I sat at my computer screen as a fourth-year medical student, thinking about the residency interview season ahead. I had just watched some informative videos about the type of questions interviewers might ask me, and how I could respond in a way that was both authentic and complimentary, eloquent without sounding rehearsed. My top-choice residency programs were outside of the Midwest, and I felt that I really needed to pack a punch and make a good impression. However, I’m also an introvert and didn’t want to come across as disingenuous.
So I sat at an empty Word document, and thought about how I would respond to my interviewers’ inquiries, but my brain seemed stuck – as blank and uncommunicative as the white screen in front of me.
Since those canned questions weren’t sparking any inspiration, I made up some new ones for myself: “Who are you? What are you? Why are you? Who do you want to be? How will you become it?”
As words finally began to spill across the page, some of the answers I came up with were the same as they would have been 4 years ago, when I applied for medical school. “I want to be a kind and humble physician.” “I want to do no harm, and not prescribe medicines or procedures that aren’t improving people’s lives.” Some were new, and would have surprised me back then. What kind? “A med-peds physician. A primary care, outpatient physician.” (I didn’t even know what those words meant when this all started.)” Some were due to an increased awakening of conscience. “It is my job to disassemble systemic racism in the health care system. It is my duty to figure out ways to incorporate restorative justice into my practice of medicine.”
Some were not related to medicine at all. “I am a mother. I want to be there for my children. I don’t want to miss a single smile or a single milestone. I am a wife. I want my husband to know he is my rock, and that my calling as a doctor is second in my heart to my calling within my family, even if it cannot always be second in how I spend my time.” You see, I had now experienced what some doctors go through, and what they sacrifice for their patients. I had listened to a nurse in the OR as she told me that the worst part of her job was watching the families of physicians fall apart — that her least favorite moments were when a surgeon asked her to call their spouse to let them know they weren’t going to make it home for their young daughter’s soccer game, or anniversary dinner, because a patient could die if they were to leave. Now I know that one of the most important parts of my future job is finding balance, and passing the baton to the next provider so that I can continue to take care of myself, my family, and our life outside of medicine. I have learned the hard way that if I don’t take care of myself and my family, I can’t take good care of my patients either.
As a kid and teenager, I was praised for being so high-achieving—for being a good student, an athlete, a coach, a member of the band and choir, a cantor in church, and a volunteer in my community. My mother was so immensely proud of me, but she was the only one to see what it did to me—the lack of sleep, the pressure. She always told me to slow down, that I had to say no sometimes, but I hardly paid her mind. During university, I heard self-care buzzwords of “Treat yo’ self!” and “You deserve it!” that were just annoying to me when I was battling to get nutrition into my body, sleep a couple hours a night, and pass calculus, organic chemistry, and genetics at the same time. During my second year of medical school, I had a lecture about The Quadruple Aim, explaining the idea that care of the patient requires care of the healthcare provider. I appreciated everything they discussed, but also scoffed internally at the thought of being allowed to be human, in the midst of the long hours I was required to put in, in order to succeed. On Facebook support groups for moms and stepmoms, I felt the seeping sharp edge of jealousy creep into my soul as I saw the hours some mothers poured into educational arts and crafts for their children, when I couldn’t even make it home to read a story at bedtime. This year, I had especially heard strong refrains about self-knowledge and self-betterment in the context of an anti-racist society. The thing is, I WANTED to slow down and concentrate on being a better human. However, through all I remember of my life, my internal compass and institutional feedback have been pointing, pointing, pointing to the next, the bigger accomplishments, the longer journey, with no destination in sight.
Why am I? That one I had to think about for a long time. I took a hot shower to help soften the thoughts, to feel them melt into swirling emotions and abstract notions, and harden into comprehensible words. When I had dried off, gotten dressed, and wrapped my hair in a towel, I wrote down, “The best version of me makes the best version of we.” It was such a simple statement, seemingly cliche, but intensely meaningful to me in that moment. With everything that was going on in my household, in my rotations, in my city, country, and world, this statement was something for me to contemplate and strive for. We need to be better, which means I need to be better. And if I’m going to be better, I need to treat myself as a complex human being with a complex hierarchy of needs. Abraham Maslow is famous for his pyramid of human needs that ranges from sleep to security to self-actualization, but I’ve found that what can happen under stress is a breakdown of that pyramid structure. I know, because I’ve broken it. I’ve skipped meals and sleep. I’ve held back from peeing for hours because I didn’t want to deal with the shame and repercussions of scrubbing out in the middle of a surgery. I’ve sidestepped morality to save face in front of an unreasonably strict attending. And I know I’m not the only one. I know that because of whispers in a quiet hallway of “what just happened in there?” I know that because of sympathetic glances shared between equally dark-circled eyes after a shift that was too long to be safe. I know that because there were amazing people in our classes that are no longer here despite reaching what appeared from the outside to be coveted self-actualization.
My time in medical school has been so incredibly difficult. What is so critically important for me is to focus on the good that can be found within the struggle. I used to look for the light at the end of the tunnel, but that got old quickly when the tunnel turned out to be 11 years long. Now, I try to focus on the beautiful things and moments that are in the tunnel with me. Life, even a life filled to the brim with privilege, can be really hard. It can also be full of compassionate conversations in a resident workroom with old and new friends, of rainbows after a storm, of golden minutes of sunshine, of fresh icy walks in a frozen forest, of sweet baby breath exhaling from sleepy rounded cheeks, and of tender toddler cuddles on stolen time. But somehow in the heat of the moment, on a night shift where the gears of my brain refuse to move and my differential diagnosis is 3 diagnoses short of 3 diagnoses, that “why am I” is extremely difficult to recall. Self-care is so far down on my priority list, below “Finish H&P. Call consultants. Make birthday cake. Sleep-train the baby. Call the dentist. Clip your nails. Fill out the 6 MedHub evaluations that you’ve been getting emails about for the last month. Teach fractions to Raquel. Pay the rent.”
The final question I had written was the one that, for me, was the most hopeful and also the most haunting. “How will you become it?” With the scarcity of time and energy that is my wonderful, chaotic, impossible and yet somehow possible life, how do I find time and space to change for the better, and to become the mother, wife, daughter, sister, physician, coworker, leader, and human that I want to be?
There are so many ways I could answer this question, but an image pops into my mind as I’m so diligently avoiding the prescribed interview questions in order to mull over these much more crucial ones. It’s an image of a glassblower in the Canal Park area of Duluth, MN, blowing a beautiful blue vase into existence from what had recently been just a pile of coarse sand. I feel the cold lake breeze moving across my face and watch as it hardens the scorching-hot liquid into an elegant form it may never have expected to become. Coming back into this current moment, I set down my cup of tea, take some deep breaths, and put my faith and trust in the Glassblower. “I will do my best,” I tell Him. “I will try to move when I need to move, and be still when I need to be still. My coarse best is all I can be. Please help me to come out beautiful.”