The Most Selfish Time in Your Life

I had an epiphany tonight… and it wasn’t pretty.

3 and a half months ago while I was on my break back home in San Francisco, I was going out to eat lunch with a friend that I haven’t seen in a long time. On the way to where we were going we began talking about old times (8+ years ago). And when you talk about how much you used to hang out with someone else, it inevitably leads to a conversation about why that suddenly stopped being the case.

“We could still enjoy each other’s company. Isn’t that enough?” she blurts out.

It kind of caught me off guard and I think I mumbled something. I didn’t have an answer at the time. And for whatever reason (after reviewing all of cardiac physiology for the past 8 hours) that conversation popped into my head tonight. And tonight I have an answer:

“No, it’s not enough. It’s not nearly enough.”

The reason why I stopped hanging out with her and most of my other friends is because they weren’t moving the same direction I was, at the same speed that I wanted to move. This action is fueled by frustration, built up over years of mediocrity of inaction. Simply put, at the time, if anyone else’s life goals weren’t completely in sync with my own, they were holding me back. At that moment in time, at that stage in my life, if you weren’t helping, you were hurting. Put into that context, what she proposed wasn’t enough. It’s almost insulting.

I’m not saying that the only people I would “allow myself to hang out with” were other people who wanted to be doctors. And I’m definitely not saying that my non-premed friends were lesser than me because of this.

I’m talking about Sacrifice.

You know, that term that’s brought up in TV and movies by people pretending to be doctors. It’s the same term that’s thrown around by premed students when being used to fuel their internet forum debates.

I’m talking about the forces that hold you back that you need to cut loose in order to move in the direction and at the pace that’s required. Whether these forces are applied intentionally or unintentionally doesn’t matter. It’s the difference between “making it” and “not making it.”

When this is all over, if I eventually graduate, not only am I going to be a different person, but the life that I knew when I started this journey will be changed as well. And this isn’t just a passive change due to other people’s goals, wishes, and wants. This will be partly due to the damage that I’ve actively caused through my actions – towards my goal, to get what I want, in spite of my friends and my family.

All of this is born through selfishness. There’s no doubt about it. This process is selfish and it’s dirty and it’s messy and above all else – it’s absolutely necessary.

And THIS is the Sacrifice that doctors talk about while they have that look on their face.

(And it’s this truth that I’ve come to realize in this moment and I can’t get it out of my head fast enough. My ability to translate these thoughts into words isn’t keeping up and some of flood of these thoughts is going to slip through the cracks.)

Friendships and relationships; financially, personally, emotionally, or whatever else it costs when they decided to be selfish – this is the Sacrifice they told themselves they would gladly pay in order to pursue their dream. For all that is good and great about “being a doctor,” people tend to gloss over the messiness of it all. I think people initially make this Sacrifice because they truly believe that the benefit will far outweigh the cost. But this benefit isn’t just in additional to what you already had. There is a price.

And what are the circumstances in which “being a doctor” requires so much more Sacrifice than some other pursuit? It’s the daily allotment of time for study multiplied by the decade+ of the grind. It’s the postponement of life. I think there are many instances in life where two or more people’s life don’t exactly compliment one another. This is normal. But I also think at some point, some people get tired of waiting for the act to wear off. In any normal situation, if your actions clashed with the expectations of a friend or family member, both sides would let out their steam and they would wait for things to settle down and for one another to return to normal. The problem is that if you act a certain way long enough it stops being an act and you become a different person entirely. The person you've become over time is your normal. And I think it's the realization about this fact (on both sides) that becomes the breaking point. You have to either choose to keep moving forward or to stop, slow down, and go back.

So no, it’s not enough to “just enjoy each other’s company.” It’s not nearly enough. It’s not fair and it’s not pretty and it’s not right. It’s selfish and it’s singular and it’s necessary. It’s a conscious decision and it’s for my benefit and no one else’s. And it’s a Sacrifice I’d gladly make again if given a second chance. Some of the people I left behind aren’t going to be waiting for me when it’s all over and the worst part of it all is that I don’t care. (Actually, the worst part of it all would be if I failed to graduate and if in the end I would have nothing to show for it.) This isn’t an emotional apology, it’s a logical explanation.

These Sacrifices can’t be undone and each doctor has their own set of damages that they left in their own wake, specific to their own lives. But whatever road each individual doctor has taken, the goal was the same, and the cost may have been just as high.

Am I crazy or am I just full of myself?

I know there are many people who read this blog that come from many different backgrounds. There are high school students, premed students, current medical students, recent graduates, residents, and experienced doctors. To other medical students and doctors, I ask:

Am I totally off? Do I make any sense at all?

I feel it and I’m curious to see if this is just a singular experience of my own or if this is, in fact, what other doctors have meant whenever I’ve heard them use “Sacrifice” in the past. Or is it all just a term that premed students spout off from time to time (including me in the past, on this blog)?

The “frustration” that I talk about may have to do with my own specific situation. I won’t go into detail about it now (because I’ve gone into detail ad nauseam on this topic, very publicly, over the past 3 years on these blogs) but there are reasons why I was 26 years old when I finally graduated from college. There are reasons why it took me past my 27th birthday to begin medical school. I think these reasons definitely played a part in my frustration, but I’m wondering if other people not in my situation felt the same way regardless.

Whatever it is, even if it is just me, I don’t think this is the end. I have a lot more to learn and probably even much more to experience before I can ever begin to call myself a doctor. Being a medical student is one of the most selfish times in your life. This selfishness may be accentuated during these medical school years, but it’s born from the initial Sacrifices that you made the moment you decided to become a doctor.

A lot of what I've just wrote are just the result of a flood of ideas. And I know that some of this is just me falling in love with my own vocabulary. But does any of this resonate with any one else or is this all just an elaborate excuse to be a jerk?



EDIT:

This post was based on a relatively high concept idea. It was also written on impulse and a little long winded. There were a lot of responses, some positive and some negative, and that was kind of the idea. The vocabulary I used was meant to draw out emotion. I think there was some truth in what I wrote, but it was rooted in a single conversation of mine and kind of grew into an overarching generalization about all medical students and the long history medical education. It ended with a hypothesis, asking input from others for validation.

I have a few other thoughts, but I’m going to keep the language simple and to the point.

It’s been 8 years since I decided to pursue medicine and in that time there are things that I’ve lost. There are many more things that I’ve missed out on. This may or may not be the Sacrifice that some doctors talk about. If it isn’t, then the things that I’ve lost are just personal losses and have no greater meaning or pattern. Although, it would be nice to be able to point to something and state: “You see? That’s the problem right there. It has a name. It has a beginning, middle, and end, and what I’m going through right now is just the middle with the end soon to come.”

I also think there are many things that I’ve gained. To think back 8 years into the past is amazing; the ability to look back to where I was then compared to where I am now. I think I’ve gained a lot more than I’ve lost. Because of this, it’s hard to second guess anything that’s happened since. Hopefully there’s more to be had in the future.