Recently, I opened Twitter to find a sea of Match Day photos. My warmest wishes to all those who matched. The photos were joyous, celebratory, but also surreal— in ultra-high definition. There were short videos, pictures, montages, gifs and even edited 4k video reels. Everything looked slick and well-produced. The Instagram generation meets the Match.
I checked my own photo albums. Not a single picture of my match day in 2009. I checked old emails. Not a single email that day. I did find a few emails trying to schedule residency interviews, and the inflexible replies.
Then, I consulted my memories. They were vivid. I remember the cold, dark auditorium room at the University of Chicago where the envelopes were passed out. I was wearing an old t-shirt and jeans. My hair, as always, was a mess. We sat in our seats and opened our envelopes simultaneously. I unfolded the single piece of paper. There were screams of joy, of misery, shouts, tears, everything in-between, and it was over. A group of us slowly made the way to the bar for a drink, or back home for a nap, and that evening, we went out in Chicago.
I phoned my father a few hours later.
“I am staying in Chicago,” I told him.
“Great!” he said, “I will tell your mother.”
“Northwestern, not University of Chicago,” I added.
My parents lived an hour outside the city. My father was glad I would remain close, and these distinctions did not matter to him.
Eighteen months later, I would do it again. I matched at NIH for hematology/oncology fellowship. I learned of this news post call at the Jesse Brown VA Intensive Care Unit. I told my father a day later, after I woke up.
“Washington DC?” he said.
“Ohh, and you leave this summer?”
“No, I leave in 18 months.”
“Great, I will tell your mother.”
Again, there were no photos. I found a few emails letting people know. Three were to people who wrote my letters of recommendation.
In those days, there was no #Match, GodisGood, MyTopChoice, IAMCOMINGHOMEEE, thrilled, wild-ride, eternally grateful, thankful, my journey, support system, dream-come-true, blessed, matched at my #1, childhood dream, #westcoastbestcoast, over the moon, I am going to be an orthopedic surgeon, can’t believe, humbled, excited, or can’t wait to join the team. Nobody had a sign ready to be filled out saying I matched at: Brigham and in: Anesthesiology. There were no balloons, confetti or banners. Our families were not there.
Recently, a colleague was promoted from assistant to associate professor. I had a nice bottle of Champagne in the fridge. Wonderful, I said, let’s open this.
"No, save it for something special.”
“If this isn’t special, you will never drink Champagne.”
It is my firm belief that even Tuesday is a sufficient reason to open a bottle of Champagne. A promotion is more than enough. And, if you don’t celebrate what seems the small things in life, one day you will be dead, and there will still be a nice bottle of Champagne in your fridge. I will be damned if that happens to me.
Of course, it brings me joy to see so many people celebrating their success in the Match. Fulfilling a dream, or climbing up one more rung on the long journey that is medicine. From the age of 22 to 32, all I did was train to be a doctor. I am glad this generation can celebrate the milestones. To me, much of it was in a sleep deprived haze.
At the same time, I worry about them. Not the celebration or joy, but the documentation and dissemination. It feels as if it is, at least in part, for the camera. I worry that their lives increasingly become commodities. They can’t go to match day in a old t-shirt with hair like you just woke up. They have to dress sharp and bring their tripod or a selfie stick.
Recently I had dinner with someone I had not seen in many years, and I told them at the outset: you know, we have to take a picture tonight. Not for the internet, but just for us. They agreed. But then the evening came and went and no picture was taken. The conversation was absorbing. The jokes were daggers. And we lost ourselves in the moment.
When I realized a day later that there was no photo, I had mixed feelings. It is a shame but, that’s life, you know— when you are living it— really living it— you don’t document it. Anyway, the truth is I probably would not look at the photo anyway. It would just sit with 29 other GBs of photos gathering dust. But instead, I remember vividly what it was I said that made them spit out their wine.
A day or so after the #IMatched threads came the #unmatched threads. These threads were: #frustration, dedication, how I turned it around, life isn’t easy, my supporters, my team, support squad, you CAN DO IT, you are not a failure, this isn’t over, still trying to process, only half our dream came true.
I never got my first choice in the match, and my fellowship was my third preference. I was 27 at the time, and when people asked me on interview days what my five year plan was, I felt like a fiction writer, telling a story with mere verisimilitude. It was all made up. But, I didn’t know what I didn’t know, and my third choice turned out to be a defining choice. My fellowship program director was Tito Fojo, who in the entire universe might be the one person whose own thinking in cancer policy is closest to mine. What were the odds? And, I was a stones throw from FDA, where I would visit, and of course, eventually push towards being a better version of itself. As the old cliche goes, sometimes things happen for a reason.
Ten years ago when things didn’t go as planned we didn’t post it online in long threads. Even our failures become a commodity. Twitter alternates between posts saying look at me, my grant was 5th percentile, and let’s remember that everyone fails, look at me, how I failed. But these are cherry picked failures. Failures we are comfortable sharing, and not the real failures, or struggles or disappointments too raw to post online.
The worst aspect of broadcasting one’s life— and I don’t mean one’s ideas about medicine or science— but one’s life— one’s day to day— is that very rarely do you understand something in the moment. The joyous match in orthopedics might lead to 2 tough years, and quitting. Failure isn’t always redemptive. Sometimes it’s the universe and sometimes it is you. Sometimes, what looks like failure is actually success, and what feels like accomplishment is not what you are meant for.
I don’t have a photograph of match day, and I don’t have a photograph from that dinner. When I am with you, I am with you. In our generation, experience was not a commodity for others to peruse, a glossy hi-res and curated version version we wished to present to the world. Match was the beginning of six hard and tough years that changes who you are, and it takes a few years of attending life to practice medicine.
I wish all those who matched in 2023 the very best. I hope they drink Champagne, but even better, I hope, next time, they forget to take a picture.
I think the thing that stuck out to me the most was the fact of when I'm with you, I'm with you. When I'm out and really enjoying something, you won't see me touch my phone and I have no desire to take photos. I usually have to make an effort to remember to do it. Meeting someone too, I will totally forget to ask for a selfie because I'm soaking in the moment. When I graduated from my bachelors degree, I planned when I was going to take photos and often didn't take as many when I was actually trying to soak up the moment.
2023 match student here, great post. I have felt weird not participating in the excessive posting and dressing up with my class, but that’s never been who I am (always have been told I’m an old soul). I wish I was a little more hyped up for this accomplishment, but maybe the coasting nature of 4th year and being removed me from all the stress of boards. Which has caused loss of the build of excitement. But I’ve also always been one to not get super high or low on life events, but rather I’ll get a little zinger when I’m driving in my car with a flood of emotions. Seems strange, but I actually like the time release aspect of my processing of highs and lows. I do appreciate the line “if you’re not going to pop champagne for this, you never will...” because it also reminded me to reflect and appreciate things in the moment more. Thanks for all you do Dr. Prasad.