A Medical Student About The Graduate. And A Lack Of Closure.

In this isolated and new existence, we are experiencing a collective grief. A deep, poignant distress caused by bereavement. Apart physically, but together mourning the loss of the world we once knew.

Life has distinct stepping stones. Birth, death, marriage, graduation. Proof that one phase of existence has ended, and another will soon begin. Traditionally, these occasions are marked by gatherings, festivities, celebrations. In the unprecedented age of COVID-19, so many aspects of human existence are altered. When literal lives hang in the balance, one can easily feel guilt, shame, and dismissal for feelings around these milestones. Thoughts such as at least I have toilet paper, at least I have employment, at least I have school, at least I have food, at least the hospital has enough ventilators, at least I have two N95 masks today at work, at least I am alive attempt to throw aside the highly individualized and unique losses we all feel in some way.

As a graduating medical student who will soon be on the health care “frontlines,” the expectations versus the reality of my last few months of medical training have been emotionally contentious. Medicine is a profession rich in traditions, hierarchy, and ceremony. Before even entering the hospital, medical students undergo the ceremonial donning of a short white coat to signal the transition from pre-medical college student to doctor-in-training. We have the passage of national board exams to permit entry from the pre-clinical years (anatomy labs, textbooks, and lectures) to clinical wards. Traditionally, the last two months of a medical student’s training consist of MATCH Day (where students throughout the United States simultaneously open an envelope telling them where they will do their training), doctoral hooding, and graduation. Not to mention the less formal, but equally important, rites of passage of looking for housing and moving across the country to start our first “real jobs” as physicians. These milestones serve as intrinsic and extrinsic notations of our increasing responsibilities in the health care world. Now I am a medical student. Now I am a physician. Without these guideposts, my personal and professional compass is starting to feel off-course.

I am by no means a party person. (I once started vacuuming during a party to get people to leave my apartment.) Nor am I a social media “influencer.” (My mom has more Facebook friends than I do.) I am probably the furthest from a person who loves the spotlight. (I slouch and wear hats in class, so professors do not call on me.) Honestly, thinking about Match Day and graduation made me a little anxious. So many people! So many emotions! Friends and family all focused on me! Yet, in the last few weeks, my expectations and fears have turned upside down, inside out, and sideways.

I do not lament the missed likes, prestige, pictures, degrees, weird tassels, and too hot black gowns in the southern summer heat. I lament a lack of closure. No seeing patients in the hospital and clinic. No seeing classmates. No hugging grandpa and hearing him joke, “You’re still Elmo to me, not a doctor.” No Aunt Sal helping put on my doctoral hood. No use for the homemade black and gold decorations mom and I made. No carrot cake cupcakes. Instead, virtual chats, hug gifs, leaving school early, quarantining myself from family, and watching too much Tiger King have substituted for a patchwork semblance of finality.

I lament future uncertainties. Will my graduation be expedited? What does that even mean? Will I get called in to start at the hospital prior to June? Where will I live? What will I do at the hospital? Who will train me?

I initially fell into the dangerous grief and shame spiral. I shoved these feelings of loss deep down and let shame bubble up. How could I legitimize my feelings when people are dying?

However, I have been working through the idea that comparative pain and its conflicting feelings do not help. To a toddler, their worst grief is not being able to see their friends at preschool graduation. To a high school senior, perhaps prom. To a college athlete, the inability to finish their senior season. To a new business owner, the shuttering of their barbershop opening. Denouncing one’s own suffering does not benefit health care workers, those who are sick, or those who have “greater” losses. A grocery store worker’s 14-hour shift does not get any easier. A nurse does not magically get a mask. So, allow yourself to feel wholeheartedly, to lament without embarrassment. Feel sad. Be scared. Yell. Have a pity party. Then, when you have a moment of strength, reach out and lift someone up (virtually for now). Together we celebrate milestones, together we grieve, and together we are strong.

Emily Masterson is a medical student.

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