As everyone around me starts to rocket launch out of the orbit of school, to their respective next steps, it's strange to stay here in the center, to move on without moving. It was my choice, which is a fortunate thing, but it leaves me (surprise) contemplative.
The strange thing is that, four years later, a lot has changed and not much has changed at all. The bloom is off the rose, I suppose; I don't have romantic visions of what medicine is or will be for me. But then again, I'm not convinced I had such idealized notions at the start. I just knew it was what I wanted to do, and, four years later, nothing has altered that. Whatever else has happened, keeping that part, that certainty, that has been more than enough- that's been everything.
But just as with any large stretch of time passing, I remain mystified at how little I know, how much more there is still to learn. About medicine, about life, and even more oddly, about myself. I do not mean to frighten anyone heading into the hospital, but I feel like it will be quite some time before I feel confident that I know what I am doing as a physician. Some people dread it, but I welcome internship as that slap of reality that will hopefully, finally shape me into a real physician.
Then, strip aside the knowledge aspect, and still there remain other things to learn. I had plenty of difficult conversations prior to starting medical school, I had plenty of experience chatting with people in a professional setting. But I have noticed I still have a ways to go when it comes to the physician-patient relationship. Sometimes I talk too much, occasionally I interrupt too much, sometimes it takes me a bit too long to understand what the patient's objectives truly are, and I can still feel the hesitation when the conversation is turning towards something the patient does not want to hear. All of those things, though, worry me far less. The whole point there is to pay attention to your deficiencies.
In that way, it's not that different from any other relationship. It can be easy to say, especially the older we get, this is just how I am. That, however, is some weak sauce. A remark like that is a cop-out. You have to own your decisions in life, but you have to own your behavior too. It's easy to conclude I'm not good at having conversations about dying, but that's also an easy way to close yourself off from being a good doctor. No one is born able to have a mature, informed, sensitive discussion with a patient's family about their loved ones' health. It comes with time, and, unfortunately for patients, it comes with experience. Some people have more of a natural inclination towards it than others, but it really does a disservice to medicine to not push yourself to be better, to be competent.
I feel that way about my other little quirks. Some of them, I own. I don't find it strange to go off the grid occasionally, to take some time to myself, to spend a morning experimenting in the kitchen. But there are other things I have learned to change. I forgive people and friends now in a way that I did not before. I've become better at giving people extra chances without letting them off the hook. And I still have other things I need to change, like the way that sometimes I still have trouble accepting help, sometimes I still have trouble recognizing that I am being disrespected. I am no longer content saying that's just how I am. If anything, I guess in the past year, I have learned to want more, to be comfortable with wanting more. Shouldn't we all want that?