One year ago, I became a doctor. Amidst a raging pandemic, miles away from my medical school classmates, I heard my dean utter the words “Dr. Prerana Chatty” for the first time. I struggled to get out the words of the Hippocratic Oath as tears streamed down my face.

I do not think my family understood why I was crying — I do not know that I even did – but in retrospect, I believe I felt a sense of combined pride and anticipatory grief. I was afraid of what (and who) I was going to lose over the next year. I wondered what the world was going to look like. 

Anyone who met me before my pediatrics residency knows how much I loved to write about medicine and how much it centered on my medical school experience. Yet over the past year, writing has often felt more like an act of labor than an act of solace. Only now am I able to realize how consuming it has been to be a resident during a global pandemic — and that my avoidance of writing about residency has stemmed from a desire to protect myself from this submersion.

To start residency is to have the highlights reel of humanity brought into view in a single moment. To start residency during a global pandemic is to have that highlights reel constantly refocused and reconfigured, just as you are beginning to process it. 

When I wrote about my patient experiences in medical school, I often sought a key lesson at the end of each of my articles, something that gave the narrative meaning. I now understand more clearly that not every patient experience has a takeaway to neatly tie everything together. 

One year later, I have lived the highlights reel.

I more deeply understand what systemic racism can look like for my patients — for my young Black teenagers, who have served as pallbearers in their friends’ funerals. I have learned what gun violence can look like; my patients whose parents were shot and killed on the street. I more clearly understand what the effects of trauma can look like in children of all ages: a 5-year-old afraid of the dark, a 10-year-old scared to speak in public, or a teenager suffering from depression and suicidality. I now know, more deeply, what it means to feel helpless, to know that I cannot alleviate a child’s suffering, that I am part of a system that does not always serve those you are trying to protect. 

Systemic racism, gun violence, homo/transphobia, xenophobia, sexism, and poverty do not have neat takeaways. 

I also know more deeply what it feels like to check the boxes and feel like a cog in the system, to wonder if your actions have a real impact. I know what it means to fight physical and emotional exhaustion on a daily basis. I understand that the first step of taking care of others is taking care of oneself. 

But while I understand the pain more authentically, the “wins” feel more like my own too. Yes, there are a few clear moments of joy — a child being born, a baby learning their first word, a sick child getting better. But more often, there are the subtle moments of fulfillment — providing space for an adolescent to safely express themself, successfully advocating for a child to receive support services in school, lining up all the checkboxes so a baby can be discharged from the hospital for the first time, learning something new alongside a co-resident. No, those moments do not necessarily represent the reasons I chose to be a pediatrician — but I know they matter — and after one year of being a doctor, those moments feel so much more like my own.

I do not know what the next year will bring. I know it will be hard, and there will be fewer bows to tie everything together than my medical student self would have desired, but I also know that I have learned how to take care of myself and others, and I will embrace these new moments authentically.

What discoveries did you have during your residency? Share your revelations below.

Prerana Chatty is a resident in the categorical pediatrics program at The Children's Hospital of Philadelphia with a particular interest in the medical humanities, wellness and resilience, and hospital medicine/endocrinology. In her free time, she writes, explores the Philadelphia brunch scene, and builds her candle collection. Follow her on Twitter at: @preranachatty 

Illustration by April Brust