then and now

So!  Match Day!

Match Day, for those lucky enough to not know, is the day that fourth-year medical students across the country find out where they will be doing their residency training.  Our Match Day was--oh lord, could it have been?--EIGHT years ago.  I was much more awake that morning than most of my classmates, who had been up late partying the night before at "Super Night," our name for the big annual pre-Match bash at the med school.  I'm sure a similar tradition exists at medical schools around the country, and though regional differences surely exist, there is one commonality of which I'm almost certain: the involvement of booze.

I myself was still recovering from a bout of peritonitis when my acute appendicitis in February was misdiagnosed and I subsequently developed a small bowel obstruction and a perforated viscus (TRUE), and so during Super Night I was on Flagyl and couldn't drink anyway.  It was still fun though, and basically ensured that I was not hung over the following morning for Match Day, enabling me to recall each nerve-wracking minute in crystal-clear detail.

I'd heard that in the olden days, Columbia had a tradition of holding Match Day in a giant auditorium, where one by one, students from the fourth-year class were called up to a podium and handed an envelope with their match results, which they were then to open in front of everyone and read aloud, into a microphone.  Of course, not everyone always matches exactly where they want to match, so this ritual (thankfully) came to be regarded as somewhat inhumane, especially in the already high-pressure environment that is med school.

So by the time Joe and I were cycling through in 2003, they had reduced Match Day down to a reception at the faculty club, with a table full of labelled envelopes off to one side of the room.  People could take their envelopes and leave, or open their envelopes there with everyone else.  Within this group, there were people who would open their envelopes and cheer, others who would open their envelopes and start crying, and possibly some that would open their envelopes and promptly punch one of the poor waiters who was trying to pass out shrimp cocktails on toothpicks.  One hopes against that last option, for the waiter's sake.

I am telling you this because the fact of Match Day, and the ritual of Match Day, is one that makes you think that Match Day is probably one of the biggest days in your life.  And it really seems that way at the time.  Hell, Joe and I were getting married about a month afterward, and I think I had put in more time, energy, anxiety and thought into Match Day than I had about the wedding.  It was a big fucking deal, this feeling that the rest of your life was hiding inside this one thin envelope.  It was a big deal, but also...it wasn't.

It was eight years ago.  This is what I can tell you now.  I matched at my first choice program, which was in a Pediatrics residency at the Children's Hospital of New York at Columbia.  Eight years later, I'm not even in that field anymore.  Joe matched in his first choice program too for residency, but for his transitional year, he got his absolute last pick, a fact which deeply dismayed him.  Didn't matter.  He had a great year, got excellent training, and he still has many fond memories of that institution to this day.  We had friends that failed to match at all, and who instead scrambled into spots in other fields, or in cities they never dreamed of living.  They are all successful, happy, healthy, and practicing the kind of medicine they want to practice today.  They have significant others, spouses, children, and they are enjoying their lives in medicine just as much as their lives outside the hospital.  They are happy.  It all works out.

Most of you are probably pretty excited today.  Some of you maybe aren't.  Some of you are dealing with hard choices, and I know that talking about this now doesn't make those choices any easier.  But if you went to med school, I know you have a long memory, so I'll tell you this: some day in the future--five, eight, ten years from now, you're going to look back on this day, this Match Day.  Then you're going to look to the present, at the life you're leading now.  And you might not be where you thought you would be when you were a medical student.  Hell, look at me, I thought I was going to be a pediatrician in academia, and now I'm an anesthesiologist in private practice.  You can't find two more different fields.  I couldn't have predicted it.  But it all works out in the end.  It really does.  You'll find where you need to be, what you need to do, who to go there with, and you'll get there.

So congratulations to all the fourth year med students in the Class of 2011!  Can't wait for you guys to graduate and join the team!

Now on to what's next.