Do you ever think sometimes that the internal state of your mind reflects exactly the kinetics manifested in the immediate environment? I am sitting here trying to articulate the torrent of thoughts and emotions that have piqued over the last few days, but as the narrative becomes refined and my fingers strike the keyboard I’m at once pulled internally by another powerful distracting idea. Another wave of excitement, or sadness, or terror, or you name-it washes through my consciousness and I’m once again at a loss for words to describe it, or the preceding thought. This mania is a peculiar personification and imitation of my external environment over this last week. Preparing to move (and move everything in a 4-door sedan). Graduation. Wedding celebration. A dive-bar band performance. The (good!) surprise of the decade. Brunch and more brunch. Graduation celebration with family. Reconnecting to a friend group whose bonds were forged in the crucible that is first-year medical school anatomy. And this morning’s near sleep-less jaunt to borrow much-needed energy from, as I’ve said in the past, the greatest group of people there ever fucking was. Was graduation already (and only) 5 days ago?

I feel like I’ve never been happier in my life and at the same time have had a lump in my throat for a week. My mind has gifted me intermittent and overwhelming sensations of gratitude, of which have externalized as these sort-of “mini-crys” over the last few days that come and go as quickly as the frenetic thoughts and emotions I’ve been victim to. No doubt a reflection of my innate egoism and strong desire for attention being fed an inordinate amount of love, but also perhaps stemming from a modicum of love I’ve (hopefully) transmitted, of which I’m grateful to have relayed back to me by the beautiful people who tolerate my precense in their lives. I’m reminded of the words a fellow classmate (now doctor and colleague!) expressed to me at graduation regarding this blog. “You’re an inspiration,” is a phrase that, for the paradoxically self-effacing narcissist like myself, finds simultaneously endearing and wildly undeserved. But overall, I find it is a patent reminder of the ethos I strive to live by: The desire to produce and reproduce, as much and as often as possible, unconditional generosity. To be radically and unapologetically vulnerable so as to be not just honest to myself, but further normalize emotions as healthy expressions of our human selves. And to know, viscerally, that the incalculable sum of my impact on others is not reciprocated proportionally – the molecularly small impact I effuse pales in comparison to the cumulative benefit of having the company of people who reek of inspiration.
My life this week has been flooded by proclamations of personal success amongst my unbelievably smart and talented colleagues. It demonstrates the utilitarian aspect of pomp and circumstance. As much as I admonish the self-aggrandizing, masturbatory exercise of glorifying “achievements,” the silver-linings exist. Even though the torrent of emotions elicited by smashing together 200 students who’ve not seen each other in person in over a year can be manic in nature, it provided me an opportunity (a self-avowed lover of theatrics) to grandiosely bathe in sentimentality. But more importantly, it provided another reminder of what “success” means to me.

For me, I cannot help but I understand my own “success” as the simple and inevitable product of the folks I’m surrounded by. Mentors who’ve inspired me since I was in college. Classmates whom I’ve learned from (and commiserated with to no end – an equally important exercise) and most importantly engendered lifelong friendships with. Residents who’ve set a seemingly unachievable example of success in every aspect of hospital medicine, and future coworkers who so warmly entertained me in my new home (Tacoma here we come!!). Old friends who’ve endured my bitching about medical school content, and who’ve guided me to reality when the vacuum of academia became all-consuming. And my family. Regardless of the divides that may exist amongst us and between us, they are unequivocally a repository of love older than any other I know. So, I’m really only the company I keep. “Success” is a shared experience that, similarly to the externalities that define and refine each of our individual personas, represents only an infinitesimally small product of our own volition (at least in my case). Recognizing the contribution of others, authentically, not with performative virtue signaling, is a process I’m working in an attempt to engender humility otherwise innately absent from my character or that I’ve (unintentionally) dispossessed myself of. Suffice to say (as I’ve written ad nauseum here now, and already in the past) my comrades are the foundation of all things “me.” My “success” is simply the recreated amalgamation of theirs.
Our arduous journey of medical school is closed. This destructive, instructive, (re)constructive process of physicianship, an odyssey like no other, finds brief pause now. A foreshadowed exhale that once again will start the process of sculpting ineptitude into mastery, just as we’ve done in each stage of our journey thus far. And just as before, the stakes are increased. The prerequisite commitment demands, as always, a level of work that I’ve necessarily been unable to comprehend until such time as the responsibility to comprehend it is at once required of me. Another expansion of my medical expertise coupled with a paradoxically deepening and widening of the well that is the unknown. And, once again, ensuring I don’t flounder in the process. There exists (for me at least) a dialectic and evolving resolution/dissolution of increasing knowledge and practical expertise appositional to my internal feeling of incompetence. Each subsequent stage in training seems to embody both, with increasing magnitude, a sense of mastery and confidence while unveiling the broad and deep reservoir of yet-to-be-learned knowledge. College was my first foray into actually giving a shit about school, just in time to meet the demands of mastering (iffy on the mastery) gen-chem, o-chem, physics, etc. Acceptance to medical school provided me some confidence that I was capable of learning medicine, while ensuring my terror that I indeed was about to learn medicine. Two years of preclinical work assured me (or at least my school) that I had the medical knowledge to start scratching the surface of learning about medical practice during 3rd and 4th year – another terrifying proposition. And now, having just accrued enough confidence to say I know a thing or two about medical practice, here I am anxiously awaiting the ultimate phase of training where I learn to perform. Put into practice that which I’ve been merely a redundant, partially active observer to until now, and ultimately make decisions regarding peoples’ lives where the buck stops with me.

I know for certain only two things regarding this next chapter in the odyssey: I am, as in every preceding transition, feeling woefully underprepared and confident of success. But here I am, nonetheless. But most importantly: There is exactly nowhere else I’d rather be.
To all of you readers, friends, old and new, near and far, in Minnesota and everywhere – you are exactly perfect. I’ll see you all for the next chapter 😉



