Letter from the Editor

What happens next?

It’s a question that I’ve heard more frequently - from patients pursuing gender affirming care in an uncertain climate, from classmates on the residency interview trail, and from loving family members trying to make sense of where I may end up next.

The air is thick with uncertainty.

In this gray, I am caught imagining multiple realities; trying to balance each successive spinning plate without letting the others break.

In testing out these myriad futures, I’m struck with both excitement and apprehension. Only with this added time to pause and reflect do I catch myself realizing that the same patterns of thought feel tangibly different than they did at my last Decision Nexus.

I was told when I started medical school that it would be a time of “transformation”. I was also told to remember my amino acids and that I would drink from a fire hose and make my lifetime best friends and change the world. I thought, I can only absorb so much.

But in thinking back on the past almost-four years, the transformation was right.

To be quite clear, it is not all rainbows and ponies (and I’m even going into Pediatrics).

There is plenty lost in the process - hobbies, hours of sleep, relationships.

But also - insecurities, self-imposed limitations, internal fears.

Contrasting the loss, I’m caught in the richness of what is gained. The growing steadiness of self, the hard-earned illness scripts laminated with experiences that brought textbooks to life. The indelible patient stories demanding new ways of problem-solving and connecting.

This ebb and flow of training enacts a certain weathering, uncovering new shapes and versions of ourselves previously unknown. Who are the providers we are striving to become? How do we make sense of our “befores”? And how do we find the capacity to adapt and expand from them, making ourselves more human in the process?

This issue we put out a request for pieces on the topic of Discovery. As a field rooted in science, medicine is full of discoveries of all kinds. However, our authors expanded upon the forms of discovery within the healthcare training process. They explored reckonings with ill and deceased family members and the marvels of the numerous ways in which we can heal failing bodies. They navigated the cynicism and challenge that comes when the rose-colored glasses fall away and the complicated dreams of what a future practice can look like. They reflected on the insecurities and pains of our first forays into the anatomy lab, the clinical space, and the large new world of Medicine. These pieces showcase the complexities of training through the eyes of a student. One limb still in each world, trying to navigate identities and new vocabulary in rapid time.

Our featured poem, Uninvited Guest, paints the uncertainty of illness with animalistic intensity; with disease as a powerful and hungry ever-present being. Hughes conquers the darkness with a bold step into an imagined future unburdened but always remembering the silent power of disease.

Dubose’s Lessons from Anatomy Lab is our featured narrative this issue, serving as a powerful reminder of the small acts that encapsulate some of the heaviest emotions. In grappling with the death of a parent, she beautifully weaves the layers of knowledge gained through the continued reflection of anatomy lab where personal experience and professional practice intersect and challenge.

In Back Then, Dougherty explores similar themes, elegantly contrasting the lens of a budding provider with that of a family member, finding tension and balance while holding both views. In Sorini’s Pass/Fail alternate futures are imagined and confronted, bringing worst fears to the surface and finding moments of tenderness amidst confusion. Chen’s Spots allows us to imagine the richness forming in familiar hospital hallways, life moments big and small colliding, overlapping, and making new homes for patients and providers.

While both preclinical and clinical training can often confront an emotional heaviness and intensity, so too can they bring a sense of awe and wonder. Ode to Antibiotics not only celebrates pharmacologic wonders but the expansive knowledge of pharmacists and the expertise brought by an interdisciplinary team. Similarly, Roberts’ Jane Doe provides a near-religious reverence for the intimacy and lessons of cadaver lab and the constant imagining of lives never met.

Looking towards the future, Forer’s Unpeeled highlights the relearning and reshaping of future ideals through medical training, finding a balance between cynicism and heart along the way. Adeyemi grapples with the tensions and reciprocities of rest and advocacy in her In Between Futures - In My (Our) Hands, taking us on a weaving journey through her experiences on the interview trail.

I sincerely hope you enjoy this issue. With darker days come time for introspection and slow moments. May these inner discoveries, though not always pretty, be points of connection and hope rather than points of further pain and isolation. In many ways, the role of the student is one of constant purgatory. No longer patient, not yet provider. But through a two-eyed approach, may this lens make us more human providers and bring a much-needed heart to the work ahead, regardless of what happens next.

Your editor,

Dev Gingrich