I am approaching the moment of challenge and significance: this Saturday marks the true end of my existence as a preclinical medical student. Afterwards, I have another three and a half weeks of rest and relaxation before I begin my clinical rotations in July (with my first month on Neurology and my second month on Psychiatry). In the midst of my studying, I have taken time each day to listen to the new adventures and stories of my fiancée, a third year medical student on her Surgery rotation. In some ways I envy her: she is beginning to live the life of a doctor intimately involved in the lives and troubles of real people, no longer restricted to the world of hypothetical situations and clinical vignettes. The sine qua non of the work of physicians is to immerse oneself in the scientific, emotional and psychological complexity of the human body and mind and the troubled souls that inhabit them. This is what attracts me and many of my colleagues to this profession: the privilege and ability to be involved with a positive, guiding, and sometimes interventional role in the transitions and challenges all members of our species must face.
On the other hand, I wonder if I should feel hesitation in welcoming this new transition: in entering this strange new world, am I leaving something behind in my previous routines of comfortable thought and experience? In dinner conversations with old high school friends, I find myself with a narrower repertoire of topics to share. Despite reestablishing roots to communities and friendships outside of medical school and engaging in recreational activities completely unrelated to medicine, the acquisition of medical knowledge has dominated the landscape of my mind. If I do talk about anything vaguely medical, I wonder if my friends are simply indulging me with tolerance rather than interest. Furthermore, and perhaps most astonishing to me, is the notion that perhaps many people (including my friends without a medical or biological science orientation) simply do not want to know more. Since I was boy, I was always curious about the inner workings of the human body, triumphs and failures alike. However, although medicine and health are increasingly topics of open discussion and news coverage, there is a limit that many individuals impose on the role of these topics in their conscious minds. Even my father, a biomedical researcher, is only willing to go so far in seeking to promote his health, address health problems, or simply discuss health issues. It is no wonder that physicians often find frustration in trying to steer their patients toward positive lifestyle changes and seemingly necessary medical interventions! It is not difficult for doctors to perceive health as the underlying fabric of all we can achieve in our human lives and medicine as the thread and needle that repairs and holds that fabric together. My stepmother, a physician, is ecstatic about my emergence into the relatively small club of physicians: now there is someone in the family with whom she can share her experiences in the medical world and her understanding of this life. However, this is only one aspect of what makes us human and meaningful, and in growing in clinical ability and knowledge, I feel myself slowly backing away from this principle. So, when friends of mine do express some symptom or slight sign of distress, I seem to instinctively jump on this opportunity to connect to them across a burgeoning and invisible gap. This is the self-imposed gap of isolation and insulation; we are driven to understand the mysteries of medicine, sometimes at the expense of our abilities to engage others in everyday discourse. While hovering in the liminal space between sickness and health, life and death, we discover levels of understanding achieved only by those who care for the suffering and the sick themselves. However, this understanding is necessarily alienating, because those who have not suffered (or who wish to forget their suffering) do not wish to share in the dark and troubling world we walk into each day as physicians.
I am incredibly lucky to be engaged to a wonderful woman, and it is an added bonus that she is simultaneously pursuing a career as a physician. However, in practicing mindfulness, I hope that our conversations continue to not be limited to the world of medicine, sickness, and suffering. We may find ourselves striking a truer chord with fellow physicians and those we hope to heal, but our relationships are not only defined by our conduct in foul weather. We must also enjoy and full engage our lives outside medicine and the hospital in order to bring some of that life to our friends and patients, to avoid burning out, and to maintain our own human compositions (of a body, mind, and soul).