On the eve of 2021, I felt like I was peering down an unlit road. Theoretically, I knew what lay ahead: my debut on the wards in scrubs and my embroidered Patagonia, six weeks to study for Step 1, then the glorious freedom of PhD-land after the summer. My entire year had been meticulously planned out by the MD/PhD program, yet I had no conception of what each day would look like. I had no idea I would be peeling myself away from my sheets at 6AM and pre-rounding by 7. I didn’t even know what pre-rounding was, but I was thrilled to do it. This was the year of beginnings – not just for the young physician-scientist in me, but also for the bright-eyed, often bewildered 26-year-old woman navigating the many loves in her life.
When I was 23, I knew I would love medicine. This was a premature conclusion I had drawn from interacting with patients at the NIH during my gap years. I had no knowledge of pathophysiology. Nor did I truly appreciate the hours of studying and the sacrifices my education would demand of me. I only had a stubborn intuition that my place in this world was beside a patient, comforting her at her most vulnerable. I wondered if my intuition would prove true or if my idealism would yield to the toils of clerkships.
I entered the wards with glee. I found it so funny that the attending, senior resident, interns, and medical students would travel everywhere in order of seniority. The attending would lead the charge at breakneck speed while medical students struggled to keep up at the caboose. Though, there was one intern who walked at my pace. He’d amble next to my sub-I and me, teaching us about congestive heart failure or how to work up anemia. He even spent part of an afternoon setting up all the tabs on EPIC for me so I wasn’t frantically clicking through pages to pre-round in the mornings. I loved having the privilege of learning from physicians who enjoyed teaching and who cared for their students’ wellbeing.
There were many unexpected joys. Like my first paracentesis (I insisted on doing three more after that). My fingers memorized how to pull back on the plunger while advancing the long paracentesis needle into the fluid pocket in my patient’s abdomen. Or when I fell in love with neurology, drawn to the magic of localizing a lesion with a neurological exam and confirming our guess with imaging.
Even as I enjoyed the novelty, my six months of clerkships felt like unending rounds of speed-dating. As soon as I was comfortable with my team, my senior resident would get whisked away to another service. I would have to figure out if the replacement was a cool senior who would take us out for Rosy’s on short call days. Or if they would let me do the dance of coyly asking if there was anything left to do for my patients (and send me home when there wasn’t). Plus, as soon as I gained some competence on a rotation, I had to move onto the next. I could never gain true familiarity or competence in one area of the hospital. Such was the nature of clerkships.
There were also really hard weeks. Like that one week in March when my grandma was hospitalized in China. And six women who looked like me were murdered in Georgia. And I injured my knee. And I had a freak accident when I got my routine eyebrow wax (I wore three layers of foundation to cover up the damage on my face). And I was politely turned down by my first crush in three years which brought me into a season of brooding over previous failed relationships and why I had avoided dating for so long in the first place. During weeks like this one where multiple things imploded in my personal life, my academic life kept me distracted. But the demands of medicine also prevented me from fully processing and recovering. There were always UWorld questions to finish, abstracts to skim, patients to read up on. Though clerkships were mostly characterized by excitement, my initial encounters with medicine will always be associated with some of the most turbulent times of my mid-20s.
And just like that, on June 28th, my world transformed from twelve-hour days in a bustling hospital to twelve-hour days alone at my desk, cramming biochemistry for Step 1. Several dizzying weeks later, I officially became a PhD student and was given back autonomy over my time. There were no more Anki cards to crunch, no one to tactfully ask if I could go home.
Now, I am back in classes where I learn about ion channels, synapses, and other information I will never use in my research, but are fascinating nonetheless. In contrast to the broad but surface-level knowledge needed for the wards and boards, concepts in graduate school require depth of understanding. But one thing remains the same from clerkships. I am still speed-dating.
My advisor says that there are two crucial decisions one makes in life: who to marry and who to choose for one’s thesis advisor. He likens my lab rotations to dating and my final decision on my thesis lab as marriage. I find this analogy hilarious and maybe a little irreverent, but I take his advice. On each rotation, what I observe about the lab culture, the mentorship style of the PI, and how comfortable I am learning in the lab environment are indispensable to my decision-making.
In the backdrop of “dating” PI’s and their labs, I’ve finally decided to actually date again. Old friends ask if I’m interested in guys at their churches. Cousins of husbands of best friends offer to share my number with their brothers. And of course, the apps beckon. The flurry of introductory texts, awkward first dates, and (hopefully) respectful friend-zoning parallel the conversations I will have with PI’s this semester. “I loved rotating with you and would love to have you as a mentor if you have the bandwidth, but…”
And in the backdrop of my frenzied academic and romantic life is the emotional crux of this year: four of my closest friends got married in just the last few months. As I rejoice with these women and their partners, I also ache with the realization that our friendships won’t be the same again. Best friends move across the country to be with their new spouses. At weddings, we won’t be packed like sardines in sleeping bags, talking into the night. My married friends will book hotel rooms with their husbands. As they build their families, they will have less and less time for their friendships. This year of exhilarating beginnings also marks a bittersweet new chapter in my closest relationships, and because of how I cherish my friends, this transition has a much bigger impact on my identity than even the most inspiring moments on clerkships.
With the many raw and beautiful beginnings this year, I feel an abundance of hope. I hope that my love of medicine will continue to burgeon. I hope that in my PhD, I can study the brain under the mentorship of an awesome thesis advisor. I hope that my friends’ spouses will also become dear friends to me. And of course, I hope something good can come out of awkward first dates. If you had told me at the beginning of 2021 all the things that would transpire this year, I would’ve preferred to remain in the dark. But now that I’ve walked this road, I’m simply grateful for the many seeds that this year has sown.
Audrey Luo is a CDY3 at the Perelman School of Medicine.
Image by Catherine Yang, an MS3 at the Perelman School of Medicine.
