Medical training is often described as being an exercise in delayed gratification. This concept more or less implies a trade of instantaneous satisfaction for a (hopefully) larger reward down the road. And in so, so, so many tangible ways, this is spot on. You give up the free time, the weekends with friends, the vacations, the new car, the home ownership, the whole 401k thing. The list goes on and on (and on and on). Ironically enough, however, there are moments in medical training that all but forcefully shove right into your own two hands one of the most important, most elusive entities that I think we as human beings are all chasing:  a gratitude for the present moment.

I would estimate that the great majority of medical training is spent just trying to stay afloat. To keep your head above water. That has been my experience, at least. If it’s not a project or an exam, it’s a patient presentation or a challenging diagnosis. A battery of questions from an attending during rounds or in the OR. An outside hospital record that you can’t seem to get faxed (Yes, we in medicine still rely heavily on the antiquated thing that is a fax machine). There is so much metaphorical treading of water. It can be exhausting, and I’m fairly certain that I’m only scratching the surface of a mountain of fatigue as a student. But tucked snuggly away, in between the studying and the rounding and the assessments and the plans, there are some serious moments of clarity. Moments when you see good health taken away too quickly from people who were too young, too unprepared, too kind. These moments are filled with tears, with sideways looks to loved ones when the term “cancer” floats audibly into the open air for the first time, and with long, drawn out silences.

It might be the unabashed fluorescent lights under which these conversations so often occur in the hospital or the weight of the words themselves or, most likely, a combination of both. But in these moments, the important things become crystal clear. True gratification is not and never will be derived from the things that we think we’re giving up, the tangible things. Being healthy. Being alive. Being present. Having our loved ones around, healthy and alive and present as well. These are the things that we’re all chasing. These are the things that matter the most. I know I’m not alone in saying that I fail to realize this on a daily, if not hourly, basis. However, if medical school has given me any one thing, it is a position to be reminded of this important lesson on a semi-regular basis. The reminder usually comes on a particularly challenging day, during a particularly challenging week, when you’ve felt like you’ve seen enough human suffering to outlast a lifetime. These reminders are so important, so invaluable. They are part of the reason why it is an honor and a privilege to practice medicine. May we all, be we in medicine or not, allow ourselves to more often remember the important things. For instant gratification’s sake.