Don’t compare yourself to others, they repeated over and over at our orientation. It is something I have continually come back to, reminding myself that it doesn’t matter how well my classmates did on the exam or what they are doing in their spare time outside of class. All the while though, I have been comparing myself. Not to my classmates or even to others outside of medical school – although I do occasionally imagine what it would be like to go for a hike on a Saturday and enjoy a beer in the middle of the afternoon. But that I realize is not the mindset that has fostered my doubt and stolen my ability to appreciate the present. No, that comparison is only to myself. I have compared myself now for months on end, perhaps even years, to the self I was in Thailand.
I was happy then, so happy that I woke up smiling and excited to go to work. I want that now, but instead I struggle to get out of bed. I dream of beta blockers and ECGs and when my alarm rings I hit snooze for an hour before I finally crawl out of bed. There, I felt acutely alive with each passing hour. Sure, there were times where I was tired, where I fell asleep at 8 pm and didn’t wake until 7 the next morning. But I relished in each part of my day regardless. I loved the walk from our office to the cafeteria at lunch time, being bombarded by sticky fingers and ice cream cones, students yelling Teacha! Teacha! and then reaching for me with sloppy hugs, their arms wrapping around my legs so tight that I thought I might fall over. I loved the end of day chaos, weaving my bike through their blue skirts and brown shorts, waving to a few of them as I cycled through the front gates. Now I feel as if I am drudging through my day, getting from one hour to the next, trying to keep my head above water.
“How are you?” my classmates ask one another. They are looking for a real answer, not just a “Good, thanks. How are you?” And most days I do give an honest answer. “Okay.” “Just putting one foot in front of the other.” “I’m here.” –as if by simply showing up I have accomplished something. “In this moment, I am doing alright.”
Yet I am a little weary to tell my classmates the whole story. I don’t want to admit that over the past few months I have questioned whether going into medicine was the right career choice. Last year, for the first time since I had formulated my desire to go to medical school as a freshman in college, I felt a type of clarity. “This is what I want to do,” I told myself as I hit the submit on application after application. I made a firm choice of medicine over teaching. And yet now that I am learning medicine each and every day, I find myself thinking of my classroom, wishing I could spend each day teaching instead.
When I was applying for school a friend, who was also in medical school at the time, informed me that I would feel selfish my first two years of school. Like me, she had taken three years off between undergrad and medical school, working with youth in inner city Chicago. “You’re not going to feel like you’re giving back,” she told me. “We will eventually. We’re going to be doctors after all. But the first two years all you do is study and that feels really self-centered. All you have to do is worry about yourself.” This has all proven to be so true. I do feel selfish. I don’t feel as if I am contributing to society. All I have to do is worry about myself. Where are those 269 students who made me become a better person? Who forced me to give of myself so that they could grow to their greatest potential?
I know that this is not what my life will ultimately look like. I will not be spending 10 to 12 hours in a library on the weekend. I will not have lecture for four hours every morning and assessments on physical exam skills with fake patients. I will not have a test every two weeks. I will not only have to worry about myself and my performance. But right now it is what my life looks like. And many days it is challenging to find joy in it.
“How is school?” Shelley asks me as I drape the striped tablecloth across the rusted black, metal table. It’s Easter and instead of spending the day studying, I have spent it with family, cooking potatoes and green bean casserole, baking a carrot cake and icing it next to the window, the sun hot on my sugar-coated hands.
“It’s really hard,” I tell Shelley.
“Are you having doubts?” she asks.
I nod. “Yeah.” I don’t look up, instead focusing my attention on the zipper that needs to be pulled around the umbrella.
“I don’t know why I asked that,” she admits. I haven’t openly admitted it to anyone yet, but she is the first person to ask point blank and I’m not one to be dishonest.
She asks me if it gets easier after the first two years. “Will you graduate if you can just get to your third year?” It’s not like that, I say. And it’s certainly not where my doubt stems from. I’m not afraid that I can’t become a doctor. I’m afraid I don’t want to be a doctor.
“No talking about the test tonight,” I announce as soon as I arrive at my friend’s house. A small group of us have created a tradition of making dinner for one another on the evening following a test. We switch off whose house it is at and subsequently who makes the dinner. We sit, gathered around a black IKEA coffee table, sipping chardonnay and munching on goat cheese and pita chips. Everyone agrees with the rule – no test talk – but yet our conversations still circle back to medical school. There are so many times where I resent this. I’m not studying so I don’t want to talk about it. In Thailand my American coworkers would make the same rule at meals. We would bike to the night market, sitting in the shack restaurant that served my favorite fried rice.
“No talking about school,” they’d say.
We’d agree and yet, somehow I would always bring it up. I was the one who wanted to talk about it. I didn’t need any distance or time not thinking about my students. Now that I’m on the opposite side of that argument does it mean that I’ve made a mistake?
The scary part of doubt is not the doubt itself, it’s not even the thought of the possibility that I’ve made a giant mistake. It’s more the fear of admitting the mistake. Of undoing the mistake I’ve made. Going to medical school, if it is a mistake, is a big mistake to make. Would I feel this same doubt if I went into teaching? If I quit school and became a teacher would I wake up each day with a tiny pit at the bottom of my stomach that grows each time I am bored or frustrated or apathetic?
“How are you doing?” I ask a second year who is preparing for her first board exam, a time in medical school that is universally known as one of the most difficult times during our early careers.
“Good,” she replies. “I wouldn’t want to be doing anything else right now.” She means medical school. She wouldn’t want to be doing anything else with her life except for medical school. I wish I had the same sort of clarity. I seemed to have it even earlier this year. During our first block, Anatomy, I complained about the amount of work that was to be done, the sheer volume of structures I had to memorize, when my roommate Rachel turned to me and asked: “What else would you be doing?” Suddenly, then it became so clear to me. I didn’t want to be doing anything else, not really. Somewhere, perhaps in the middle of learning the immune system or while drawing out drug mechanism of actions, I lost that clarity.
So much of medical school is type two fun, like backpacking or camping in a rainstorm. During the time you are somewhat miserable, wanting the rain and the weekend to end so that you can go home to your warm, cozy bed. But once you return home you miss the flappy tent and pounding rain, realizing that you actually did have a good time. Medical school is like that too. Sitting on the grass at lunch the other day, I prepared with some classmates for our afternoon session performing cardiac exams on patients. Our Tupperware sat in our laps, steam curling into the brisk spring air, as we pored over my physical exam book. We had learned the cardiac exam earlier in the year during Anatomy. Then, it had felt so hard, so out of reach. All the special maneuvers seemed so irrelevant—what is a Jugular Venous Pressure, why do you measure it? Now we knew what all these maneuvers were. We even knew what a murmur was, what it meant pathologically. For the first time since learning the exam five months ago, it felt interesting, even a bit exciting.
It is the small moments like this that I must cling onto. A brief flash of understanding. The touch of a patient’s hand as she guides my stethoscope to where I can hear her extra heart sound best. The camaraderie of a fellow student who admits they too feel lost most days. I know this doubt won’t disappear in a day, or in a week, or perhaps even in this month. In the mean time I wait for my clarity to return, like a school child waiting at the front of her lawn for the bus, knowing it will come but it just might be a little later than expected.
More for my own insight than yours, I wanted to share some of my thoughts of gratefulness during this time of doubt. Each night before I go to bed I try to write at least one thing I was grateful for that day. It doesn’t happen every night, but here are some from the last few months:
I’m thankful for five minutes to sit outside.
I’m thankful for time to do yoga.
I’m thankful for soccer.
I’m thankful for snow and the ability to sit near a window all day and enjoy it.
I’m thankful for time to cook dinner.
I’m thankful for good friends.
I’m thankful for Madeline and Kaitlyn and all the learning they help me with.
I’m thankful for Ninja Nerd videos.
I’m thankful for dinner with family.
I’m thankful that today I felt happy.