more chance, and then I am not eligible to take any more tests.”
“Then you’re screwed,” Peggy said. “Let’s get back to the test. What do you think happened?”
“I haven’t been reading or concentrating well.”
“Is that new?”
“I think it is.”
“Do you know what is going on?”
“No.”
“Are you happy here in Albuquerque?”
“No.”
“Tell me more about that.”
“Faith was planning —"
“Faith?”
“My wife.”
“As in our Faith Pernitelli?”
“Yes.”
“You’re married to Faith Pernitelli?”
“Are you surprised?”
“Yes.”
“Are we that different or that incompatible?”
“I can’t envision you two together. I had no idea you two were married. Anyway, Faith.”
“Faith was planning to go to Texas Southwest Medical Center in Dallas for her residency, or to stay in Lubbock. When she did her match, she put Texas Southwest first, Lubbock second, and Albuquerque third — or so I thought. Now, I find out, she didn’t put Lubbock on the list at all. I think we were both stunned when she didn’t get selected by Dallas but matched here. At first, I thought about staying in Lubbock, but at the last minute, I got a position here and the pay was better, so I signed up.”
“How does she like Albuquerque?”
“She loves it,” Brian said. “But for me, the department doesn’t have any major research thrusts or grants, it’s not a facility that has wide scientific connections, and the mentoring is weak.”
“Don’t you think that the way you have addressed me might obstruct any mentoring that’s available? Have you been similarly hostile to the other faculty?”
“No. But what could you offer?”
“Unlike the other faculty here, I have time. I can help you learn how to find out about something you don’t know anything about, I can offer alternate views of our daily medical challenges, and a list of career mistakes to avoid.”
“How does that help me?”
“It refocuses you on educating yourself. No one can teach you, you know, you have to learn it. Once I figured that out, it was smooth sailing. It’ll be a sink hole of work, time, and money, though.”
“I still don’t see how you are who she suggested I talk to about my exams.”
“How were your in-service training exam scores? What were the scores on your first failed test compared to your second failed test?”
“I took the in-service exams each year in my residency, like everybody does, and I consistently improved on each one. When I got to the first board exam, my score was worse than my last in-service exam. Aren’t they supposed to be the same or similar tests?”
“That’s the impression I had.”
“My second fail was worse than the first.”
“Uh-oh.” Up went the eyebrows again.
Brian’s chair squeaked, but he said nothing.
Peggy said, “So that suggests that reading, studying, listening, and interacting at rounds is not the problem. It suggests there’s a deeper problem.”
“So maybe Albuquerque?”
“You know, I think it’s even deeper than that. Are you and Faith getting along? Are you drinking too much? Are you depressed?”
“None of those.”
“That’s what I thought. So, we need to figure out which of them is the root cause.”
“I thought I said none of those.”
“Your face didn’t. Your pupils are small, not like the last time I saw you, but still, too small for the light in this room. Are you on opiates?”
Brian’s posture reflected the blow. He couldn’t resurface for a breath, but came up with an improvisation. “Wait. I came to talk about board scores, not personal life. This is not what I came for.”
“Actually, it might be exactly what you came for. Maybe you should have a serious talk with Emily about the deeper issues. She has the advantage of administrative leverage I don’t.”
“Well, maybe this conversation was a bad idea,” he said, rising.
“Don’t go yet,” Peggy said. “Have a seat. Tell me more.”
Brian turned back but didn’t sit. “I’m not sure where this is going. Why are you probing my personal life? I came to discuss my professional standing, figure out how to get Emily off my back, and figure out what it is she wants me to do.”
“Maybe we should tease this apart a little more.”
“What do you mean?”
“What does Emily expect?”
“Pass my boards. Start a research project or join with another faculty member on their research project. She also suggested helping Juan, who is the Dean of Students.”
“What would you like to do?”
“Pass my boards.”
“What else?”
“I don’t know. I don’t like Juan. My research project in Lubbock was a pain because my director made me reanalyze data and rewrite and rewrite and rewrite.”
“Wasn’t it a learning experience?”
“Yes. Learning that I don’t like research.”
“That you don’t like research? Or that the learning curve was steep.”
“I don’t like research. I didn’t think it was all about learning at all. It was jumping through hoops of our own creation. Hoops don’t make sense to me, they’re just hoops. They didn’t have any point and weren’t educational.”
“Have you ever done any departmental or medical school projects?”
“No.”
“I imagine it’s rewarding. But there may be a steep learning curve there also.”
“I don’t mind learning curves,” Brian said.
“Most people hate them. At least I do. I endured them to get to the final product. So did you.”
“What do you mean?”
“You went to college, medical school, did a residency, and completed a fellowship. Those all have learning curves you must endure and hoops you must jump through to get to the final product.”
“Learning those things left you with tangible results. At the end, I could operate, do ultrasound, and manage complicated pregnancy.”
“Don’t you think learning will go on indefinitely? You are going to use technology and know more about diseases than we can even imagine at this point. Look at me. Ultrasound was a dream when I was in medical school. Tools like that are coming your way, and you will have to learn them to keep up, just like I did.”