Packing for the Trip

The image of boarding a train, with years of baggage and countless questions about the journey ahead, is a beautiful and apt metaphor for embarking on medical training. I remember hearing my dean during the first days of medical school talk about how we would be taking on a dominant doctor identity over the coming years. I certainly hoped my identity wouldn’t be all doctor, as I liked the other facets of myself, thank you very much. Over the coming years, I reckoned with—and continue to do so—all the experiences that made me choose medicine and also make me particularly vulnerable to the pain and suffering we witness. These certainly shape the doctor I am, and it often looks very different from other doctors I see.

The diversity of stories in this episode [Ep. 3 “Golden Ticket”] characterized some of the baggage folks bring to their career in medicine. The first voice mentions how 'markers of class became markers of pathology' and how she wanted to assimilate to 'reduce friction' between herself and her peers. I often think of the minefield our Black and Brown colleagues have to endure, given that the history of medicine has not only excluded them for so long but also considered them to be pathological. The experience of being in a classroom and learning that 'being Black' is associated with a myriad of diseases, when, in truth, race is being used as a proxy for the systemic racism creating conditions that promote illness. The shame that can emerge when that nuance and context is lost is profound.

The other narratives hit on countless important themes as well—the pressure to constantly succeed and strive, the silence that comes with family secrets, and the need to find the language to talk about those experiences. I was struck by the degree of trauma that each of these individuals carry, and I wondered about the trauma we’ve all packed away in our luggage. Would airing it out be helpful or too overwhelming?

The longer I’ve been on this train, the more my own luggage contents and weight have shifted. When I’m more tired, the weight is unbearable and I find myself trying to sit on my suitcase of feelings, to keep it all in. When I’m more relaxed, I can open it back up and reorganize the contents, occasionally unzipping corners to show close friends that I, too, packed way too much stuff for this trip.

I believe using this metaphor with learners and diving into the ways life shapes us could bring much needed healing and transformation to medical education.