Each year, July 1st is the infamous day when new doctors who just graduated from medical school (called “interns”) start taking care of patients for the first time as physicians. This year I’m among these new doctors. It’ a momentous day for the interns because it’s a huge milestone and a huge transition. Some words that come to mind in anticipation of the experience are “excited,” “terrified,” “happy,” and “ready.”

I’ve been mulling over what I think about starting residency. As I’ve reflected, a story from a hike I did in New Mexico came to mind. I think it captures my mixed feelings of starting this phase of the Doctorhood Quest.

New Mexico, June, 30, 2021

My partner and I arrived at our lodging place in the late afternoon so we had just enough time for a short hike but not so much time that we could dillydally. We looked up some nearby trailheads and settled on one just down the road. We were staying in a flat valley lined by near mountains on one side and far-off mountains on the other. It was spring so even though there was no mistaking that we were deep within the New Mexico desert, the shrubs were as green as they could be. The cactuses were blooming.

We started off walking across the flat valley floor following a road through the shrubs. We stopped often to take pictures of the desert flowers that lined our path and kept a lookout for elk because there were many in the area. We laughed and joked and chatted as we often do when hiking. Our mood ranged from jolly to ecstatic. The beige and browns of the dirt and rocks contrasted against the blue sky; sage-green shrubs and cactuses; and yellows, pinks, reds, and purples of the flowers.

The road neared the bottom of the mountains and narrowed to a wide footpath. We didn’t know the trail, but we had a GPS map and a general sense of the trail’s course. We were timing ourselves to ensure we turned around with time to get back to our car before complete darkness. We knew before starting that we wouldn’t be able summit if we wanted to be home by sunset. It was our first hike together in New Mexico, the western US states, and mountain lion country.

We wanted to have fun while also exercising caution. We’d learn later that trip exactly how scary things can be in the big mountains, but that would be a lesson learned on a different hike. We were experienced hikers, but we’d primarily hiked in New England and never in the western US (except as children under our parents’ watchful eye). The short mountains of the northeast are different beasts than the giants of the US west.

As the trail narrowed, we entered the woods and left behind the shrubs and flowers of the open desert. We soon crossed a small stream. There, on the far side of the stream was an elk carcass in the middle of the trail – it was mostly skeleton, almost picked clean. We paused and became quiet. The bones were a reminder that there were big predators in these woods. We debated if we should continue and decided we would. We stayed loud and watched our surroundings more carefully than before. We were especially attentive to our timing and made sure we got back to our car before darkness fell.

We had the skills and knowledge foundation to successfully complete the hike. The difference was the terrain and responsibility/higher stakes that came with a more complex hiking environment. Hiking in new, more intense territory isn’t such a bad analogy to becoming a resident after being a student – just like with hiking, as a resident I’ll draw on previous skills and knowledge as I take on more responsibility and learn more about my craft.