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Long story short- I have top 10% grades at a T10. Got severely sick just before OCIs, wound up having to go to them while recovering/still heavily medicated, look to be striking out. I am desperately mass-mailing, but am worried that many of the places I am now applying to are going to avoid bothering with me on the assumption that there must be something wrong with me, or that I am only interested in them as backups. Especially now that I've just gotten my first rejection from a mass-mail target which still purports to be looking for summer associates. How do I address this?

Keep your grades up and apply for federal clerkships.

What? There is nothing to address.

Most mass mails will lead to rejections (or no response at all). Just because they are looking for summers doesn't mean that you are a shoo-in for an interview with top 10% grades from a T10. Firms aren't going to think that you are their backup, they are going to either want to interview or not. The only thing you can do now is apply to as many firms as possible.

Most people with top 10% grades at a T10 land ok, even if they strike out at OCI (especially if it's due to circumstances rather than personality).

Are you absolutely set on or do you absolutely need biglaw to pay off loans? Keep mailing, do 3L OCI, and if those fail, go for clerkships and then try to get biglaw from your clerkship. Otherwise, you could probably at least land something in a midsize firm on graduation if you apply broadly enough.

Also, if any of the interviewers made inappropriate comments about your health, consider contacting an employment attorney.