How’s medical school? Since starting medical school, I have struggled to answer this question. Because medical school is everything. It’s amazing, challenging, soul-sucking, life-giving, exhausting, dream-fulfilling, anxiety-provoking, interesting, and — dare I say — fun? How can I explain to someone that while I’m pursuing this dream, a dream that so few get the opportunity to pursue, I have felt the lowest of lows but also the highest of highs? I typically settle for: “It’s busy, but I’m enjoying it.”

Part of me feels as though my friends and family shouldn’t have to hear my heavy thoughts, thoughts like: how am I studying this much and still getting that result? Or, how is that person handling everything so well, while I could burst into tears at literally any moment? They don’t deserve that for simply asking how things are going.

But I’m also not sure they deserve my excited thoughts, like when I finally get a five on a histology lab quiz or when my Standardized Patient recognized that I used her name twice during the encounter. Try as they might, my friends and family can’t truly appreciate the highs or lows at the level I would hope. Not because they aren’t intelligent, and not for lack of trying, but because this experience can be so isolating from those on the “outside.” I used to equate medical school to summer camp. I’d come home from camp, rattling off every funny story and interesting activity I could think of — but no matter who was listening to my stories, they would never find them quite as funny, or the activities quite as interesting, as I did. It’s impossible to really understand unless you were actually there. 

As I write this, I am sitting in a doctor’s office with my heart beating out of my chest, fidgety, finding the air a little harder to breathe than usual. Yet all I can think is, “I don’t have time for this. I have four exams this week.” The irony is that thoughts like these are the very reason I’m here. I think about my schedule — how do I fit in tutoring, club duties, board studying — and my heart starts beating even faster. I look at the number on the scale, my blood pressure, pulse — they’re all higher than they were two years ago. 

So, here I sit. Overweight, overtired, overwhelmed.

When I leave this office today, I’ll exchange the patient gown for my white coat, hang my stethoscope around my neck, and inform a pretend patient that I will be performing on them the very exam I just had done on myself. I will smile, shake hands, and move on. As we all have to. The boxes on our ever-growing checklist will get checked, they always do. That’s how we got here. No matter what looms on the horizon, we see it, we face it, and we move forward. A little worse for the wear, but forward still. Medical school is hard because you don’t get here by settling. You get here by having high expectations and meeting them. Yet once here, we are asked to lower those expectations — to fundamentally change the part of our personalities that brought us this far. We want to do our best on everything, but sometimes it is truly not physically possible. I’m struggling with that disconnect. I’m struggling with the balance of giving myself grace (for the sake of my mental health) and being disciplined enough to do the right things for my physical health and academic/professional success.

Medical school is hard. It’s relentless. But something that has always felt like a light in the darkness has been the relationships I have built with my classmates, my friends. There is something very unifying about going through this experience together. We can all fully understand each other at the level we need to be understood. We can feel what one another is feeling with just a look. We collectively feel the relief after finishing a big exam, and the exhaustion leading up to it. 

In "Harry Potter and the Sorcerer’s Stone," J.K. Rowling wrote: “There are some things you can't share without ending up liking each other, and knocking out a 12-foot mountain troll is one of them.” 

I think medical school is like knocking out a mountain troll. And I’m eternally grateful for the community of physicians and students with whom I can share this experience, and this life. I’m grateful for the times I’ve felt so deeply understood in this otherwise overwhelming environment we’ve all chosen for ourselves. 

So maybe I’m a little heavier, but I’ve grown in more important ways, too: resiliency, self-confidence, mental-toughness. I’ve learned about the complexities and intricacies of the human body, the disease processes that ensnare it, and the pharmacology that preserves it — all at a level very few are privileged to know. I’ve learned that life is easier and better when you’re surrounded by a community of support. I’ve been reminded in a very real way that nothing worth having comes easily. And despite the anxiety and exhaustion that I swear I can feel in my bones, I’m successfully becoming a doctor with some of the best humans by my side.

So, how’s medical school? It’s busy. But I’m enjoying it.

A version of this article was previously published at KevinMD.