The first days are the hardest days?

This article is about growing older. Today is my birthday, so this feels like an appropriate topic.

With each year that passes, the tasks we are responsible for are altered. This is especially true in medical education, which is filled with a number of landmark exams, clinical experiences, a residency match, and a few graduations. Eventually (hopefully) you get to the top of the totem pole and are a real life, do-it-yourself-without-supervision attending physician, but until that time, the train is constantly moving and it doesn’t stop for anybody.  In my relatively short time here at OHSU, I have had the opportunity to meet and interact with people in all stages of this medical school track. Through these conversations, I have found that what changes even more than the ‘things’ we are responsible for is the outlook that we develop toward both the milestones we have accomplished and the undertakings still ahead of us.

In my family, I am the eldest of three children. As most people have probably noticed, when you’re growing up, everything your younger sibling does seems easy. The way I see it, there are two reasons for this. The first is obvious; you grow older and wiser with each year, so what was difficult when you were eight years old isn’t difficult at all when you’re eleven. So when you see your little brother struggling with long division, instead of remembering when long division was new and pretty tough, you think, ‘wow what’s wrong with this kid, nothing could be easier than long division.’ It’s more than just an age thing though, too. I think tasks just seem easier looking back than they actually were. When you look back at something you have already accomplished or mastered, you view it as completed, and by definition it is doable. Things seem really easy once they’re done.

The hierarchy of medical education follows a similar trend. According to most, each year is more difficult than the one before it (except perhaps for 4th year, which most people seem to agree is fairly relaxed). First year is easier than second, when the material gets more complex and you have to start preparing for boards. If you’re considering complaining during your second year though, there will most definitely be a third year student around the corner ready to remind you that third year kicks it up another notch as you spend hours on the wards in a new and tumultuous environment. You think third year is tough? Wait until you’re an intern working 13-hour days, 6 days a week. Then as a second year resident you no longer have weekly hour restrictions, so in many specialties you work even more. This is perhaps, in some ways, the top of the mountain regarding work hours, but you see what I’m getting at. As a first year medical student, I’m basically constantly hearing to just enjoy myself, because things get MUCH more difficult.

The alphabet is pretty easy once you know it, but to a kid in preschool, it’s like quantum mechanics. The same goes for multiplication in second grade and algebra when you’re twelve years old – they’re new to you at the time so they’re hard. Would I describe algebra as hard right now? No, I wouldn’t, because I know algebra.

I think the same applies to medical school. Once you’ve passed anatomy, it feels like it wasn’t that tough. I’m in that boat right now. Anatomy? No problem. When I started learning the cranial nerves a mere 5 weeks ago though, they were absolutely daunting. Well now we’re in our second major class, Cell Structure and Function, and guess what, it’s more difficult.

Instead of constantly fearing the next step in this process, it might be better to just tackle them as they come. Today, I am 27 years old. Tiny gray hairs are growing into my sideburns (but don’t worry, only I can see them). I’m starting to feel that I really don’t have the time to worry about my next class, which is supposed to be even more difficult, or my next year when we’re responsible for even more information. While I may have been better than my brother and sister at well, pretty much everything when we were all kids, now we’re all adults, and surprise, we’re all on a level playing field. At OHSU and other medical schools around the country, we are all heading for the same ultimate place as well. So whether you’re in college trying to gain acceptance to medical school or a third year resident in General Surgery, we all have to succeed in similar ways in order to become a physician. With patience and perseverance and maybe a few extra gray hairs, I think that if we know we want to, we’ll make it; just as long as you can get past that next obstacle, which is sure to be harder than the last.


One response to “The first days are the hardest days?

  1. As a member of “support staff” at the hospital sometimes wonder what life is like for those intense looking young men and women behind those white coats. Just as an observer I cannot imagine the courage it must take to commit your life to taking care of the sick and dying on every level of health care. It scares me so much to see someone in pain or so ill they are dying yet you guys maintain your composure to treat them, I can say that i am proud to be a member of the staff at OHSU largely because of the poeple I see around me who are putting themselves in harms way to help others, so if you feel down or overwhelmed just keep up the good work.

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