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Medical students and physicians are forever looking to milestones

Bruce Campbell, MD
Medical Education
December 29, 2018
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“I don’t want to get to the end of my life and find that I lived just the length of it. I want to have lived the width of it as well.”
– Diane Ackerman

Nathan picks up a pen from the tray next to the dry erase boards.

“OK,” he says. “Here’s what he showed us.”

The rest of our small group watches. Nathan is one of the more intense medical students I have met. He has been irrepressible during this M1 small-group exercise over the past few weeks. He has opinions on everything, some of which are a bit questionable, particularly regarding popular culture and the sports supremacy of his hometown baseball team.

“Sometimes wrong but never in doubt,” we tell him.

Nathan takes the marker and walks down the length of the dry erase boards, creating a thick, black line from one end to the other. “OK,” he says again. “Here’s what our college professor showed us. Now come up here and take the pen.”

We rise from our chairs and join him at the front of the room.

“Now, which of you is the youngest?”

“I might be?” says one of the other students, a shy young woman who has gone directly from high school to college and then to medical school. She shares her birthday. Everyone acknowledges that she is, indeed, youngest.

“So take the pen. Imagine that this line represents your life from birth to death. Left to right. Birth over there and death over here. Where are you on the line? Right now? What do you think?”

She blinks. “I dunno.”

“Just guess. No wrong answers here. Draw a hashmark where you are.”

She is twenty-two.

“Um, here, I guess,” she says, drawing a line about a quarter of the way across the board.

“Good,” Nathan says. “Next?”

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Everyone draws their own hashmark. One student has worked for ten years as a systems engineer for a computer firm before applying to medical school. One spent six years as a middle school teacher. One earned a masters in public health. Each one steps to the board and adds his or her hashmark to the line.

“You, too, Doc.”

I am the oldest, by far. I take the pen and look at the line, adding my vertical slash a comfortable distance from the right-side terminus. I look at the hashmarks and decide that the youngest figures she will make eighty. Judging by where I have added mine, I am hoping for ninety.

“Very interesting,” Nathan says. “That’s cool. But, think about this. What if your line is actually only this long?”

He picks up the eraser and begins energetically rubbing out the thick timeline from right to left. Suddenly, my hash mark is at the far-right end of the horizontal line. He looks in my direction, shrugs, and keeps erasing, first to the engineer, then to the teacher, then to the MPH, and finally to the shy student right out of college.

“Huh? How ‘bout that? What if your line is only that long?”

He sets the eraser back in the tray and sits down.

“None of us knows, do we? Any of us? Right? So, how do we react to that? As my professor erased the line, he kept saying over-and-over, ‘How are you living today?’”

The room is quiet. As medical students and physicians, we submit ourselves to a lifetime of delayed gratifications. We are forever looking to milestones: How much longer until I finish training? How old will I be when I finally pay off my loans? When will I finally feel settled into a career? When would it be safe to start a family? What do I need to do to retire? We’re constantly looking to the next step.

“Um, thanks, Nathan,” I say. “Interesting exercise.”

“Yeah,” he grins. “Carpe diem, my friends. Carpe diem.”

Bruce Campbell is an otolaryngologist who blogs at Reflections in a Head Mirror.

Image credit: Shutterstock.com

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Medical students and physicians are forever looking to milestones
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