Did I Get a Gold Star?

What is success?

I’ve asked myself this question a lot in the last few months as I’ve battled with thoughts of comparison and self-doubt. My performance has been under the microscope as we hastily wrap up our third year of medical school where our grades are mostly determined through individual evaluations by our clinical preceptors. For them it’s a task on their to-do list, but for me these comments have impacts on my future opportunities. That feels like a lot of responsibility for a couple of sentences typed into a box on the internet.

As their words appeared on my screen some of them made me stop to think, “Is this enough to…?” To get the ranking, the membership to some society, the job at that residency program, to get the gold star. I wasn’t sure.

A conversation with a mentor has helped me start to shift my perspective. She validated my feelings, but then went one step further to suggest that perhaps my definition of success could come within. She challenged me to answer the question – what is success?

This past year success has looked like my patients telling me they would want me as their doctor in the future. It’s looked like someone telling me they trust me. Success has been making space for important people in my life outside of medicine. It’s been performance on exams, but it’s also knowing that this information I’ve learned will help me change a life. Success was overcoming my fears, trusting myself and leaning into the difficult and tireless moments. It’s reflection, tears and humanity.

The combination of letters in my evaluations might tell the story that I can take a good history and present it in a clear and concise manner. They might say that I’ve learned the neuro exam and have been a good advocate for my learning. But those are only a piece of the story and they’re missing all of the details.

I had the day before Thanksgiving off, but I had just finished a week on in-patient medicine and one of my patients was still in the hospital. I decided I would go visit her because she seemed so lonely, and I didn’t want her to feel alone around the holiday. We sat and talked about how she was feeling, then she told me about her family and what they normally do for Thanksgiving. As I was getting ready to leave, her eyes filled with tears and she looked at me and said, “Can I ask you to do me a favor?” “Yes, anything” I replied. She said, “Tell your Mom and Dad that they should be proud”.

That’s the gold star. Those are the details worth mentioning.

Who Sets This Curve?

In college, there were always those students who “set the curve”. They did the best on exams and therefore defined how the grading would play out for the rest of the class. We have a different kind of curve on our hands, but we all play a role in how this curve is set. We will all play a role in who will be beneath the curve and how steep or flat it ultimately becomes.

At first, I thought that I was outside this curve. I’m 28, young, healthy and exposed to viruses on a regular basis at the hospital. I had a trip to Paris planned for as soon as I finished third year. We were going to sip on wine and eat baguettes. I didn’t care if I got sick after the trip, as long as I got to go. This was in February, as we were first starting to see flights canceled and the numbers spread. Still, we held onto our trip.

Then, in the beginning of March I participated in a tour of community resources for individuals with intellectual and developmental disabilities. Accompanying me on the tour was a physician who cares specifically for the IDD population and I heard her express concern over how COVID-19 was going to impact this community. What would happen to them if their primary caregivers became sick? What would happen to Day Programs where many people with IDD go during the day if someone who attended became sick and still went?

I grew concerned when I began to see first-hand who was going to be impacted the most.

I still didn’t want to give up my regular schedule. There were only 6 weeks left in my third year and I had patients I was looking forward to seeing back in clinic. I had skills I was looking forward to perfecting. I had surgeries I was looking forward to scrubbing in on. Pausing clinical rotations was a devastating turn of events. But then, I thought about how many people I interacted with on a daily basis when I was working in the clinics. I did the math. At least 25 people in one day. How many others do those 25 contact in a day? I understand now how things go viral.

Maybe I will be outside this curve meaning that I won’t get sick, but that doesn’t mean I don’t have the ability to affect it.

So, I stay home and hope that others do too.

We get to determine how this plays out.

We get to decide to flatten the curve.