I am here and alive
I know why I left medicine. It saved my well-being, my family, and my life
I hear the whispers behind my back
I see the pity in their eyes
I want to leave this world, but
I am here and alive
I pretend to smile in my new career
I feel isolated here
I touch the hand of my spouse
I worry what could happen if I were not here
I mourn for my failures, but
I am here and alive
I understand that medicine was never meant for me
I say thank you for the experiences
I dream of reclaiming self-worth
I hope my kids are proud of me
because
I am here and alive.
This poem was inspired by my interactions with former medical school classmates. Although the vast majority of medical school matriculants graduate to become physicians, there are a few who will not make it to the finish line. Whether that is due to poor academic performance or cumulative stress resulting in burnout, there are multiple ways that medical school can (at times) feel more like a filter than a pump. Unfortunately for far too many cases, this results in a breaking point that causes some students and doctors to leave medicine permanently.
The first stanza of lines reflects on how many students feel when having to interact with former classmates and colleagues. Having to re-explain your circumstances and final decision to leave medicine can be emotionally taxing and socially embarrassing. This is further exacerbated in the culture of medicine and academia where your self-worth is dictated by your evaluations and performance in school. Given how emotionally scarring these interactions can be, some students contemplate self-harm.
This is further exacerbated in the second stanza where the feelings of isolation are coupled with having to put on a “pretend smile” in front of others. Many times it can feel like the only things tethering us to this world are our families and loved ones. In these lines, we find the speaker assuming the role not as a provider but as a parent and as a spouse who must continue to live their life for others even after leaving medicine. This is particularly important in bringing to light the idea that we as providers are human beings who also have lives after we take off our white coats and scrubs.
Finally, in the last stanza we see our speaker come to a moment of acceptance and gratitude with their decision to leave medicine. It is in these last few lines we see self-redemption but more importantly self-resilience in the face of adversity. Overall, I hope that this poem serves as a beacon of light for other physicians, students and healthcare providers to know that leaving medicine is not a wrong decision. The individual circumstances that dictate whether a provider stays or leaves are highly diverse and variable. However, it is our job as future and upcoming physicians to develop a safe culture that favors well-being over superior grades and evaluations. To foster such an environment requires change from within to ensure that unrealistic expectations and high stakes pressure are not the driving factors in determining the self-worth for future generations. We must continue to support the choices of others and not pass judgment because in the end we are just happy that they are here and alive.
Image credit: Sunset over ocean, sonoma coast by ((Brian)) is licensed under CC BY 2.0.
Resident Physician Contributing Writer
Walter Reed National Military Medical Center
Ervin (Erv) is beginning his general intern year at Walter Reed National Military Medical Center and recently graduated from the Uniformed Services Univerity of the Health Sciences in May 2022. While in medical school, he was the co-director for the on-campus peer-led curriculum aimed to foster conversations about diversity, bias, discrimination, and inclusion in both medicine and the military. His interests include medical education, promoting diversity, and utilizing the arts to augment the healing nature of medicine.