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Two weeks ago I left my training hospital for the last time. I had one month to make up after my maternity leave, which I completed, and then I turned in my pager and my badges and checked in with medical records about unsigned notes, and then I left the building.

It is surreal to think I won’t be a resident there anymore. It’s more surreal to think I won’t be a resident at all anymore, at least not for a few years. I’m waiting for my application for a medical license to finish wending its way through the maze of bureaucratic red tape it has to go through and then I will be a licensed physician. When I practice, I will be on my own, making my own decisions without someone supervising me. That is, quite frankly, terrifying.

Don’t get me wrong — my program has trained me very well and when push comes to shove I am confident in my ability to know how to help people and/or know when I need to ask for help in order to help people, it’s just that moment of realizing that even if you don’t need them, the training wheels are completely gone. Even though I don’t think I’m going to crash and burn, the possibility exists. That is scary. I suppose I could make the argument that it should be scary, and that if I were to be cavalier about the part where I have someone’s trust and health in my hands I might want to re-think my profession.

When I think back to where I was in July of last year, I can hardly believe how much has changed. Set aside my personal life (having a baby is completely cheating when it comes to major life differences over one year), and I still hardly recognize the intern who cried every day on the way to work for most of the first month. At my exit interview, my program director told me he had been very concerned that I was so shy that I would wilt and fade, those first few weeks. I didn’t. I bloomed. I am not generally a poster child for self-esteem but I really am proud of my work this year, and my evaluations over the course of the year back me up. I learned so much about being a good doctor, and a good resident, and also I learned some medicine while I was at it. I still have a lot to learn, heaps and piles of it, but when I look back over this year I will always be able to say that I did very well. I am grateful for that.

Sufficient unto the day, as they say, so I am trying not to worry too much about all of the challenges which are going to crop up over the next few years. It’s hard to do, since I am a worrier, but I have to try and focus on one step at a time. Next, I will worry about what to wear and where to go on my first day at my new job. Then I will worry about what comes after that. What a blessing it is to have this year to think back on and realize I have already made it through some rough waters, and come out better for it. As one of my favorite Pinterest pins says, I can do hard things. It’s been a very long year in very many ways, and it’s over now. Time to move on.

I should be in bed, but I’m still awake and it seemed remiss to not comment on tonight, if only briefly.

In the morning, I will get up and put on what BWB and I affectionately call “grown-up clothes”, also known as work-appropriate attire. I will then go to the hall closet and take out the coat I spent most of the evening prepping. It is a long, white lab coat with my name embroidered on the right side with the initials MD after it, and the name of my hospital on the other. My ID badge is already attached to the lapel, my prescription pad is in one pocket, a pocket reference text in another, and still another holds a granola bar, my wallet, and some chewing gum. Other than looking terribly new, it is a bona fide doctor’s coat, and it is mine.

My friend C recently graduated from nursing school and has been having approximately the same experience as I have during orientation the last few weeks. We’ve been texting each other photographs of ourselves in our new attire, pictures of our ID badges that indicate our new positions, and sharing virtual glee over being given our signature stamp — because the stamp makes everything official.

Today I sent him a photo of myself in my coat, following one from him in his nursing uniform. He responded back, “So official and profesional!! Do you think they can see our fear deep down?”

“I sure hope not!!”

Because it’s true. I’m quaking in my cute yet sensible flats. Today I was introduced to a patient as “Dr. Girl” for the first time, and I think my heart skipped a few beats with shock. What if I can’t remember anything I’ve learned in medical school? What if the senior doctors think I am an idiot? What if I AM an idiot? What if I screw up someone’s medication? What if I make a mistake? There are so many systems in place to prevent anything major from happening that I know it’s not really worth worrying about, but the part where I look like a fool? That seems less unlikely.

Don’t get me wrong, I’m excited, too, and proud to have made it to this point. But tonight my nerves are reigning supreme, and that is why I am still awake at this late hour. I am afraid of letting everyone else down, but I think even more than that I am afraid of disappointing myself, having come this far.

But there’s no getting around it. In a few very short hours, the time will arrive and so will I, in whatever condition five hours of sleep and the butterflies in my stomach allow.

Tomorrow morning, when I walk into the hospital as doctor (a lowly intern, but still a doctor), it will be the end of a very, very long road. Through that door, I will take the first steps into the next phase of the journey, in my very new, very long coat.

Note: Identifying details in the following post have been changed.

I saw my patient’s mother this morning.

My patient, the one I had three years ago when I was on Pediatrics. The one who, at the ripe old age of 12, was a survivor of the levees breaking and a sexual assault, had been pregnant, had miscarried. The child who looked up at me with ancient eyes, wary of my concern for her well-being. Suspicious.

Her mother, exhausted by life, kept a thin vigil from the large armchair of the room, trying to say the things that the doctors wanted her to say. She barely had enough energy to pull herself out of a post-Katrina haze to speak with us, much less help her daughter. The medical issues at play were not complex; it was this case that taught me how much of my job was going to be social work in nature. Still, by the time they left the hospital, I wasn’t entirely sure we’d managed to help them much at all.

I’ve looked for them ever since then, one or the other, hoping I’d see one of their names on my patient roster for the day. I’ve kept an eye out for them in the clinics and hospitals, thinking they might turn up again and I would have another chance at making a difference. No luck, though.

Then I saw her this morning, my patient’s mother, walking down the street as I was driving. She was wearing a work uniform and looked healthier than she had back in the hospital. Her eyes were not as sunken, her gaze less vague. I wanted to stop and get out and chase her down. I wanted to ask how she was doing, how her life was. I wanted to ask if she had married that guy, if her house had been repaired yet. I wanted to ask if her daughter was still in school, if she hadn’t had a baby yet. I wanted to ask if they’d both gotten the help they needed. I wanted them to know that they affected me, the wide-eyed medical student on her very first rotation. I wanted to ask if they were both okay.

But there are boundaries.

So I didn’t stop the car, didn’t chase her down, didn’t ask any of the questions that have been bothering me for three years. Instead, I just kept driving.

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