I began this journey in 2010. It began as a fresh-smelling breeze after a year and a half of anxiety, depression, and uncertainty. I did not think I would be a surgeon. I thought maybe family medicine, psychiatry — at worst, I would like gynecology. I outgrew the fear of the stereotypes and chose surgery for myself, despite what my now-husband warned me. He thought it would change me, depress me, destroy me. He wasn’t wrong.

In a very real way, surgical residency has broken parts of me.  It has fundamentally stagnated the natural development of others. The things that kept me from completely unraveling came with me from before this training. I told myself, “I know what can truly break me; this is not it.” I repeated those words like a mantra through training. As if surviving depression and hopelessness immunized me. In all honesty, what truly helped had nothing to do with my previous sadness. It had everything to do with the knowledge of happiness that followed it.

I am not trying to be dramatic about this. Just truthful. Looking back, I discovered the real reason I managed to weave some sense of self through this. It was always the people I love. Not just the waking up to his music in the morning, or the memories of Sunday breakfast with my parents, the smell of niece’s sweaty scalp. Also, the more selfish memories of a warm afternoon in a café in Lisbon and the smell of old books in an antiquary in Edinburgh. Selfish travels, only possible with a human that truly understood me. A human that knows me and grounds me.

Now that it’s over, my overall thoughts about residency are neither positive nor negative. I unlearned some things about the nature of life and death. Seeing it as often as we did, one would assume some level of expertise surfaced. However, I remain humbled about how little I know. I have perfected a few scripts along the way — for efficiency, for distance. In the end, there is always a silence that improvises its way into the script. It reminds me of why I routinely chose to refer to my patients as “the humans.”  It is said that Hippocrates once wrote that, “Wherever the art of medicine is loved, there is also a love of humanity.” I think I did that as a way of vocalizing my own humanity, as much as theirs. In honor of those unscripted blaring silences between us.

My biggest challenge during this process was (is) always the self. I am sure I am victimizing the self. Maybe, ignoring all systematic and deeply depersonalizing violence of the training. I acknowledge it; I denounce it, but I cannot control it. I will ruthlessly quote Viktor Frankl and perhaps play an unjust parallel. But, his words reverberate with truth as he describes “the last of the human freedoms — to choose one’s attitude in any given set of circumstances, to choose one’s own way.” If I had to choose one, this would be the biggest lesson from my training. Taught to me once by my father, it echoed through those men and women who showed me how to bring forth a veil in between the world and my responses to it. Those who encouraged humming to myself in the midst of chaos so I could focus. The ones who signaled the distractors so I could shut them down (especially those disguised as my own thoughts and fears). Making me live, learn and grow like Walt Whitman’s verse, “Listen to all sides and filter them from yourself.”

Finally: You — my family, my teachers, and colleagues — have shown me just as many weakness as strengths. I take with me a true picture of humanity, mine and yours. The good, bad and flawed: Never ugly! I harbor no infatuations with childish happiness. But, I leave these walls of healing with an appreciation of our humanity. Never perfect, but never broken beyond repair. My love to all of you, my humans.

Milagros López Gerena is a general surgeon.

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