This summer, what is likely my last real summer, I am working as a research fellow in an elite hospital nestled in a North Eastern City that used to be my home. In fact, it is one of the world’s best hospitals, something we are often reminded of. While talking to a first year fellow last week, I was strongly warned not to “drink the kool-aid”. She, a newly minted physician activist, spoke of coercion and loss of ideals. She warned of the magical allure that these old white men have, drawing the vulnerable young idyllic doctors in with promises of prestige. She has a compelling point, but at the same time she seems to be making it work.
Plus, I am learning this summer how tasty the kool-aid is. I have come to terms with the idea that I am smart and capable. But, while smart enough, I have never been THE best or THE brightest, instead always having to settle for my second or third choice. Such was the case with my college selection, with my post college employment, and with medical school. While I loved my college experience, and I am content with my medical school, this was never the path I envisioned myself on. Being at the best hospital this summer in a relatively elite fellowship is giving me a glimpse at the power and freedom that comes from it all. Because they are the best, they are able to talk about taboo topics: sexuality, psychosocial complications in delivering health care, medical standards; and, shockingly, can even conduct research in these uncharted lands. This is not something we can readily do in my southern medical school, where instead we are instructed to not tremble the waters. What I am learning is that the kool-aid gives you a pass to the unknown, but with it comes a signed contract: no matter what, the institution, one of the world’s best institutions, needs to be kept on its pedestal.
The other problem with the kool-aid is it leaves you thirty, and unable to settle for anything less than kool-aid of equal caliber or better. But the better kool-aid is going to cost you more of your ideals and personal autonomy for the sake of protecting the institution. The point of all this kool-aid talk? I am in limbo between loving the reality I am experiencing this summer and being terrified about my future. I want more of this opportunity- more ability to do research at a hospital with countless resources and copious respect. I want to apply for a fogurty or a doris duke fellowship so that I can accumulate prestige to compensate for my decently (but not overly) adequate Southern medical school’s reputation. I also want to be smart enough so that I can work and live in this, or a similar, North Eastern City that used to be my home. The terrified? That comes from feeling insecure by the elite that surrounds me. From worrying that I will never be smart enough for this to be my life, and that again I will have to settle for second or third best instead. That before this summer even ends, they will discover that I shouldn’t even be here now. Even worse, I fear what will happen if second and third best aren’t even options when it comes time for residency matching? What if all this work is for naught, after sacrificing so much, I never become the physician activist I so hope to be? But on a third hand (which anatomically we don't have), I am also learning that sometimes going with the less prestigious option allows for a better fit and more flexibility to be a change-agent, and less hurdles to jump through... a lesson I assume will be important to remember over the coming years.