My career in medicine is something I am proud of. I was the first one in the family to enter the field of medicine, and I have navigated the maze of my medical education and training often blindly, without footsteps to follow. I have built a career in which I am both passionate and successful. From the outside, it is an incredible accomplishment. But it has not been without sacrifice – and those sacrifices have impacted everyone who loves me.

I’ve missed a lot.

My little sister graduated from college and I wasn’t there. While my family celebrated, I studied. She said “It’s okay” when I told her I wouldn’t be able to be there. It wasn’t okay. My heart broke and then re-broke along the same fracture lines when she got pinned for nursing school graduation and I was on call at the hospital. Later on, she got engaged and planned a wedding. I was there for the ceremony, but I missed many little moments leading up to that – and as they say, it’s all in the details.

My Grandpa died and I wasn’t there. When he went into the hospital, I was sitting at a desk memorizing biochemistry pathways. There was an entire ocean between us, and no method of transportation fast enough to get me home in time. The last time I heard his voice, it was telling me to stay right where I was - to do well, to keep working hard, and become a doctor. He told me he was immeasurably proud of me. And then, he died the next day. I sat in my tiny apartment bathroom in the dark and cried. None of my medical student colleagues knew how to console me. Because in the end, we all were in the same boat and that boat was on a course that had been plotted by someone other than ourselves.

Two years later, when I was in medical school rotations in NYC, my family called and said that Grandma wouldn’t make it through the weekend. I told myself “I won’t make the same mistake twice.” And then, I got on the next plane home. I steeled myself with my newly acquired medical knowledge and braced my heart as she took her last breaths with her hand clasped in mine. Do you know that hers was my first experience with dealing with death directly? Do you know that it impacts my approach and discussions with patients and end-of-life care? It has left feelings that are stirred up by counter-transference with patient encounters to this very day.

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I was deep into a surgery rotation in residency when my long-term relationship crashed to the ground. Fault lines, many unrecognizable, had been building strain for years. Compounded by the stress of a dual-resident relationship, long-distance, and barely manageable schedules, the great quake finally hit. The damage was extensive. The relationship was not salvageable.

I Skyped with my family a few days later on Thanksgiving and they passed the computer around the room. They all looked happy – a little flushed from a couple of drinks and giddy from a day of laughing. I hung up and when I scrubbed in to my next surgery, mascara streaks ran into my surgical mask. Heartbreak compounded by exhaustion had me hanging by a thread. But I was determined to find a silver lining. Life went on – and the more I immersed myself in medicine, the more perspective and purpose I found.

As the years passed, holidays started to feel different. During residency, I accepted on-call shifts during the holidays without reservation – after all, I had no children and my immediate family, lived too far for me to make the trip home with only one or two days off. But holidays at the hospital meant I would still be surrounded by people – and with an inevitable pot luck held by a nursing department somewhere, I knew I wouldn’t go hungry.

I still remember the Christmas Eve I spent delivering a baby for a mother I had provided prenatal care for during her pregnancy. His family, quite fittingly, chose to call him ‘Jesus’. It was one of those surreal moments in medicine that I knew I would remember forever – and as I was written into that family’s story, I felt the weight of the impact I could have in my profession. On New Years’ Eve, my co-residents and I ate cake we found in the call room freezer and when the ball dropped, we toasted with chocolate milk. I may not have been with family, but at the same time...I was.

I didn’t know what to expect when I chose medicine as a career – or rather, when it chose me. The sacrifices that I have made have weighed heavy not only on myself, but also on the ones that love me. There is a period of time during my medical training that feels like a gap I can’t fill in, like I had to hold my breath in order to come out on the other side. My absence during important events – birthdays, weddings, celebrations, and deaths - has made it difficult to sustain, much less strengthen relationships. I have chosen other people – strangers – over my own family, time and time again.

But I can’t apologize for any of this. If I did, in that same breath, I would have to take it back. Because medicine, although it has taken a lot from me, it has given me even more. It has given me friends as close as family to supplement the amazing and supportive family I already have. It has showed me a darkness that comparatively, makes the light shine incredibly bright. And it has allowed me to touch the lives of others in a way that is lasting and tangible. This career, for me, has been worth every sacrifice. And for the things I’ve missed, I now get to spend wonderful moments filling in the gaps. And I hope, for my sake and the sake of those who have chosen to love me through it all, that the time with me is worth the wait.