Looking back, looking forward, and looking Up

Standing at the bottom of the residency totem pole, I spend most of my days looking up. I imagine what my life will be like as a PGY-2 (post-graduate year two), 3, or one-day, an attending surgeon. Not long ago, as a medical student, I used to similarly look up to the interns in their knee-length white coats, their names decorated with the title of “MD.” Before that, I was a premed student fancying the lives of medical students.

In this strict hierarchy, where everyone is deeply motivated by advancing upwards, the importance of everything above where I am standing feels magnified. My seniors’ words feel more impactful than mine. Their work and time feel more important than mine.

As a corollary, it is just as easy to dismiss the concerns of my own or my juniors’ as insignificant in comparison. I catch myself often having thoughts such as, “I remember when I used to be preoccupied with those worries. If only I knew back then just how trivial they are compared to what lies ahead.”

For instance, I remember unnecessarily worrying that my teams were observing my every move. If I left the operating room to use the restroom or to drink a cup of water, would that negatively reflect on my work ethic? If I left early because I had finished all of my work ahead of schedule, would they think that I was cutting corners? These are just a few of the trivial concerns that occupied my mind as a medical student.

However, on further reflection, I realize that, instead of always pining for the future, it is essential to recognize the unique influences that I get to have as a product of where I am now. There are incredible opportunities that one can only have as a medical student or an intern. I have the unique privilege of conversing with patients about their day-to-day concerns at length or mentoring students who are considering careers in surgery, not despite, but precisely because I am at the bottom of the residency totem pole.

I recently took care of a patient on the Thoracic surgery unit. I would wish him good morning and wave goodbye each day. Because I was the intern covering the floor, I had the time to check in frequently during the day and get to know him and his family. Nearly a week later, he said to me, “You know doc, I have to thank you for checking in on me each day. Even if it’s brief, it has made me feel that you care, and after being in the hospital for so many days, you’ve helped me stay positive.”

Recognize the power that you have in your current role, although it may seem diminutive compared to the potential you hold in the future. We cannot let hierarchy dictate or distort our perspectives.

Even as a medical student, your words can be tremendously influential to premeds who dream of one day being in your position. Even as interns, our jobs make a meaningful difference in our patients’ care and well-being every day.

The true wisdom is in being able to look back, as much as we look forward. Don’t always look up. Take the time to acknowledge and help those who are enthusiastically climbing behind you. There were moments in my training where a few words from a thoughtful senior made all the difference. After a long day, a resident once bought me a cup of coffee and briefly thanked me for all of the hard work that I had put in during the rotation while we were making our way back to the OR. With just one gesture, I felt genuinely acknowledged as a part of the team. It changed the way that I perceived of the entire rotation.

These moments are sparse, and shine like color spread out within a film of black and white memories. The importance of a few well-intentioned, sincere words and advice cannot be underestimated. No matter where we are within the hierarchy, our action and words are powerful.