This post first appeared on Transforming Medical School.

GREENVILLE, S.C. (June 27, 2018)—I’ve been contributing to this blog for a few years now, and every entry seems to eventually come around to this one idea: how much I love being a medical student and how much deeper that feeling is each time I reflect upon it. My class’s 3^rd year of medical school started in May 2017. In that month alone, I saw more patients than I had ever seen before, at least ten-fold. As suggested by an upperclassman, I kept a shorthand diary on patients who struck me academically, emotionally, or humorously. The joy of first learning inevitably fades with time, and this diary is my reminder.

Reading that diary again now, I am struck by many things: the diversity, the intensity, the intimacy, the progression. The progression startles me the most. Diagnoses that once seemed obscure now appear so obvious. Conversations that might have given me anxiety before are now well-practiced. Things my non-medical student friends find unusual or weird, I have come to accept as normal and commonplace. While I enjoy the knowledge and the camaraderie it creates, occasionally it strikes me that my knowledge—precisely the thing that allows me to help patients in a special way—can get in the way of my empathizing with patients. Like many things, although this cosmic irony cannot be eradicated, it can perhaps be tempered by awareness.

Much is written on how humbling it is to witness from the perspective of a health care worker how vastly different and yet essentially similar we all are. I don’t have much to add except that I feel it has made and makes me a more forgiving and understanding person. I realize and continually discover how little we truly know about people, and how much we assume even in passing.

The intensity of medicine can be overwhelming. It is never our lives or well-being at stake, but we see many people every day, regularly more than twenty, perhaps more in certain settings. If even a few of them are experiencing some major life stressor, that could be more distress than I experience in my own life over a whole year. Yet day after day after day, sometimes over weekends and through the night, we see these people who are our patients and hear their stories and work in the shadow of their pain and fear, relief and joy. It exhausts and invigorates in equal measure.

And the intimacy. In what other world would I comfort a complete stranger about the death of her son? Assist in the appendectomy of a man I have yet to meet conscious? Press my stethoscope to the chest of a child whose parent I met but moments before? I have touched and listened to and sliced open people’s bodies, the physical manifestation of their very being, in every state of health, sickness, and even death. Through all these interactions most barely even knew my name. In every other way, we were strangers passing in the night.

Being a medical student creates such purpose, meaning, and fulfillment in my life, though such existential ideas rarely occur to me unprompted. I’m usually more interested in what’s for dinner and how early I can productively and reasonably get to bed. But I’m realizing the importance of purposefully collecting and recollecting such ideas. In preserving and prolonging the limited breaths and heartbeats of others, I can’t help but wonder if medicine is the best way I can spend my own. Over and over and over again, I come to believe it is.