An Unwrapped Gift: Joy and Disappointment in an Unusual Graduation Season
A few weeks ago, I mailed a birthday gift to a friend. Amidst the current pandemic, I had built a routine of social distance practices and thus planned to make a single quick trip to the nearby post office and back. I used what I had ready at home — old newspapers and plastic bags — to wrap up the keepsake that reminded me of one the qualities I loved most about my friend. Most concerned with the item not breaking, I placed it in one of the common brown cushioned postal service envelopes and gave the sealed package to the postal service worker across the newly installed plastic screen. A day earlier than expected, she texted me with excitement, grinning in a photo of her with her gift in hand. During our scheduled birthday chat the next day, she thanked me for the gift. As my friend spoke, I realized that she never mentioned or stated concern about the plain packaging. In receiving her gift, her joy was defined by the value and the personal meaning of the gift, not at all dampened by its lack of more formal gift packaging. Our conversation then turned to current events and then the impact on our upcoming graduation days. She shared her disappointment about our graduation ceremonies being cancelled and the dampened anticipation for the planned virtual accommodations. At one point my friend remarked, “It hardly feels real.” That resonated with me. Cerebrally, I know that graduating from medical school is a major accomplishment. But in our unusual times, something so noteworthy now ends on a bittersweet note. I thought back to her birthday gift as we discussed the gift of accomplishment that we were about to receive, devoid of the fine wrappings of traditional ceremony and regalia. Though the meaningfulness of our upcoming moment still holds true, why does our joy still feel dampened?
The gravity of the gift I have in education is strong. My parents, my now middle brother and I immigrated to the United States from Cameroon when I was almost five years old. In impressing their deep values for education, grit and gratitude, my parents led by example. Entering a new country with the dream of promise, I watched my parents work hard to build a life of greater opportunity for their children. They never took the gift of learning for granted. I remember how diligent they were in checking over every school assignment I had. My mum still has some of my old grade school work that she kept; she took so much joy in even the smallest moments in the process of our learning. I remember how every summer break, my dad would run his own “summer school” for us. We would turn in our assigned math problems to him, which he would give us marks on, before we could go off outside and “spin around,” as he would say. They too had assignments of their own. I watched both of them study and complete their doctorates while they raised us. They were the first to teach me the importance of life-long learning and a commitment to academic growth.
The first seed in my growth to medicine was planted when I was 11 years old. An elder in my local church had suffered from a heart attack. When my father took me to visit him in the hospital, it was the first time that I had personally known someone who had been on the precipice of death. I was struck in seeing how illness could render a person to be so vulnerable; here a once vivacious man now laid languidly. In overhearing me ask my father how they had fixed his heart, the surgeon who had been speaking with the patient gathered a few brightly-colored, laminated sheets and sat beside me. He traced blood vessels with his finger, explaining that years of smoking lead to creation of something called plaque that gets stuck in blood vessels and that the elder had suffered because a couple of the blood vessels in his heart got really blocked. He explained what I now know as atherosclerosis and coronary balloon angioplasty in a way that I could grasp with my sixth-grade understanding. I found it incredible that an object as simple as a balloon, in trained hands, could save a life. I got hooked on the heart. One of my best friends from childhood still reminds me how much I loved the heart section of our seventh grade science class. Inspired by seeing the power of medicine, I became involved in health and community service organizations. I remember how much I enjoyed our Teens Against Tobacco Use field trips to local elementary schools. I loved seeing the look of awe in the kids’ faces when they saw real lungs — albeit from a pig — for the first time and explaining the effects of smoking in such a tangible way.
By the time I started college, I was quite certain that I wanted to pursue a career in medicine. We learned about how microscopic molecules in cells could be manipulated to have profound macroscopic effects, translating to therapeutic solutions for human disease. While certainly fascinating, studying chemistry was grueling work. It was the first time I truly struggled academically, and the vision for my childhood dream became smudged with self-doubt and imposter syndrome. The novelty of learning how to push electrons became marred with a crushing workload of problem sets. Many a night I spent alone in my dorm library, holding back tears, trying not to hyperventilate when it seemed to just be too much. Many a morning I woke up with my head resting between the pages of a textbook. I became accustomed to feeling like I could barely catch my breath, learning to keep my head just above water. The crucible of the academic rigor was pressure enough, but I brought my own anchors and buoys into college with me as well. The value for process and the love of learning in itself instilled in me from childhood kept me going regardless of the luster of my academic performance during undergrad.
The summer after declaring chemistry as my concentration, my desire to see how scientific innovation had the capacity to heal led me to join a laboratory research group. Through my work in a tuberculosis lab in college and an HIV immunology and vaccine development lab after college, my interest in medicine continued to grow. I felt continuously inspired in seeing daily how intellectual curiosity fueled a process of generating medical advancements that would transform people’s lives.
My desire to be a physician was solidified through my clinical experiences — in witnessing how medicine recognized a person as more than complex protein pathways to modulate, more than caseload numbers, and more than their medical condition. I wanted to be the physicians I shadowed. I watched as patients placed the vulnerability of their personal narratives and afflicted bodies into the hands of physicians. Each time I saw a physician caringly and skillfully lay hands on a patient, I was reminded of the same competence and compassion that I had first seen in the surgeon who had helped the heart of a community member beat again. It was the pull to learn how to experience the unique nature of the doctor-patient relationship that fueled me as I studied for the MCAT in additional to lab work and clinical volunteering. I still remember exactly which conference room and where I was sitting when I received my first medical school acceptance letter. It was impossible to conceal my joy from my lab mates nearby. The later crystallization of that joy was the day of my medical school White Coat Ceremony. As I stood on stage to receive my first white coat and stood alongside my classmates to recite the Hippocratic Oath, as I hugged my new classmates, family and lifelong friends, it was then that the start of my medical training felt real. And it is still one of the best days of my life.
If college had been akin to a crucible, medical school often times felt like an inferno. But now the additional pressure was that we were no longer just learning for ourselves. Our understanding of the material presented to us would eventually have real-life implications, affecting our ability to care for our patients. Again the old thorns of self-doubt and imposter syndrome reared up as I tread water more quickly than I ever had before. The process of learning medicine was learning a whole new language, fraught with moments of both fluency and not-yet-fully-competent utterances. Starting with anatomy as our first class was like jumping into the deep end. I remember feeling the mix of intimidation and gratitude in dissecting a human cadaver for the first time. I also remember feeling the sting of my first embryology exam. Anatomy gifted me with people who grew from being classmates to true friends and planted my now blossomed desire to be a surgeon. I vividly remember the almost-crushing anxiety that permeated all of the second year of medical school from the imminence of the looming Step 1 exam, our first ever medical boards. If there is one time of my life I care to never relive, it would be the six weeks of 10–12 hour days of studying during boards study block, the rite-of-passage that every medical student must surmount.
Third year of medical school was even more incredible. The intensity had not lessened and there was now the learning curve of applying knowledge as an active member of a care team. But I loved that we had an additional motivation to learn: the betterment of our patients. It was the year that I found my lifelong career, realizing that somehow time seemed to fly by so much more quickly while I was in the operating room. By the end of clerkships, I was certain that there is nothing quite like the field of medicine. It is an unbelievable privilege to have a person trust you with the intimacy of their body and life. We not only witness but help shape humanity often its most raw form. That is a gift, one that is heavy steeped in a far-from-perfect system that still grapples with inequity, disproportionate representation and imbalance. But a gift it is, nonetheless. As I applied for residency positions this past fall, I loved that it afforded reflection of this journey to medicine and the opportunity to share why it is so deeply meaningful.
For so many of us, being a physician has been an idea not-yet realized. It has been a dream that we so desperately worked for years, for some well over a decade, in the hope that it would come true. Our hope may have waxed and waned from roadblocks on a precipitously difficult path, but those same road blocks have been carved by our own determination into stepping stones on our climb to the finish line. For many of us, this dream has been one that has been shared. It is the culmination of the labors of generations in our families, the persistence of generations of communities rooted in plight, and the exaltation of sustained words of encouragement from our dear friends and mentors.
So as the finish line of this long-sought aspiration nears, I also worry that it will not feel fully real. For the past three years, as I watched graduates be inducted into this revered career in ceremony, I had imagined that someday I too would experience my doctoral hood being placed around my shoulders by mentors who believed in me as I again looked out to see the faces of my beaming family. And I hoped to hug my classmates and now lifelong friends, to watch their eyes light up as we laughed at shared hardships and finally said our farewells before scattering across the country for residency training.
I am giving myself the grace to experience the disappointment that bridges the gap between the expectation I had and the reality that is. But I am approaching my virtual graduation ceremony knowing that the inherent value of my accomplishment and gift of finally becoming a doctor — sans the in-person ceremony — is still the same. It just feels different.
