Boxes

By Jacob Balin, MD, Cambridge Health Alliance

Boxes

In medical school I felt trapped

Against the walls of boxes

Boxes of the hardness in my teacher’s voice.

Boxes of assumptions—of our weakness and the weakness of others. Assumptions of what can and can’t heal. Assumptions that things couldn’t be any other way.

Boxes of power to do unto me. Boxes of my perception of others’ power.

Boxes of my compliance.

Boxes of my resentment at others’ willingness to be boxed—leaving me alone.

Boxes of staying on schedule and on task. No bushwhacking into the undergrowth.

The boxes are sensitive. When they feel threatened, their walls stiffen. The boxes are afraid. They’re afraid because they remember being something other than boxes. They remember being every patient they’ve ever seen die, and every one who was healed. They’re afraid because they’ve been wounded, and have wounded in return. They’re afraid because if they weren’t boxes, then what would they be?

And yet the boxes yearn. They yearn because they remember being something other than boxes.

Feeling boxed taught me firsthand where medical education fails students, and this is invaluable as I write and work on med-ed reform. Also, experiencing the lack of regard for medical students forced me to examine whom I treat with that same lack of regard—medical assistants, housekeeping staff—and to work to change that. So there was good that came out of it. And yet I hesitate to say so, because taken to an extreme, the fact that adversity may cause growth can be used to justify not addressing factors that harm trainees and students.

Feeling boxed caused me to waste a lot of time drowning in my loneliness, confusion, and anger. I was trapped in my little box and mostly, it seemed that my professors and classmates were trapped in theirs—boxes of busy schedules, frazzled nervous systems, unexamined trauma, and the background programming stating that we don’t talk about the depths.

If we hadn’t felt so trapped in our boxes, I wonder if we might have helped each other grow—supporting one another in challenging moments, gently pointing out blind spots, and pushing each other to accept the gravity of the physician’s vow—the vow not just to master technical knowledge, but also to grow toward empathy, courage, and the other virtues on which clinical excellence rests.

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.