Love in the Time of Clerkship Year
A 2019 throwback, for Valentine's Day
I normally feel meh about Valentine’s Day, but the pandemic has made me value holidays as something to look forward to (in the absence of travel). And having kids has associated Valentine’s Day with family love, for me, which feels joyful.
A project I’ve been recently working on has been compiling all my unpublished writing from pre-medical and medical school days into one Google doc. As I was doing this, I came across an essay which I had submitted to JAMA back in 2019, and after it was rejected, I kind of forgot about it. I don’t think I’ve ever shown it to N, either. (He’s in for a surprise! Oops).
Reading it again made me smile, because so much has happened since then, and getting married in clerkship year is nowhere near as topsy-turvy as having twins in intern year during a global pandemic. But, the message still resonates with me.
Feel free to read or skip, I know it’s long! And any editorial feedback welcome.
Oh, and before you read it - here are the podcasts recommendations I received from readers last week when I asked for podcasts with good banter. I’m making my way through them, and having a great time!
We Can Do Hard Things, with Glennon Doyle
How I Built This
All Fantasy Everything
The Awful & Awesome
Love in the Time of Clerkship Year
The strangely specific training timeline of medicine calls for strangely specific alignment of major life decisions. Proposals or breakups happen around the time people decide to couples match (or not) at the start of fourth year. Weddings happen at the end of medical school, before the chaos of intern year. Babies happen in the third or final year of shorter residencies, or perhaps in the research years of longer ones.
Hewing to the timeline is our desperate appeal to be maximalists—that is, use our prescribed periods of greater free time to the maximum potential for life, and use our periods of busy time to their maximum potential for work. This is both a medical training philosophy and a millennial one: everything can be optimized, if we can make it so.
But that leaves little room for spontaneity, non-traditional paths or timelines, and doing things when they just feel right. After doing post-baccalaureate pre-medical classes and working for a few years, I started medical school four years after college, while in a long distance relationship with my then-boyfriend. Because the medical school admissions process is so competitive, and the pool of schools one gets into is often very small, long distance relationships are very common in medical schools and residencies. Like clockwork, Friday night after that month’s exam, I would see many of my classmates also wheeling their suitcases out of our school’s atrium in a rush to catch a ride to the train station or airport. I’d video-chat my boyfriend between study sessions spent cramming facts into my brain, and feel like I had nothing of import to say. My friends dubbed him Oprah because he’d come up with such aphorisms as: “Long distance relationships need to be a relationship, not just a ‘communicationship.’” And so we visited each other frequently, he during my study periods when he’d sit with me in the library on a Saturday, watching soccer on his laptop; me after my exams, flying up for a blissful weekend where I could pretend to feel normal again.
When he proposed at the end of my first year of medical school, it wasn’t a surprise—we had been so in love, and we both had dreams of officially linking our large, loving families and starting a family of our own in the not-too-distant future. And we wanted a summer wedding, about a year later—which was a reasonable timeline for planning. And yet I felt guilty—planning a wedding during clerkship year and getting married smack in the middle of rotations, during our only vacation, a two-week break? I felt I was “supposed” to wait until fourth year. When I guiltily approached one of our school administrators about this, she only responded with excitement and affirmation: “This is an incredibly important event in your life and it should happen when you want it to,” she said. I held that advice close and remembered it throughout the flurry of clerkship rotations, shelf studying, calls with photographers, DJs, venues, decorators, and the like—through the wedding itself, and our honeymoon—and after, coming back to the medicine clerkship with my hands and feet still faintly stained with bridal henna. Having our celebration of love and having my new husband finally able to relocate his work to my city meant we could live together. And yet, it felt so lonely to come back to clerkship year with the feeling that I was back at the bottom of the totem pole when I had felt on top of the world. On top of that, my patients were very sick: there were multiple deaths or situations that I knew were terminal. I went to the hospital feeling inadequate and came home feeling despair; this continued on throughout the rest of clerkship year.
My husband hugged me as I cried about the elderly patients who had no family to support them. When I came home one morning after witnessing the delivery of a stillborn child and was mute with sadness, he was there. When I made mistakes I thought were colossal, he’d say with incredulity: “But you’re a student. You’re supposed to make mistakes. Isn’t that what learning is?”
It was a meaningful but tough time, as it was for most of my classmates. We’d meet up with them and afterwards, my husband would say: “Wow, they’re saying the exact things you always say. Why do you feel like you’re the only one who feels this way?” I realized that the marriage was but a moment in clerkship year, but the love was this—the unflagging support, wisdom, and warmth through the toughest moments after that. And in the patients I met, I saw how important love was in their lives—how spouses asked the challenging questions during doctor’s visits, how children massaged the aching limbs of their elderly parents, how parents kept vigil all night the bedside of their hospitalized infants. How fear and worry lurked in their eyes but how they masked it in front of the loved one who was my patient. How they felt they had to be brave. The love was sometimes messy and argumentative and explosive and resentful but it was there. And it was in equal parts tender and gentle and steadfast, if you caught it at the right moments. I closed patient doors with tears in my eyes, and I remembered these stories, these relationships, far beyond the esoteric factoids I learned for my shelf exams.
In the Western tradition, marriage calls for a vow to support one another “in sickness and in health, till death do us part.” In our Hindu-Jain wedding ceremony we walked around a fire seven times as our priest chanted Sanskrit; one of the 7 rounds involved a commitment to each other through illness, a similar vow to the Western ones I’d heard in movies or at friend’s weddings. In many ways the vows we make are simply words, but the lived experience and the actions we take are powerful. As I am now halfway through my pediatric intern year, I am reminded again of the power of love through tough times—the love in my relationship, but also the love I see in patient rooms. I am reminded that it’s okay to not follow the timeline and to be spontaneous. It’s okay to celebrate love in busy, tougher times as well as easier ones. It’s okay to make life a little more topsy-turvy for the relationships you care about. It’s okay to prioritize love in the time of clerkship year.