Springtime in Richmond

The ospreys are back on the Richmond James River marking the arrival of spring in this city that sits at the hub of Virginia’s highways. Match Day, a different mark of spring, took place earlier this month. It always falls in March, an odd kind of Ides of March. This year, with that phase of the Doctorhood Quest behind me, I was unaffected by it. My Match Day will forever dwell on St. Patrick’s Day of 2023. That’s the day I found out I was moving to Richmond.

It was about this time last year when I saw Richmond for the first time. We visited the city only a week or so after Match Day to look at apartments. We wanted to move to our new home as soon as we could. I liked Richmond instantly. I’ve visited enough places and lived in enough more to know, as a gut feeling, if a place I visit is a place I could live happily. I had that sense about Richmond.

Spring is always a transition season but since I started the Doctorhood Quest it has come to mark additional important transitions that didn’t exist in my pre-doctor world. As I write this, I’m three-quarters of the way through my first year of residency (or one seventh through the whole thing). Residency years start on July 1, meaning that as spring slides into summer it marks the closing of one year and the opening of another year in residency. Residency years are hard years. As happy as I was last March when I transitioned from medical school for residency, I am enthusiastic to leave my first year of residency behind for the second year.

The seasons of my first year of residency almost followed the seasons as I knew them when I lived in Vermont. Summer was a glowing time when everything seemed possible because the leaves were new and vibrant; the sun stuck around longest. Fall was my favorite season because by that time the year was familiar; the weather was perfect. Winter was dark and gloomy; it was hard to understand why the world didn’t pause the whole season to drink mate and eat chocolate. Spring came with new hope and new beginnings.

With the ospreys back on the river and a recent vacation behind me, I’m excited to embrace spring. I love the ospreys and was so disheartened to learn last fall that they left for the winter. In Richmond there are numerous walking bridges across the James River from which you can see osprey nests and watch them hover-dive-catch fish. This spring marks a year living in Richmond and a year since graduating medical school.

Comparing this spring to last spring, I know the parks of Virginia way better now and so plotting my days off has become more exciting. And, more down to business, I’ve learned so much about medicine and how to be a doctor. The Doctorhood Quest continues just as the seasons march along unwaveringly. Year two of residency will be a time to develop independence and hone my knowledge. Internal medicine residency is three long years. So, I have two springs left before I get to confidently say I’m ready to work independently as a physician. Two more springs of celebrating the ospreys’ return as a resident. Then we’ll see where the Doctorhood Quest sends me. Perhaps I’ll also celebrate the James River ospreys as an independent physician too; only time will tell where I am three springs from now.  

How Strange to Be Unable to Name a Daffodil

“We saw daffodils!” I said. My voice sang with an enthusiasm that only such a definitive sign of spring could coax from me on such a rainy, gray afternoon in February. My co-resident looked at me blankly. The importance of a daffodil passing through their genius brain just as the medical terminology doctors like to use pass through patients’ ears – jargon without meaning, hardly in and definitely right out. “You know, it’s one of the first flowers of spring. I saw it in the park.  They’re yellow…” I gave up and the conversation moved on to other topics.

Doctors are more diverse than we once were, but our makeup doesn’t come close to mirroring the population we serve. My visible profile is common in the medical world – white (always very common) and female (slightly more females are entering medicine than males these days). Yet my unseen profile, my story before medicine and path to medical school, is unusual for a doctor.

Sometimes I’m reminded of my different background when it’s easier for me to relate to patients than my colleagues who come from medical families and have never known what it is like to not know what “coronary artery disease” and “hypercoagulability” mean. Other times I’m reminded of my different background when it’s easier for me to understand the social determinants of health such as why someone might not have transportation to appointments and why medications might not be worth the monthly bill to a specific individual. Where I grew up if you didn’t have a car you went nowhere; further, I solely used public transportation for most of my 20s. I’ve also run a tight budget most of my life which has given me a lot of practice deciding where my money will and won’t go.

It’s not just my economic background that makes me different from many of my co-residents (though I’ve come to realize more with each passing year that economic background is a mountain that dominates world view). The nuances of my difference from many of my colleagues present themselves at unexpected times such as on slow days when making small talk with co-residents and supervising physicians.

I grew up in a world where medicine was minimally understood, mysterious, and (perhaps) feared. The distance of medicine was partially possible because my family was healthy and required minimal medical care; it was also who we were. Our lack of medical knowledge did not mean, however, a lack of knowledge. For my colleagues who have known the medicine way of life since childhood as they watched their parents (many doctors and some nurses) come and go from work, the hospital system is familiar and almost second nature. I didn’t grow up knowing the hospital. Yet, I know other things that are part of who I was, am, and will be.

For example, I know the birds, trees, and plants of my childhood and I’m learning the ones of my new home in Virginia. I know how to grow plants indoors or in a garden because I grew up in a culture where we all knew how to tend plants. In a similar way, I don’t believe cows are cute because I’ve been almost late to school chasing them after they got out of the fence. I know how to stack 6 cords of wood in a day, use power tools and wood tools, and change my car tires because these are skills that were necessary in the world where I grew up. I notice architectural details, complementary colors, and other design elements because these were some of the themes of my childhood.

Being an older resident with a different background and careers prior to medicine is isolating at times. A small portion of my co-residents can relate or are interested in where I’ve been before medical school. I’ve become accustomed to this. My life extends beyond the hospital. I have family and friends who understand the nonmedical aspects of my life just as my co-residents understand the Doctorhood Quest in a way non-physicians can’t.

I have so much to learn about medicine from my co-residents and supervising physicians regardless of whether they understand any aspect of my life outside of residency. But, on days such as when I find a resident who can’t name a daffodil, I’m torn between amusement and sadness. In my world it’s ridiculous to be unable to name one of the most common spring flowers in the US. The realization that there may be many doctors who can’t name a daffodil reminds me just how different we all are. It also reassures me that there is much I can teach my co-residents too. And, perhaps more importantly, it reminds me how much physicians can learn from our patients and non-doctor colleagues if we find time to listen.