Kiersten Kelly1
doi: http://dx.doi.org/10.5195/ijms.2020.836
Volume 9, Number 1: 82-83
Received 11 08 2020: Accepted 27 12 2020
We were two fourth year medical students who poked our heads out of the tent at 2:00 am. The stars shone brightly and cascaded through our peripheral vision. We were at 12,000 feet elevation and had 2,000 more feet to climb before sunrise. We did all of the preparation we had done so many times before – boiled water for a couple packets of oatmeal, dressed in layers, checked and rechecked that we had everything. We flipped on our headlamps and began our ascent.
Up and up we went, our breath becoming short and our legs fatiguing with the decreased oxygen. It was completely dark except for the small halo of light provided by our headlamps, so we couldn't see where we had come from or where we were going, the cliffs that we were skirting or the rise in mountains beside us. We were just walking, up and up, blindly following the path that so many had taken before.
Every once in a while, we turned around and saw the glow of headlamps that snaked up the mountain, curving with the switchbacks. Each individual was on their own journey, up the tallest peak in the contiguous United States, but at the same time, we were doing it together, walking the same path, striving towards the same goal.
The last quarter of a mile was the most challenging. My quadriceps burned with every step, my hands were numb, and I couldn't find my breath. The faint glow of light behind the mountains now revealed the silhouetted peak we were ascending. The view was already beautiful. I turned to my friend and asked, “Do we have to go all the way?”
She simply said, “Yes,” and we kept going.
As we were about to summit, an older gentleman was already on his way down. He told us we wouldn't be able stay for long because the wind at 14,508 feet would cut through our layers of clothing. He was right. Once on top of the giant boulders that comprise Mt. Whitney, we spun around and took in the vast expanse of surrounding mountains and valleys before we started our descent, already preparing for the next passes we would encounter. This was Day 4 of our 21-day backpacking trip to complete the John Muir Trail, which for us totaled 250 miles, ranging from Mt. Whitney in the south to Yosemite in the north. Our journey was just beginning.
The moments when I turned around and saw the line of headlamps in the clear night as we ascended the highest peak resonated with me profoundly. It looked like a vigil up the mountain and I immediately thought of the path of medicine: we follow a trail and can't always see where we are going or how difficult it is going to be. People have been there before and more will come after, each generation of new providers following in the same footsteps but making them their own.
I was also reminded that the journey of medicine is one fraught with challenges. Before the COVID-19 pandemic, the pressure on physicians was already incredibly high, and more providers were experiencing emotional and physical exhaustion along with burnout, resulting in an estimated 400 physician suicides each year.1 Among medical students, burnout has also been shown to develop over the course of training, with emotional exhaustion increasing substantially after starting clinical clerkships.2 Personally, there were times during my training when I did not know if I would be happy in this profession. I had spent so long studying and working that all of a sudden, it very much felt like a trap. If I was exhausted after a day in the hospital or clinic as a medical student, I asked myself – how would I make it through residency when my workload and responsibilities would increase exponentially? I wondered if all it took was one misstep on the trail before I hurdled down the mountain towards inevitable burnout.
Then I remembered that I am not alone on this vigil. Residents and practicing physicians continue their journeys because they know medicine is not one peak or one diploma, but rather thousands of steps through many summits and valleys. I remember that despite the stress and the toll of this path, medicine is the most meaningful way that I could spend my life. I am inspired by my colleagues and mentors who have each chosen to put the lives of others in front of their own. I am inspired by my patients who, despite all of the barriers, showed up to receive care or who are pushing through some of the most difficult experiences of their lives.
To the newer medical students, welcome. You are part of the vigil, the string of headlamps that snake up the mountain, the journey that you will take one day, even one heavy step at a time, in the pursuit of science, empathy, and better health for our communities. Sometimes, particularly when the trail is intimidating or even isolating, it is better to focus on the small halo of light in front of you. Take comfort in knowing that many have passed before you but that it is simultaneously your own climb, your own struggle against your mind, your body, and the flood of life paths you suddenly realize you could be walking instead. Also, do not be afraid to take a moment to look behind you. Already there are more people with headlamps wishing they were in your shoes. In the 2019-2020 academic year, over 53,000 applications were submitted to United States medical schools, and just under 22,000 students matriculated.3 Take a deep breath, find your shooting star, and remember that you have been training your whole life for this journey and the ascents to come. Hold onto the strength of your first steps and the reasons you started. I hope you never underestimate the importance of a nutritious breakfast, supportive shoes, and a good friend who encourages you to keep going. The climbs are worth it.
Thank you to Ellen Asselin, MS4, who always encourages me to keep going.
The Authors have no funding, financial relationships or conflicts of interest to disclose.
Conceptualization, Writing – Original Draft, & Writing – Review & Editing: KK.
1. Stehman CR, Testo Z, Gershaw RS, Kellogg AR. Erratum: This Article Corrects: “Burnout, Drop Out, Suicide: Physician Loss in Emergency Medicine, Part 1”. West J Emerg Med. 2019 Aug 21; 20(5):840–1.
2. Hansell MW, Ungerleider RM, Brooks CA, Knudson MP, Kirk JK, Ungerleider JD. Temporal Trends in Medical Student Burnout. Fam Med. 2019 May;51(5):399–404.
3. Association of American Medical Colleges. 2019 FACTS: Applicants and Matriculants Data. AAMC; 2019 Available from: https://www.aamc.org/data-reports/students-residents/interactive-data/2019-facts-applicants-and-matriculants-data. Published October 28, 2019. Accessed September 28, 2020, cited 2020 Sep 28.
Kiersten Kelly, 1 BSc; MD Candidate, UC Davis School of Medicine, Sacramento, California, United States
About the Author: Kiersten Kelly is currently a fourth-year medical student at the University of California, Davis, USA in a four-year program. She is a Rural Community Health Scholar and is pursuing Family Medicine.
Correspondence: Kiersten Kelly, Address: UC Davis School of Medicine, Sacramento, California, United States. Email: kiekelly@ucdavis.edu
Editor: Paul MacDaragh Rayan Student Editors: Duha Shellah Student Editors: Colleen Campbell Copyeditor: Madeleine Jemima Cox Proofreader: Anna-Maria Chantaliyska Layout Editor: Sushil Dahal
Copyright © 2021 Kiersten Kelly
This work is licensed under a Creative Commons Attribution 4.0 International License.
International Journal of Medical Students, VOLUME 9, NUMBER 1, April 2021