[Editor's Note: This submission, from Katherine Bakke, an MS4 at the University of Michigan Medical School, was my personal favorite of the 117 applications. Perhaps it is because I could relate to looking out the windows at the Arizona sun rising and setting multiple times during the same 36 hour shift. Maybe it was the memory of staring at a trauma patient with 3 limbs in splints and two chest tubes and thinking I needed that bed more than he did. Perhaps it just reminded me of those moments of sitting on the curb in the ambulance bay with tears in my eyes after telling a family their 17 year old son was dead despite all I could do. Whatever it was, I thought it was excellent, and it explains much of the reason why I continue to practice medicine despite the fact that I no longer have to. Many of the judges agreed. Katherine's prize for third place is 10% of the cash, or about $2500. Hopefully that will help with interview expenses this Winter.]

katherine-bakkeDuring the second week of my surgical rotation, I tried to wash my face with toothpaste. I had always considered myself a morning person, but 4:30 AM was too early, even for me. I had just started my clinical clerkships in the hospital, a hands-on apprenticeship of practicing medicine that begins in one's third year of medical school. Despite the excitement of finally getting to care for patients after two years of study in the classroom, I was struggling to accept the fact that most of my days would now start before the sunrise.

When you spend twelve or more hours in a hospital, it is easy to forget the time of day. The long hours contribute to this sense of disorientation, as do the windowless team rooms, located centrally in the hospital and lit with the yellow glow of fluorescent light bulbs. The rooms with windows are, rightly so, reserved for patient and located along the periphery of the hospital. But couple the long work hours with this degree of sensory deprivation and it is easy to become not only disoriented, but also disillusioned. Patients start to blend together, writing progress notes becomes tedious, and the lack of thanks can wear a person down. Call me weak, but after a month of 4:30 AM wake-ups, I was beginning to feel a little numb.

In this time of emotional and physical challenge, I found myself focusing on light. While rounding with the surgical team, I stole glances out of each patient's window. The hospital, 12 stories high, sits on an East-West axis and afforded incredible views of the rising and setting sun. Each morning's sunrise and each evening's sunset were different depending on the wind patterns of the day. Cool oranges and blues signaled an arctic air force, while jewel-toned purples and pinks meant a southerly jet stream. I found calm while watching the vibrant colors dissipate into pale hues, like food coloring in water, across the sky. At the beginning of night shifts, I watched the sunset from the vantage of a sky bridge which connected the main hospital to the cardiac center. The bridge, encased in glass, trapped the warmth of the sun’s rays throughout the day, and offered me a warm embrace in an otherwise overly air conditioned hospital.

This calm and this warmth spread throughout my whole person, steadying my hand in the operating room, my voice when talking to senior surgeons, and my heart when counseling distraught patients and worried families. The day I worked 30 hours straight with the trauma surgery team, I watched the sunset from the hospital cafeteria and wondered what the night would bring. When I left the hospital at 6 AM the next day, I sat on my porch and watched the sunrise before going to bed, meditating on the capacity of the human body to withstand tremendous strain, be it illness or injury (or in my case, hours on my feet and lack of sleep). In that moment, I realized I couldn't be happier with my life and with my work, and I was grateful.

In those two months on surgery, the celestial cycle grounded me, affording me a rare moment to myself. It offered a moment of beauty and serenity amidst the cacophony of beeping hospital pagers and the ugliness of disease. Perhaps most importantly, it provided me with a moment to reconnect. The sunrise and sunset awed me, moved me, humbled me. In the midst of difficult days full of sick patients, the warmth of the sunlight and the vibrancy of its hues reminded me that I chose this profession to care for others in their most vulnerable times.

If the product of our efforts in health care is time–the years we give to the patient with heart disease to grow old with his spouse, the handful of months we give to the patient with end-stage renal disease to see her first grandchild graduate high school, the few hours we give to a dying patient whose family is traveling to the hospital to say goodbye–then our work is sacred and our purpose is good. I love this profession because, for the effort and sacrifice it demands of me, it gives me time in return, time to reflect on life’s most profound and provocative questions: What is my purpose? What is my responsibility to others? How can I be courageous and compassionate? Am I doing the right thing?

These days, as I change into my scrubs and drape my stethoscope over the back my neck, I pause and look out the window. Watching as the sun dips down into the horizon, or lifts its circumference into the sky, I take a deep breath—thankful that I am able to do so—and start my shift.

What do you think? What do you love about practicing medicine? Is it worth the headaches? Why or why not? Comment below!