The following manuscript was submitted to the March 2017 s/p The Match — One Year Later Themed Writing Contest.
I had such difficulty explaining to my family and friends not in medicine the concept of the match. I finally settled on a lottery-Bachelor fusion to explain it. Just replace the aspiring lovers with program directors and medical students, and roses with Match Day letters.
I was terrified, ecstatic, worried and excited all at once. My stomach churned with stampeding rhinos rather than butterflies, as I contemplated the massive life change that awaited me. I calmed my fears with the “at least I know I matched … at least I know I have a spot…”
Time seemed to blur until Match Day. As we all started to count down to that accursed and blessed moment we could open our envelopes, we all spontaneously started yelling the numbers, “Five, four, three, two, one!” And then I saw through a haze of happy tears that I’d matched where I wanted to be. As I celebrated, a quiet voice in my brain asked me where I thought I would be in a year, in two, in three … I had no idea, and I savored the moment of completeness in all its glory, and in my ignorance.
Now here I sit, in a small room just off the emergency department at my chosen program, about to start a trauma call. It’s a freezing February morning, and I want nothing more than to stay in bed. I’m here today because duty drives me — the duty of being a physician, with responsibilities and patients who depend upon my being there.
Post The Match, I’ve gone from the eager but functionally useless medical student to a clinician of some sort. I, by some curse of the gods, function as the front line of an emergency medicine system. I see more patients than I ever thought I could see. I make life-or-death decisions relatively frequently; I am the “doctor” in the eyes of many of my patients and their families. I’m reminded, however, of my lack of education and incompetence not infrequently as I am schooled on the diagnoses I miss or the things I fail to consider.
I would have never imagined that two years after The Match, I’d be providing emergency department palliative care for a patient I intubated after a massive intracranial hemorrhage that caused him to fall onto his kitchen sink. I never realized that this transition meant that I, someone with almost two whole years of post-graduate medical education under my belt, would be able to sit down with the patient’s wife of 57 years and talk to her about end-of-life care. I never imagined that I would be the physician who went into the room when the patient passed and who had to try to soothe that soul-searing anguish. Nor did I imagine that just weeks before my own grandfather who saw me match through an iPad would pass away in India.
That alone pretty much sums up life two years post The Match. I’m busy in the department and out of it. I juggle research, thoughts of fellowship, education and running for chief resident. I’m growing as a physician and learning both the art and science of medicine. I supervise interns when they first pick up a patient who appears sick, making sure they’re supported and capable, despite sometimes realizing that I was an intern only nine months ago. But, outside of the hospital, sleep is often wished for and not always realized. I spend many nights fretting about life, about finances, about the future, about family and friends and the terrible illnesses my mind concocts for them. I will probably always regret not being able to be there, by my grandfather’s bedside as he softly exhaled his last breath, two months shy of his ninetieth birthday. I continue to offer myself the cold comfort that I have to provide for the families of my patients. I silently curse every time I realize it’s been weeks since I called and spoke to my family. I wonder with a start, when I reconnect with friends, that it’s really been six months since I called them and we spoke. My significant other and I joke that despite living together and owning a house together, we see each other less frequently than I see some of the regulars who visit me in the ED.
Two years post The Match, the journey to get here has been life itself — glory and passion, and hurt and sadness, blended in equal measure. I’ve gloried as I’ve become facile with procedures, with taking care of the sickest of patients who would have died without my presence at their bedside. I’ve begun to realize that I have some, still nascent, abilities as a physician and that they have some trace of competence within them. I see the faces and remember the names of each patient who died because I didn’t act quickly enough, because I didn’t figure out the diagnosis fast enough or because I did everything I could and nothing worked. As I’ve walked across the street to the hospital, grateful family members of patients I’ve helped have stopped and thanked me. Other patients’ family members have threatened to find and kill me. This journey, that I started in earnest on Match Day, has been a rollercoaster of emotions and realizations. Looking back now, I wouldn’t trade it in for anything. Though, a nap does sound really nice right about now…
Image credit: Emergency Room by KOMUnews licensed under CC BY 2.0.