Roshni Ray, TXACP Student Member, UT Health Science Center San Antonio

It felt as though I was playing a convoluted game of dress-up.

It was the day before my first day at medical school and I was volunteering in a high school to provide screenings as part of a back to school event. I spent some time standing in front of my bathroom mirror scrutinizing my appearance. My white coat was spotless and stiff, a vivid reminder of my inexperience.

On the drive there, I recited the steps to each of the screenings we were providing: always wipe the first drop of blood when taking blood sugar, make sure to palpate and place the cuff over the brachial artery.

As I drew near to the school, my first reaction was disbelief. The line of people made a dizzying course through the grass and wound up and down the sidewalks. Children of every age stood in the scalding sun to receive school supplies and health screenings. A sense of panic erupted through me, “I am about to disappoint so many people.” As the day continued, however, my nervousness waned and I found conversation flowed more naturally.

“What do you want to be when you grow up?” I asked, while distracting a particularly nervous teenager from the needle stick.

“A doctor,” she said sheepishly. Before I could say anything, she added, in hushed tone, “But mom says it isn’t realistic – too much money.”

As I began to respond, the display on the glucometer flashed. Her blood glucose level was right underneath 300 mg/dL and she had not eaten that day. I swallowed my shock. I wrote down the number on her sheet as her mother came over and the teenager was ushered to the next station.

Her mother craned her neck to look at the number. Guilt tore through her face. “I know it’s very high,” she said quietly, “and insurance has been a problem.”

What do I say to a mother whose child is ill when she cannot afford to get help? We spoke about diet and exercise and I guided her to the counseling table. Later, when the family waved goodbye, I had this unshakable feeling that I wish I was more capable to help.

As our group of students left the clinic, a child pointed at our white coats and said, “Look, there are the doctors!” I dropped my head. I certainly did not feel like a doctor.

In the hospital emergency room, a week later, I found myself standing over a man who had been in a car accident. The cuts on his face needed stitches and I was the extra pair of hands to hold the skin together. A discerning viewer might have noticed how my knees shook or the light sheen on my face. When we paused to get more sutures, I saw the wife waiting in the hallway. She forced a smile, but her knuckles were white.

While I waited, I thought of my mother and how she had waited for my father’s surgery after his car crash. She had told me about the direness of the situation and the panic in hearing he had been brought in by helicopter. She talked about the mangled remains of the vehicle and how, with bated breath, she had waited to hear from the surgeons.

Would I have wanted my mother to speak to a nervous, unconfident physician? I straightened my posture and tried to command my knees to stay still. I focused on following the fourth year medical student’s instructions and listening to how he spoke with honesty and empathy to the patient and his family.

After finishing the stitches, I watched him discuss a plan of treatment with the resident. I stared, amazed by their speed. I mentioned to him how it felt like I was wearing a costume and putting on a charade.

“I think it’s always like playing dress up,” he said, smiling, “it’s impossible to know everything, but it is always possible to care.”

Those words serve as a mantra for me. I think it is relatively easy to sink into a sense of nihilism in medical school. Everyday I go to school excited to learn and come back confused by a new system. I came to medicine, in part, because I loved understanding the science – the why and the how of our bodies. It was a field where the uncommon act of looking within a body and understanding its workings became second nature.

That fascination with science becomes difficult to maintain when I am knee deep in a metabolic cycle and every step has a disease and drug associated with it. However, whenever I think “What am I even doing here?” I think of the girl in the high school clinic who is fighting to become a doctor. When I hear the thuds of helicopters as I study, I think of my father. I remember: I came to medical school to become capable. I came to help to relieve suffering. I came to become the physician that comforted my mother on the worst day of her life.

Nothing about learning or applying medicine happens overnight. I remind myself of that each time I watch older students and doctors interact with patients. They felt the same way I do, and they fought to get to where they are today. Ultimately, my white coat was not boasting of knowledge, but one promising service.

It has been quite some time since that first day at the clinic. With more practice, I am less worried about “the charade” and more patient with myself. Every so often I catch my reflection in a window and pause. My white coat has lost its stiffness and I wear it with less hesitation. More and more, I look like a doctor. In those moments of reflection, I reconnect to the person I was when I started that very first day; standing in front of the mirror, sure of nothing else but my determination to serve.