More Than Just a Piece of Paper

 
That's what we say, sometimes, when we're tired, when burning the candle at both ends seems to have done little to bring the end of a long academic journey into view. "___ more months, ___ more rotations," we say, "I'm going to get my piece of paper and I -- am -- gone."

I've said it. After slamming into another obstacle that meant I'd graduate another year later than my entering classmates, I've said it. On good days, I tried to act a reasonable approximation of my age and call such things "character-building." On bad days, they were miserable. The truth is, the good ones really did outnumber the bad by several factors of ten, no whitewash -- except on bad days and then they seemed to multiply as fast as zits on a teenager's face.

Medical education is a group effort and a personal one. We begin in community, like runners in the Boston Marathon, and we string out along the way. I lived off Beacon Street in Boston for a while and stood within inches of the Marathon as it passed by. First came elite runners, like the Kenyans I got to know in Boulder while walking my dogs, some in training for Boston. Long after they were out of sight, came local runners, wheelchair athletes, and those for whom a personal best was the point.

Every year there are runners who, for reasons of their own, cross the line at Boylston Street, where the bombing occurred, way late, maybe after midnight. A father, pushing his wheelchair-bound son, someone else who was injured and refused to quit. It could be anyone. There have been times in this process, when I felt like that, hell-bent on crossing the line whether anyone was there or not, and not really expecting anyone to be, certainly not at that late hour. The virtual presence of more than a hundred cheering friends on Facebook showed me how wrong a guy can be and how amazingly good it feels to discover them waiting for you.

But that's how things can go. All the potential in the world can't ensure the medical education master plan is carried out without a hitch. Something happens, then another, and before you know it, you've had to stop and regroup. Most students make it by the clock (four years), some say they made it by the grace of God and maybe they did. Maybe that's how all of us make it, even when it seems like sheer, dumb luck.

Anyway, yes, I called it a "piece of paper," especially when circumstances and/or my own frailty conspired to raise the bar -- and right when I was starting to get good at reaching it! One of my favorite Robert Browning lines goes, "A man's (person's) reach should exceed his (their) grasp." Well, gee, thanks, Bob, bet you never went to medical school, huh?!

Eons ago, when I was a kid watching classic movies about doctors and psychiatrists on our black and white TV, medical school was something other people did. To me it was as far away as growing up. Eventually, however, I did grow up or at least got taller, and found my way to medical school. When my diploma finally came in yesterday's mail, I can tell you, it was much more than just a piece of paper.

A friend, on his graduation day in 2010, waved his diploma in its protective cardboard mailer and shouted to me, "Don't forget, Beggar, there's one of these with your name on it!" I thought about him as I walked back to the house, carrying mine the same way he had. I thought about him again, opening the package and seeing my name. He was right; there was no mistake.

How does it feel, having finally crossed the elusive finishing line with my diploma in hand to prove it?  It feels empowering. Better than all those other times the bar was raised and I cursed and swore and stretched and strained and reached with all my heart and realized I could reach higher and farther still. It feels right. Residency is fast approaching (Please, God, let it be psychiatry) and it feels like I'm in the starting grid at Indy, waiting for that cute little country singer to finish the National Anthem so I can hear the words I've waited a lifetime to hear: "Ladies and Gentlemen, Start Your Engines!"

Varoooooooooooom! 

(Photo copyright 2013 by the author)