Today is Match Day. The Ides of March. A day defined by a ruthless algorithm, one which was once developed to solve the problem of producing romantic couples in such a way that every person would stably be in a monogamous relationship. Perhaps a fitting analogy indeed, as a career in medicine is often as demanding (with respect to time and effort) as a romantic relationship.

Today is Match Day. A day where tens of thousands of students discover, all at pretty much the same time, where they will be serving their roles as physicians-in-training for the next 3+ years. Some students will not match. Others will not match at their top choice. But all will receive, by way of a single sheet of white paper enclosed in an inconspicuous envelope, news of their fate for their foreseeable future.

Today, I did not match, as I am currently taking an interim research year and will be applying for residency in the coming months. But I did spend several hours with my fellow classmates who are graduating this year, and shared in their joy and excitement for the next phase of their careers and – by extension – their lives. Several moments I was on the verge of tears, as their joy today has reminded me of the mission I have long dedicated myself to, and rekindled a sense of excitement within me as I eagerly await the coming few months, when it will be my turn to be thrown into a whirlwind of interviews and campus visits. Soon, I will emerge from that tornado with my own inconspicuous white envelope.

I dedicate this letter to my classmates and to those students around the country who have, for better or for worse, found out their fated future today. And partly I dedicate this letter to Future Me, who will also this time next year be lucky enough to undergo the mysterious Match.

I write today not from the perspective of a medical student or pending doctor, but as a patient. A long-time patient in the world of Children’s Hospitals, to be more precise. And I write in memoriam my doctor, Dr. Finklestein, a man who has so permeated every aspect of my life that it is impossible to disentangle my identity as a patient-slash-future-doctor and my admiration for this childhood hero.

We begin with a story of Dr. Finklestein, a quiet and down-to-earth bespectacled man, with whom my first encounter was so long ago I cannot say when or where I met him. This was a man who I was forced – frequently in the middle of class – to visit every three weeks, for a routine belly tap-tap and a stethoscope “take-a-deep-breath-in-Aaron”. And invariably, a visit to his office always ended with a sharp steel finger-poke, me wailing and crying and shaking to avoid the needle, and a box of stickers to choose a superhero from. I always chose Iron Man, but that explanation is for another time.

Dr. Finklestein was a staple in my life, whether I welcomed it or not. And I, for the longest time, certainly did not. A visit with him meant another bandage around my finger and bandage on my arm, and another play session with my friends abruptly cut short. But struggle as I might (and struggle I did), I would always be forcibly brought by my parents to his office for yet another needlestick. And though I squirmed and yelled and cried that I hated him, Dr. Finklestein never seemed to mind. He had such an incredible patience for my antics that I soon learned that must be where the word “patient” really comes from.

Dr. Finklestein ended every single appointment with the same question. “Did you hug your mom today?” My answer was always a reluctant no. And he would stand and wait until I stood up to quickly give my mother a hug. “Did your mom tell you she loves you today?” “No.” And my mom would do the same. A quick “I love you” and a quick “I love you” back. This ritual lasted into high school. I was not allowed to leave until I gave my mom a hug and we both said I love you. Imagine me, an 18-year-old metalhead rebel, doing this at my pediatrician’s office!

Dr. Finklestein dedicated a couple minutes every appointment to look after my parents. How was Dad’s work coming along? When did Mom last speak to her parents, and when will she go back to Taiwan to visit them again? Dr. Finklestein once called my uncle on the phone to demand that he help set up Skype for my Mom to video-call her parents, since to him it was unacceptable that she was unable to go back home as often as she wanted.

One day, I was talking to my Mom while in the waiting room. There was a word she couldn’t pronounce, and I started laughing. “It’s so simple, why can’t you just say it like I do?” And Dr. Finklestein, upon overhearing our conversation, took me aside and told me the story of how his parents fled from Germany during the Holocaust, and that differences in culture and language and appearance and religion and wisdom are what makes the world go round. I hung my head in shame, and went back to apologize to Mom. I never again laughed at her for her accent.

Dr. Finklestein got me a dog. This story I have told to countless friends, and I will not belabor the point here. He got me a friend when I most needed it, and it must mean something that both my dog and Dr. Finklestein passed away in the same year, months apart from each other. I am not religious nor particularly spiritual in any sense of the word, but this fact alone I choose to interpret as some sort of deep connection between two beings who meant a lot to me.

Dr. Finklestein is the sole reason I chose to enter medicine, as he instilled in me the belief that an individual physician can care so deeply and fully about his individual patients as to completely change their lives for the better. And not only care for his patients in the traditional here’s-your-medicine-take-it-with-dinner sense, but care as in to learn about their lives and devote oneself fully to setting them up for a better future. And it is a testament to his effectiveness as a doctor and his love for human beings that I am where I am today.

It is an unfortunate fact of life that, no matter how incredible the opportunities afforded to us are, and no matter where we are in life, we eventually and invariably adjust and even assume a sense of boredom. This happens to us all. I remember the first time I walked through Harvard Yard, I was overcome with a sense of wonder and incredulity that a school in the middle of a honking city could have a miniature serene forest. By the time sophomore year came around, I would no longer feel this sense of serenity, instead rushing through a memorized path to get to my next class and complaining to myself about how many problem sets were due the next day. It wasn’t until after I graduated and went back to visit Harvard Yard that I thought to myself, my God, I got to walk through all this every single day!

I worry that this is happening to me again. The first day in medical school as I ran my hands through the etched letters “Harvard Medical School” along the stone wall by the quadrangle, I could not believe that I had made it this far. And now, in my fourth year, I have once again been overcome by that familiar sense of self-imposed pressure and exhaustion. Time and time again I find myself wondering whether this is the right career path, considering that there were easier and more lucrative options around the corner. And, trapped in an environment where every muscle twitch and every word I utter is evaluated by some attending somewhere and may make it into my final grade, I find myself entertaining the idea of some other career.

And then I go back to the hospital for another blood transfusion. And I see the nurses and doctors and the kiddos who benefit from their care and humor. And then I realize that I went into medicine for the right reasons, despite (or maybe because of) the intense grueling training process that it takes to get us to become the confident confidants whom our patients rely upon and trust to make the right decisions for them.

Today is Match Day. A day where that youthful sense of wonder, excitement, and giddiness befalls medical students everywhere once again, just as they had when we initially started medical school. And, along with this happy moment comes the stark reminder that this feeling will not last, after weeks upon weeks of sleep deprivation, ruthless judgment, emotional ups-and-downs, ungrateful patients and colleagues, and the sheer knowledge that people’s lives depend on you. This feeling will not last. This feeling will not last. This feeling will not last.

But as fleeting as this initial honeymoon period may be, the mission of medicine is permanent and unbudging in its importance, urgency, and solemnity. And I can tell you that, as a person with a chronic disease, medicine never strays far from my mind, not from the perspective of a tired medical student but from the perspective of an anxious and scared young adult who does not know what will happen to him later in life. Not a day passes when I stop wondering whether I will be the recipient of gene therapy at some point, or whether my meds will tear a hole in my gut again, or whether some day I might get diabetes and what that would look like, and will I be able to run or rock climb or travel or hang out with my friends or take care of my family when I’m 40, will I even live to 50 or 60, what should I do today to maximize my chances of a good quality of life in a decade, etc. etc. etc.

And I implore you that when the day comes – and oh it will come – when you look to the sky and question why the fuck you’re even doing this shit when nobody gives a damn and your patients aren’t even grateful and you’re just a Tylenol and opioid dispensing machine why do you even need to be here right now…remember your patients do care. It’s all they have in their life is their health. And if they don’t care, then by God they need you even more since they’ve given up. Your impact matters. And though you may not have impacted the sheer number of people as have Presidents of the United States, or Apple CEOs, or Big Pharma Company Founders, your impact on a single person can be the biggest deal of that person’s life. You make an Impact With a Capital I, and to measure it by number of people cured is simply the wrong way to think about it.

And I must say, I am damn excited to see how many more Dr. Finklesteins we can contribute to the world.

One more story and I’ll wrap this letter up.

I had lunch with a 90-year-old president emeritus of a nearby Cancer Institute yesterday. The conversation was, as always, filled with stories (some of which should probably remain untold on a public forum). But yesterday there was a deeper theme to what we talked about.

“Sit down, Aaron.” he said.

I sat.

“What I am about to tell you is very important. It may be the most important lesson you gather from medical school.”

I listened.

“Do not, under any circumstance, take authority figures at their word. I am an authority figure, and I’m sitting here telling you right now that you’d better take my words with a heaping mountain of salt…

The greatest disservice you can do to your patients is to throw your textbook medical school knowledge at them hoping what you’ve ‘learned’ from school will stick. You had better develop a sense of nuance and think about each patient individually, because damn it, would you want to be taken care of by a doctor who doesn’t question everything? And would you want a doctor to treat you with some medicine or some procedure just because some higher-up says so?”

“But,” I countered, “the problem is that there’s such a sheer volume of knowledge we have to attain and it’s impractical to fact-check everything, and we have to take some things at face value. And medicine is so hierarchical nowadays!”

“Medicine has always been that way,” he said, “And it is to the detriment of the patient if you play by its rules. Question everything, and especially question those things you’re ordered to do from some higher-up just because they have more power.”

A full minute passed by as he let this sink in. “You’ve got your head on straight, you’ll be just fine.”

You’ve all got your head on straight, you’ll be just fine.

I would end this letter with a conventional “break a leg” or “knock ‘em dead” or “blow them away”, but strangely these sayings seem unnecessarily violent and against the whole concept of improving human health. So instead I’ll end with a standard “Good luck.” I cannot wait to join your ranks next year.