Pivot
Amy couldn’t help but stare at the dean’s accolades - they practically dripped from the walls. The degrees - Harvard, Columbia, Dartmouth - slid in staggered lines the way blood would, down the baby blue paint and insidiously filling the un-fillable creases in the molding. Amy wanted to shatter them, to silence their pretentious derision.
“I am not here.”
“Can you explain that to me?” Dean Kyoto’s eyebrows whispered the softest suggestion of frustration.
“This is not my life.” Amy was deadpan, exhausted and still giving what she was able. As always.
“Amy I want to help you, but you need to parti-”
“I am not here! I can’t be here! I stand in conversation with my classmates and it feels like I am not here! It feels like I’m watching someone else’s life. I don’t eat because it doesn’t occur to me to be hungry. Because eating is for the living. Eating is for the alive. And I’m not even here.” The tears flowed so quickly in the worn rivets down her cheeks that it seemed like they had been there all along, and her desert skin welcomed them home.
“Amy.” Dean Kyoto sighed.
“I tried not to. To feel this way. But I think it’s the truth. It’s the truth.” She was at once two people. Splintered. Disintegrated. “My classmates, I wanted to meet them and talk to them during this week, during orientation, to find out if they felt like I felt, to see if they would justify away my dread and sadness. But they don’t, they are excited to be here. They want to be doctors. Some of them are nervous about classes because they have been out of school for a while, but that is not how I feel.”
“Are you telling me that you want to leave medical school?”
Amy’s shaking hands flew up to her long, dry hair, then slid down to cover her ears. This was the truth she had felt screaming from inside of her, but to hear the words spoken aloud made her viscerally frightened. She had been working her way toward this slow truth for weeks, and Dean Kyoto had just wrenched it from within her tender gut. Amy willed her quivering voice not to break, “Maybe.”
“This is a yes or no, hun.”
“I think so. Yes.” Amy looked up into Dean Kyoto’s skeptical eyes, “You think leaving is a mistake.”
“No, this is your choice,” Dean Kyoto rushed, with the tone of a woman who preferred, in her bones, to make others’ choices for them, “I want you to make the right choice for yourself.”
Now, with a hint of defiance and her tears slowing, Amy returned, “I’m typically a very well-adjusted person. I am not just freaking out because I drove across the country to start medical school. It’s not the enormity of coming here, it’s the dread about where this will take me. I don’t want to go.”
“You mentioned feeling dissociated - that feeling like you’re watching someone else live your life. And you say you’ve been crying a lot, and feeling dread about the future since being accepted to this program. Lack of appetite, even. Many of these feelings are symptoms of depression. I don’t want us to rule out any role that mental health might be playing here.”
“I’m not sick, I’m just having a crisis. I’m not supposed to be here. This is wrong for me. Once, in undergrad, I was walking across campus in the depths of winter with the snow blowing all around me and I thought to myself, ‘If my parents were dead, I would not be going to medical school’.”
Dean Kyoto’s jaw loosened but she did not let it drop. She was far too measured to ever accidentally express an emotion she did not plan for. Her eyes roved Amy’s face, seeking genuinity and finding rawness.
“Can you remember a time when you loved medicine? Can you remember the things that used to make you excited about medical school?”
“Yes, they don’t feel genuine anymore. I’m not sure they were genuine at the time. It was just so convenient to like watching a child with cerebral palsy be injected with drugs that help him stand up. To like medicine would allow all my hopes to align and cohere, would make me the kid my parents deserved, would earn me a spot in the economic class and world I grew up in. It was all I knew until recently. But - did you know this - there are other worlds?! We may, all of us, be living in different worlds!”
“What do you feel now, when you reflect on the memories of things that made you love medicine?”
“I feel mistrusting of those memories. I feel like I am so good at drowning out my heart with the sounds of my head. I feel like, I am starting to feel like, there is truth in me that I haven’t been listening for. Until now, until lately, until this all became concrete and now I’m really here and I could really spend the next four years, then 40 after that, on medicine. I have the power to...ruin my life. To do the wrong thing.”
She took a breath and her eyes flicked to the bright window and the green campus beyond, locking onto the carefully-landscaped shrubbery. “Medicine was never a purposeful decision for me.” Amy looked back to the dean, “It was always on the table, and the decisions that kept me on this track were easy to make, were the decisions of least resistance. Until this one. This cost feels...unfathomably high, it feels like sacrificing myself. And my classmates - they’ve, some of them, have had other careers, and explored, and arrived at medicine! I don’t want to be here just because it is the sum of a bunch of tiny, convenient decisions. I want to live more purposefully than that.”
Dean Kyoto took a breath but did not soften her face. She did not offer compassion. She did not belie any personal emotional presence. She had achieved, after years of rigorous training, clinically coldness. “Well think about it more tonight, make a pros and cons list, that will help, and I will see you tomorrow at the - you are coming to the white coat ceremony aren’t you? Oh, to miss it would - “
Amy was exhausted into steadiness. Her voice was sure and her eyes were bold, “I…I…don’t think I want to do that. The other students are so excited to be here, they are looking forward to their futures, they want to be doctors. I would feel fraudulent to stand up there with them. It would feel…sick.”
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