I spoke with a third-year classmate today. I'll call him Todd. Todd is a very decent guy; He is considerate and intelligent, and will be a fine orthopedic surgeon. He shared some of his disappointments with me: Before medical school he dreamed of being a physician -- working with a team of dedicated people who spend their days in the task of helping rescue others from serious disease and early death. 

Instead he found a medical system built on egos, and days filled with impersonal work centered on almost anything but caring for people. Through the academic years he told himself that it wasn't really "that bad,"' but now he looks back at the relentless, life-draining load and pressure and knows that if he had the choice he would never repeat it again. He admitted how medical school has changed him. Not that he is bitter, but he just no longer feels the way he used to. At this point he knows that he is going to just go about his business, keep to himself, with no illusions of changing anything for the better, except perhaps for what is directly near him.

At least he has kept a small spark of life within him.

Yes, I hate to say this, but it is true. Medical school takes life away. It flattens. It takes a young, idealistic soul and tarnishes it, rubs it around, poisons it, molds it into an instrument.

But it does not have to end up this way.

You can tell yourself:

I refuse to give up.

I refuse to give anything up, not even an inch.

I will not die.

I will not so much as wilt.

I will take a hit and leave it right where it came at me.

I will look it all straight in the eye and stubbornly plod along my way.

In the end, I will find a way; I will find the people to do it with me in the proper way.

I will be attentive.

I will be present.

I will treasure the obligation and opportunity to care.

I will fight every thought to judge or have prejudice toward people unlike me.

I will be personal.

I will be loyal.

I will be a friend.

I feel humbled to say that I am not one ounce lessened by the ardor and difficulties of my three years in medical school. The commitment, compassion, idealism accompanying my decision to become a physician is with me today. It is burning deeply within me, as strongly as ever. I am grateful for having a community of like-minded souls that has been a major source of support and strength for me over the last two years, the Humanistic Medicine community of the American Medical Student Association.

I ask you. . . Where are you today compared to where you where when you started medical school? Are you the same person? Are you flatter? Are you greater? What have you done to secure yourself?

If you are on the humanistic road to medical school, where are you now? What will you do to make sure that you exit medical school in the same or better place?

If you're in practice, how do you hold your vision today?

The truth is that each of us must be responsible for the course of our own growth, through every punch, challenge and joy. Whatever negativity your school or your professors and deans or your attendings and residents - or your fellow classmates - put on you can be shed like loose skin. It is your responsibility to find a way to do that, to find the deep spot within you where your compass pointing ever to your true North, your soul, resides. It is your responsibility to seek out like-minded souls, to find a community that offers each other the flame and fire that is so squarely lacking in our medical school environments.

We are correct. Compassion and love in medicine is right. To know this, just look into your heart. . . or ask the last person you know who has been to the doctor. Keep fighting with love.

Billy Fenster
University of Florida College of Medicine