A Journey of a Thousand Miles . . .

. . . begins with a single step.

A quote I believe attributed to Lao-tzu (or Laozi). It has been more than a month since I last posted, not for lack of material or lack of desire. Simply I didn't know where to start and now there is some catch-up to do. So let this be a couple beginning steps.
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Andrew's Wedding

In mid-July I attended Andrew's wedding. He was my roommate during the last 2 years of undergrad and an overall great guy. So of course how could I not go?

It was at a Catholic chapel somewhere in Plymouth, MI. I realized then I knew next to nothing about what "protocol" was during such a wedding. My awkwardness was compounded by the fact that I knew almost no one there.

But the reception was really nice and in this large indoors courtyard area adjacent to the chapel. It was a beautiful hall. Both the groom and the bride looked so happy, and truly their story together is almost a fairy tale. To begin the dancing of the night, they danced the choreography to "Jai Ho" from the movie Slumdog Millionaire. It was great seeing them before they moved to New York, where Andrew will be starting his Master's degree.
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White Coat Ceremony

At every medical school there is a white coat ceremony to mark the initiation of the new incoming students into the medical profession. Donning the short white coats of med students marks our entrance into an ancient tradition of healing. It also places us at the bottom of the totem pole, as it were, of this profession.

The white coat ceremony was every bit as formal and joyous as one would imagine. During the ceremony we received speeches on what it meant to be a professional, what it meant to be a doctor, the unique privileges we would eventually enjoy, the power we would one day wield, and of course a reference to the Hippocratic Oath. But I could not help but notice and wonder at the gap between the old generation of physicians and us, the new generation. Something felt different, something was changing. What it was I could not quite put into words.

I had felt this in many (if not most) of my classmates throughout orientation week. There was this air of cynicism, of resignation, and of hope. Cynicism about the current state of the profession we were soon to inherit upon leaving med school. Resignation at the self-sacrifice required of us to survive in this system. And hope of perhaps one day changing things - to make things better for patients and for ourselves. It seems there's no longer a full acceptance of altruism at the expense of the self. While we were told repeatedly that the patient always came first, many of us wondered "What about us?"

Perhaps you'd think we were ungrateful and perhaps unworthy of being entrusted with our white coats with this selfish thought. Shouldn't we be grateful that we were accepted into one of the most elite and selective professions on earth? Shouldn't we prove our worth and deserving of our white coats through absolute dedication for our patients? Of course we're grateful and willing to prove ourselves worthy, but times are changing.

While we are excited to help patients - to cure and heal, while we rush forward to learn everything we could to be the best we can personally be, while we endeavor to do good, there's always this nagging thought. The mountain of debt for our education, the long hours of residency in the future, the exhausting prospect of being on call, the stress, the lack of vacation opportunities - all make us give pause. There is a reason why many med students, often the best and brightest, drift away from primary care and towards higher paying specialties with good hours and little on call. We are essentially giving up - sacrificing - the best and last years of our youth for our future patients. And few outside medicine understand that.

As my roommate remarked, "Getting our white coats is like donning on responsibility. It's scary."