Last Monday I sat in a chilly exam center for eight hours and took a very important test.  When I arrived home, I looked at the walls surrounding my desk.  They were cluttered with upwards of seventy hand-written index cards.  Very methodically–and resisting the urge to tear them to pieces–I took them down.  Atypical anti-depressants and their side effects.  The organs behind your abdominal cavity.  Every anti-viral drug and its machinery of attack.  The biochemical pathway an amino acid takes to become a neurotransmitter.  Chemicals that turn your blood dangerously acidic.  Which bacteria need air to live.  What happens in your cardiac cells from hour zero to month two after you have a heart attack.

It wasn’t that I wanted to forget the knowledge that I had crammed and re-crammed into my brain.  It was that I didn’t want it to be the first thing I saw anymore.

The last few months of second year had been a blur of caffeine, question banks, ignoring phone calls, and sighing.  The exam itself culminated in the biggest blur of all, and for this I am grateful.

Two days after my exam, I attended hospital orientation and became a third year student.  This means that I will be an apprentice of sorts (the kind that still pays tuition), working full-time in the hospital until I graduate in two years.  Instead of seeing one patient every week or two, I will be seeing and discussing dozens each day.  Unlike in years one and two, when my entire job was to learn from the patient, now my role has expanded: to help the person in front of me.  All the interpersonal skills that have atrophied over the last few months will become important again as I contribute to patients’ care.  All the medical details that I have tried to file in my brain will become part of a larger picture as I apply them to make people’s bodies feel better.

Since I last wrote in January, I tried to write two separate blog posts.  They started very differently, and they both ended with the first sentence.

One post I wrote at midnight a week before my exam.  “This is not who I am,” I typed, cringing at the clichéd and whiny words.  Then words stopped coming altogether, and I went back to studying.

The second I wrote at noon, several months ago.  I had performed my first (minimally) invasive procedure on a patient, and it was to help a medical team I was shadowing.  It was the first time I had ever interacted with a patient in a way that directly contributed to his care.  On a high, I wrote, “Today, for approximately 60 seconds, I did something that mattered.”

I really want third year to matter.

The walls around my desk are bare now.  The vast white space looks unfamiliar and slightly discomfiting in a place where I am used to seeing smudges and coffee stains.  But there is an energy in the blankness, and a nervous excitement as I wonder what will fill them.

I did keep one small card taped up.  It always looked different from the rest.  It was given to me by a terminal cancer patient I worked with who found her strength in religion.

“Don’t worry that you’re not strong enough before you begin.  It is in the journey that God makes you strong.”

Orientation is over.  My journey begins tomorrow.

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