Gravel crunches beneath my feet as I pound up the next uphill stretch. “Deep breaths, Andrew, keep breathing,” I tell myself as I inch closer and closer to the crest. At last, I arrive at the top, where I’m greeted by a panoramic view of Virginia farmland in autumn. As the sun rises, golden rays illuminate leaves the shade of ochre and crimson, intermixed with the usual green, now fading. Despite feeling like my lungs are about to collapse, I smile. Running certainly has its rewards. 

I must have heard the phrase “medical school is a marathon, not a sprint” countless times. But it was only when I began training for an actual marathon, during medical school, that the expression started to resonate with me. Preparing for the race over the last several months has taught me the meaning of pacing, endurance, perseverance, and several other lessons important for getting through medical school.

First, run at your own pace. I was definitely the least experienced runner out of my group of classmates who participated in the marathon. But I didn’t let that discourage me. I trained on a schedule that worked for me and ran at a pace that didn’t exhaust me within minutes. Though a marathon is a race, the only person I was “racing” was myself. That is exactly the mentality I wish I had when I first entered medical school, surrounded for the first time by many individuals who were as driven, ambitious, and intelligent as me. I fell into a pattern of comparison that drove my self-esteem downhill. Now, I have become much more comfortable with doing my own thing. Focusing on my strengths rather than fixating on my weaknesses has worked wonders for my happiness. 

Second, Murphy’s law. I believed that I would be able to stick to my training plan completely when I started. It was easy enough over the summer; I was only balancing research and a social life at the time. But the second year of school changed things, and not for the better. Early morning classes, round-the-clock studying, and extracurricular activities made for a very careful tightrope walk. Adding an intense running schedule pushed my time management skills to the edge. One time, I got painful shin splints and couldn’t run for an entire week. Suffice it to say, I wasn’t as consistent as I had hoped to be when I began training. And that’s OK. The spirit of life rests in how you bounce back from the unexpected, unfortunate things that happen. I’ve learned to be like a willow tree in a storm: I bend to the gusts, weather the rain, and twist back into place when it’s over. 

Third, respect the wall. When it comes to a marathon, many runners mention fear of “the wall” — the moment in a long race where the body’s glycogen stores run out and fatigue quickly sets in. The muscles become painful and heavy, and the body loses breath with each step. Runners prepare for this by fueling midrace with sugar-heavy snacks, as well as the standard prerace stretching, tapering, etc. But it took a couple of brutal occurrences hitting the wall before I learned to respect it and prepare for it. 

I feel that there is a similar phenomenon in medical school; we refer to it as burnout. Especially difficult weeks have brought seemingly immense and sudden drops in my motivation level. But the phase eventually comes to an end, and time keeps moving forward. Taking it day by day, not skimping on my sleep, and getting perspective from friends and family — that’s how I made it through the tough weeks. Whether it was a mental wall or a physical one, when it hit me, I learned to focus on putting one foot in front of the other. 

Finally, remember your purpose. This last lesson was one that I came to realize on the day of the marathon. For the first 15 miles, I felt amazing. I had never run better before, and the abundance of spectators and other racers around me only amplified my motivation. However, this did not last. Around mile 20, I was “bonking out,” and each step was agony. I was wheezing, my fingers felt tingly and numb, and maintaining my balance was no longer a passive activity. Clearly, my body was giving out. How in the world was I going to run 6.2 more miles when I was fighting to put one foot in front of the other? 

Just as I began to question myself, I noticed a spectator holding a simple sign with the following inscribed on it: “Find your why.” Those words ran through me like a razor sharp, red-hot blade, cutting through the pain and fatigue. I thought back to the months and weeks I had spent training and pushing myself. I thought of the patients that I had fundraised for. I thought of my friends who were running this race with me. But most of all, I thought of myself, and how I wanted to remember this day.

I asked myself, “Am I the kind of person to give up?” There was only one answer to that. So, I dug deep, pushed past the wall, and kept running. With every step I took, I told myself that the pain was temporary. And soon enough, I had crossed the finish line, tired, most likely hyponatremic, but triumphant all the same. 

In challenging moments, search your soul and rediscover why you wanted to be a doctor in the first place. Carry that purpose, keep it burning inside of you. And if the tough nature of medicine makes you question your resolve, count on your purpose to get you over the wall and closer to the finish line.

What drives you to carry through the challenging moments of medical school? Share your thoughts in the comment section.

Andrew Schmidt is a second-year medical student at the University of Virginia. He is passionate about the power that stories can hold, and enjoys writing and reading in his free time, along with running, cooking, and photography. You can find him on Instagram @andrew.schmidtty.

Illustration by Jennifer Bogartz