How Far We've Come (Or, Cake)

It has been another cold & rainy weekend in Eldoret. The first week on the wards was full of ups and downs, but overall I’m still very happy to be working at MTRH. I probably pushed myself a little too hard this week, amid walking back and forth between IU House & MTRH 4-6 times per day, soccer, jogging, and yoga, (all at an altitude I am completely unaccustomed to), not to mention some degree of baseline mild dehydration, I gave myself a pretty nasty muscle pull yesterday. This is frustrating to me, as I am decently active at home, and I would like to think my injury is more a result of my new environment, and not simply because I am getting old. Be that as it may, I am under strict orders from my team leader to take it easy today. With the rain, the cold, and a strained quad and hip flexor, I’ve had quite a bit of time today to reflect not only on the last week, but on the past several years as well.

The fourth year medical students here have recently been in a flurry of activity and anxiety over their ERAS (Electronic Residency Application System) profiles, as the online system has recently opened for submission. This is the most significant event yet in their medical careers (only one of many more accomplishments to come), and I can remember those feelings of doubt, angst, and even fear that I would not match into a residency program. Looking back on it now, it seems a very minor step on the road that I’ve travelled, though I can certainly recall that it seemed more like Doomsday at the time.

All of the senior medical student talk of residency programs and their futures has really got me thinking about How Far I’ve Come. From the juncture mid-way through my freshman year in college when I decided to “go pre-med” until now has been an indescribable journey, a prolonged process, a road of pure joy and true hell. I can hardly remember a time when I wasn’t focused on my medical career. Starting in undergrad: concentrating on getting good grades, joining the pre-med club, volunteering and extracurriculars, planning for, studying for, and taking the MCAT, med school applications, interviews, selection, matriculation, and white coat ceremony. Then history seemed to repeat itself from the very first day of medical school: worrying about grades, clubs, extracurriculars, projects and volunteer experiences, not to mention working harder than I ever had on clinical rotations, applying for residency, interviews, ranking, match day. And THEN starting the entire process again from day one of intern year: working harder than I ever had, projects, volunteer work, extracurriculars, research, publishing, chief application, interview, and selection. Throw into the mix the various board exams along the way (USMLE Step 1, Step 2 CS, Step 2 CK, and Step 3), and it’s no wonder that most residents graduate feeling about 50 years older than when they started. Not to mention that at every step along the way I became a little more interested in actually having a life. I have recently begun to comprehend, appreciate, and understand the extraordinarily long, never mind expensive, road I have been navigating since I was 19 years old.

Even as I type all of this now, I can’t help but think: this is completely insane! Why would anyone want to do this?! I admit there have been more than a few times over the past 3-to-9 years when I’ve thought: “no really, why am I DOING this?”. It is a question that I will probably never completely answer. Even though it has been hard, it has not been without its rewards. I cannot imagine life now without the friends I have made in both medical school and residency, and the support and encouragement I have received from my comrades-in-arms has seen me through the darkest of times. I have learned, I have grown, I have grappled with the meaning of Life and Death, contemplated my own existence, and been forced to confront my own humanity and the darkest aspects of the human soul. I saw my family less but started appreciating them more, I learned that book knowledge is necessary but by no means sufficient to make a good physician, and I realized that being a successful pediatrician means treating all patients as children, but not all children as patients. I started this nine year process with great deal of naiveté and idealism, but I have been tried, tempered, formed, and emerged on the other side a better doctor, and a better person.

And really, though I still have 10 months left before (my last?) graduation, the rest starts to become Cake now. It’s not that I’ll ever stop working hard or putting in long hours, ever stop studying or learning, but the steep and seemingly impossible learning curve has finally started to plateau. Now I get to look at the anxious faces of the MS4s here and tell them it’s going to be ok and know, actually know, that everything is going to be ok. Because now, for me, I can finally stop focusing on what’s going on my CV and start focusing on what’s going on in my life.

Though I may not have known it, when I decided at 19 years old that I was going to be a doctor, I was committing myself to a very career-focused life for the next decade. Though I may still wonder why I did this; why I let the last 9 years of my life be dictated by how good my grades were, what med school I could get into, and how competitive my residency application was, in the end it was my decision. I will probably always regret the family birthday parties missed, the holidays spent in the hospital, the homecomings not attended, the friendships that have lapsed; but in return I get the great and awesome privilege of caring for other people’s children. I get their trust in me to guard the health of the most precious things they have on earth. And that, to me, is amazing. Amazing, and completely worth it.