The click-click and rickety wheeze of plastic jarred me back to the present from my thoughts about what I wanted to say about finishing my third year of medical school. Even though it’d been 3 years since I operated an ambulance stretcher, I knew that sound like I knew my own voice. The stretcher sound was among the many I’d learned in the past years.

The third year of medical school was a robot period. A term coined by my sister back in our college years. A robot period is a time when you just do as if you were a robot because sometimes you just must get to where you’re going.

I’d ended my third year of medical school learning that the squeak of premature infants is distinct from the wails of infants born on time. I also learned that the cry if a one-year-old is different from the tears that well silently and then exposed loudly before a 5-year-old boy gets a shot.

Before the crying nuggets served by pediatrics were the perfect one-two, one-two sounds of the hearts I heard in family medicine. Or the easy wooshes of lungs moving air happily. In outpatient internal medicine, I discovered the crackling stiffness of arthritic knees.

Before that there was the more forceful woosh of the ventilator in the intensive care unit. Pushing air into the lungs of someone who was silent. That same person had once been a DJ. How odd it was to see them existing quietly when they’d been mixing beats and filling dancefloors for most of their life. Neurology is a dark specialty.

And there was the sizzle sound and burning flesh smell of the electric scalpel in the operating room. The sound of metal tools on metal trays. The snap of putting on rubber gloves and the crinkling of paper gowns as everyone took their assigned places for the operation.

On internal medicine, there were the patients yelling for help. Some of them knew they were yelling. Some were just trying to reconnect with their minds which were lost in the fog of being sick. The beep of heart monitors. The dull sound of lungs full of junk. Oxygen monitors and bed alarms dinging, dinging, dinging.

Before all that, were the screams of women in labor. Of babies announcing their successful arrival with a gurgle-cry. The patter of footsteps as nurses and doctors ran because a baby was coming faster than everyone thought it would.

And that brings us all the way back to the beginning of the year. To psychiatry, where adult tears fell to the sound of congested voices. Or flat voices trudging along telling the stories of visions that no one else could see.

All those sounds are behind me. Today, I find myself listening to bachata and reggaeton. The traffic hums outside of my window. I’m studying for another huge exam. Exams are old news, but this is my penultimate of medical school. It’s the final countdown at long last. It’s been such a noisy year.

Just before I finished the year, I pulled out my violin. I hadn’t played it for almost as long as I hadn’t operated an ambulance stretcher. The songs that were like oxygen in my teens came back slowly. My fingers were awkward on the strings and bow but the jig I’d always loved most bounced around the room just the same. If you do something enough, you don’t forget. If you practice, you get better. Third year of medical school is about practicing. And the best part of practice is not practice, but what you’ve learned after doing it. That’s where I am now. Really glad to have done the year while also certain I’d prefer to never do it again. I’m grateful for the things I learned and the people I met. But, mostly, I’m excited to move on to the next phase of the doctorhood quest.