the first thing i've written in 6 months

Before starting medical school, I regularly wrote. For the most part, friends and family comprise my readership, but every now and then, a piece was deemed legitimate enough to be published for the pleasure of a broader audience. I lack the imagination for fiction, and I don't pretend to possess the intelligence or knowledge to write critically about anything of real importance, like say, renewable energy or ending global poverty. So with limited options, 'creative non-fiction' has been the genre under which most of my attempts to write have fallen. I like to refer to my pieces as 'aggrandized journaling.' When you get good at this, folks bind these small stories and call it a memoir.

To heal and to write: both of these dreams have traveled with me since childhood. For me, the beautiful combination of relieving suffering by curing or simply instilling hope, working with people that are partners in this task, and creatively sharing these experiences is work that takes us to places where we can learn the essence of what it means to be human. A few years ago, while I was really struggling with whether pursuing a career in medicine or continuing to write while working multiple dead-end, minimum wage jobs was the best thing for me, my mom –in her infinite wisdom and steady, middle-class conventionality-- reminded me that you can be a doctor AND write. She seemed to have a point, so, with my mother's prompting, a grueling admission process, and some radical lifestyle changes, I'm going after the dream. However, the unfailing thing about dreams is that they neither come with the tangible details that actually get you to your target, nor do they give you eyes to anticipate all the pitfalls that will impede your progress along the way. I envisioned that the process of becoming a doctor would provide ample experience on which to reflect and write. I failed to consider what the demands of the process would do to the part of me that wishes to write.

Throughout the journey of my first two years of medical school, I am constantly reminded that writing is a task that requires a disproportionate amount of mental work to give birth to even the smallest of products. In my mind, any event that is worthy of retelling must be first fully experienced, then carefully considered, and finally put to the page. Each element in this process is intoxicating; I get lost in this process every time I undertake it, meaning that even in an optimal environment, weeks may pass before a word is typed. The demands of medical school have greatly hindered my capacity to do any of this. First of all, fully experiencing requires exposure to things other than lectures or reading as well as a concentrated attendance during these rare occasions. Often, chatting with the lovely Kiwi librarian, who never forgets to sweetly wish me a pleasant night’s sleep, is the day’s only interaction that isn’t somehow involved in information acquisition. And sadly, in my utter exhaustion, I usually forget all but the spirit of the chat before I reach my car. These prize conversations get lost amongst the pathology, or the demands of tomorrow, or the drunken combo of sleep deprivation drowned in caffeine. In the event that they are retained, capturing these stories seems like simply another task to be completed, another thing I should do, another demand of my precious time and energy.

The deeper I plunge into this strange world of medical education, the more I realize that it may not be drawing me nearer to the essence of the human experience, but rather pulling me further away. The struggle to write is but a first stop on a long, painful track of becoming the physician I hope to be. Soon, I will learn that not only do the knowledge of disease and the daily exposure to pain and suffering inherently alienate one from those who live on the other side of the divide, but it is all but impossible for these things --coupled with the medical institutions expectation of detachment-- to leave ones emotional capacity unblemished. I fear that as I continue to move down this path, my ability and opportunity to interact with people without thoughts of their pathophysiological state will be incredibly limited. Overtime, this will lead to the transformation of my acts of compassion into how well I can diagnose and dispense a treatment to a patient, foregoing the attempt to understand what it means for them to be ill and what it would mean for them to be healed. This is a scary vision, but one that I believe is becoming more and more the norm for those who practice medicine. We enter the profession with hopes of caring for those who suffer and end up only managing their health services.

I hope we discover our imaginations and create a new paradigm for becoming and being physicians. If we do not, my mom might have to rethink what’s possible.