Medical training and practice are marked by constant change, which can feel uncomfortable. Embracing discomfort as an opportunity for growth can help us to improve our care of patients.
Passion in the Medical Profession | April 22, 2020 | 5 min read
Last summer, I finished my first year of medical school, boarded a plane, and flew to California. Alone, I hiked 1300 miles on the Pacific Crest Trail. For 52 days, I woke in my tent, ate cold oatmeal, laced up my shoes, hoisted my pack, and walked north toward Canada.
A year later, my mind is still there. It is amidst the green trees and the texture of the rocks beneath my boots. It is on the flash of lizards, the early morning forest chirping with birdsong, the dusk humming with mosquitoes, the rising and setting of the sun and moon. Nature brings us deep into the minutiae of life. There is no distraction.
I didn’t emerge a different person. Previously, my longest trip was 500 miles hiking a section of the PCT in the Sierra Nevada of California; backpacking, the wilderness, roughing it—these were not novelties. “Transformative” has this connotation of eliciting dramatic change, of altering the way we look at the world, but I think the reality is that growth is subtle, iterative, and slow.
After a year of medical school, I wanted a break from the academic environment in which I felt my value was judged by my performance, my sacrifice, and my intelligence. In college, I learned that hiking made me feel powerful by standards I could set for myself. But even in the early days of my trip, I started to draw comparisons between hiking and medical training, two things I had previously viewed as entirely separate.
Everything is temporary; change is constant
Often, I walked through a dense forest one moment, and suddenly, the trees opened up to a meadow of wildflowers. A minute later, the trail skirted around the side of a volcano and dove into miles of snow. Before lunch, I passed through wetlands, forests, meadows, and rushing rivers.
I tried not to compare landscapes, and instead appreciated them for what they were. There was beauty in deep green forests, their gentle silence, a flat trail that allowed me to reach and hold stride. There was beauty in open fields where the trail stretched visible in front of me, beauty in steep climbs that taught me to endure discomfort a little longer, beauty in burn zones where small shrubbery thrived.
As I hiked, I recorded my musings to send to a few people. In one to my medical school friends, I said, “Things are always changing here. Was our first year preparation for that? Things change, you either love the change or you feel uncomfortable, and then one of two things happens to alleviate some of that discomfort: you adjust, or things change again.”
Medical training and practice are marked by constant change, which can feel uncomfortable. Accepting this discomfort as just a feeling—not something disabling nor inherently bad, but a marker of opportunity for growth and change—allows us to work through discomfort to focus on the patient in front of us.
We are nothing without the help, guidance, and company of others
A winter of record-setting snowfall meant that people were delayed in getting to northern California, where I started. The trail was quiet. Some days I trekked for hours without seeing a soul, singing loudly to keep the bears away (with mixed success).
On my fourth day of hiking, I had a particularly scary fall, followed by a thigh-deep river crossing, followed by 10 straight miles of snow. I was sitting on a rock and checking in with myself, feeling the fear that I had put aside to cross the river. Then, I noticed that my footprints were not the only ones in the snow. Elated, I started hiking and sped up. A few hours later, I caught up with a mother-daughter duo, and exclaimed, “I could hug you!” We laughed. I told them that I needed a mother for a few miles.
They understood. I had gratefully followed their tracks for the past few hours, which had relieved me of trying to find the trail in the snow, so now, I offered to lead. We walked slowly, sometimes in silence, sometimes exchanging stories from our previous days on the trail.
In my first year of medical school, I had practiced looking patients in their eyes, giving them space to share, recognizing their distress—and now here I was on the receiving end. There was something so pure about stopping, greeting each other like old friends, hearing the fear and delight and courage in our voices, and knowing that I could hike with them for as long as I needed to feel ok again. It felt so human to share what the last few days brought; to hear and be heard. To say to each other, you are not alone, I want to celebrate your joys and hear your challenges, and together we will walk.
Hike your own hike
My daily mileage increased as I got stronger. As I was setting up my tent at the foot of the Three Sisters mountains in Oregon, another hiker passed and asked if he could join me in this lovely spot. I was always grateful for company. He asked how many miles I had done that day. I said 37.
I wanted to make it to Canada before school started again, and I chose to sacrifice the lake baths and sunsets for the miles. While the first year of medical school took diligence and often more effort than I thought I had within me, this physical exertion was an entirely different kind of effort. It was a release.
I’m still learning to feel proud of my pace while not comparing myself to others. There were people who stopped at 3pm, found a perfect camp spot every night, and watched every sunset. There were people who spent days in trail towns and people whose packs weighed 60 pounds. Long distance hiking is not a one-size-fits-all experience—each person chose their own way to hike. A phrase heard on the trail is “hike your own hike.” I like this, a lot.
Recently, I fell prey to the comparison that so often strikes in medicine, feeling guilty for not doing as much research as my classmates, not studying as much, and not knowing a “simple” answer when questioned. “Hike your own hike” came to mind. We are all hiking our own hikes, all here for different reasons. We want to provide our patients with the care all people deserve—we all want to get to Canada—but there are so many different ways to do that. Comparison is a surefire way to eliminate joy.
When I go back, I’ll watch more sunsets.