So you’ve just graduated from medical school. Your face aches from smiling for countless photos and there’s a large, rectangular, official-looking piece of paper in your hands that says in fancy lettering that you are now a Doctor of Medicine. You! That’s your name on that piece of paper.
Everyone asks if you feel different now that you’re a doctor. You do and you don’t. On the one hand, you still don’t know how to file your taxes and you still become irrationally enraged when someone cuts you off on the highway. You still feel compelled to sit for hours on your couch, binge-watching Netflix and eating spilled potato chips off your own grease-stained t-shirt. You haven’t magically transformed into some superior being now that you’ve been handed a fancy-looking paper. But on the other hand, there is something subtly different about you, a warm, nagging sensation in your chest. It’s as if you have a surprise in store for someone you love, and you’re just dying to let it out. Like a secret.
Ironically, it is anything but a secret. Now that you are a doctor, the world—the tremendous, vast, staggering world—is suddenly smaller. You will know the most intimate details of strangers’ bodies and minds. You will come across a profile on Facebook and realize that the person belonging to that profile suffers from diabetes or PTSD or was born with only one kidney. And you know that because the person told you. You, specifically. You will order a latte at Starbucks and realize that you were present at the barista’s abortion last month. And when you wear a white coat and introduce yourself as “Doctor So-and-So”, people will have expectations of you. People will make demands of you. And you can’t hide from these demands, the way you can hide from a parking ticket or an embarrassing hookup. You are exposed. You are no longer shielded by anonymity; in this vast world of seven billion people, you are now one of few. You will be held to a standard and expected to perform.
You have read many trite, earnest essays on the gravity of this profession, so none of this is news to you. You are prepared for the responsibility, the expectations, the long hours. What you are not prepared for is how unfair it will be. You will pound on a dead man’s chest, breaking his ribs, trying to make his heart pump blood to his brain, to no avail. You will eat stale crackers for dinner and forget your mother’s birthday and wear the same underwear three days in a row because you don’t have time to do laundry. You will discharge a six-year-old boy with a tracheostomy to a nursing home, knowing that he’ll live the remainder of his life in diapers with his tongue lolling out of his mouth because his stepfather threw him down a flight of stairs while high on PCP. None of it will make any sense to you, even though you studied and did well on your exams and performed well. That is not fair. You will cry and be angry and afraid, and still work 100 hours per week as if you were never sad or angry or afraid. That is not fair.
Because not only will you see people suffering all day, every day—you will suffer too, and you will never process it. Instead, you’ll be expected to go on as if nothing happened: as if you’re not exhausted, overwhelmed, trying frantically to impress your chairman, lonely, terrified, discouraged, hungry, horrified by what you’ve seen and heard. You will have to be “tough”. Because when a crisis arises, the people around you will want to know that you can rise to the occasion, put aside your own humanity, and take care of business. And you can. You will. You have no idea how much you can handle until you have to handle it.
Someone will collapse on a train and you will be the only doctor on board. You will have to handle it. A woman will go into labor in the lobby of your hotel when you’re on vacation. Guess what? You’re not on vacation anymore. A family member will get sick and you’ll have to drive home after working 35 hours straight. Handle it. A child will die on the operating table in front of you, gurgling pitifully while the room erupts in beeps and smells and shouts. And then you will go eat lunch and write progress notes. You may not want to do that, but that’s what you’ll do.
You feel different now that you have graduated from medical school because you are different. You don’t get to fall apart when things get difficult. You don’t get to make professional decisions strictly because they benefit you or serve your own personal agenda. You don’t get to run away when something awful and traumatic happens. You’re held to a different standard now. If you make a mistake or have a bad day, an innocent person could die. You have to be “tough”.
And because of the awful and traumatic and difficult and self-destructive things you’ve seen and done–and handled–and been toughened by–you will earn the right to be trusted, and strangers will make themselves entirely vulnerable to you. You are different. You’ll always be different. Get used to it.