S5E11: Building and Sustaining Authentic Friendships in Medicine

Harjit: I think HLM Squared sounds cool.

Leen: Can we get a bundle merched with HLM Squared? Anything to make me feel like I'm in a band.

Harjit: Yeah. Please do that, Chloe.

Lina: I want a sweatshirt.

Leen: All right. Welcome back, everybody. This is another episode of "Bundle of Hers." What episode is this? I should know.

Harjit: What do you mean what episode is this?

Leen: This is number gazillion and three. So today in the virtual studio, we have Harjit and Lina.

Harjit: Hi.

Lina: Hi.

Leen: So today's episode is something that I wanted to talk about because I think it affects maybe a majority of people who go through the medical field, through medical school and residency, and that's the creation of friendships. And not just the creation of friendships, but also sustaining previous friendships and the importance of friendship, I guess, as we go through this journey.

It's something I think maybe I took a little bit for granted at first, but it's not until you're really in the mix of medicine that you realize, "Wow, this is something I really need in life. I need this support in my life."

I think especially now where I am now across the nation in New Jersey while a lot of my Bundlers are in Utah . . . All of them are in Utah. I think I started to realize, "When this used to happen, I used to quickly jump to Harjit and tell her this story. I'd jump to Margaux and tell her this story or Lina." That's something that is . . . it's not there anymore. Technically, it's there via phone, virtual, or whatever, but it's not there in person anymore, right?

And I think it'd just start getting us thinking about what are the values that we have when it comes to friendships.

Harjit: I'm really excited about this topic, Leen, because I think it's something that all of us medical students or people in the healthcare system or residents, we are always in a place where we have relationships. And oftentimes it's the people that are with us in the hospital or in medical school.

Thinking a lot about the values that we all share and kind of seek in friendships, I used to, when I was much younger, also think, "Friends are just somebody who's there." But lately, or when I was a young adult, I realized that my friendships have really shaped the person I am today.

You kind of were mentioning values, Leen, and I think the big things that I see when I seek friends is having something shared between each other, be it an identity, be it an interest, and then kind of "How can I grow with them? And is there honesty and trust in our relationship?"

A lot of that takes time to build, but it's really hard because we are all bound by one thing, which is medicine, but a lot of us have differing values, and so it's hard to find that match-up.

And I think that was my biggest struggle, starting something new, like starting medical school, starting residency, and I think it's something I've been thinking about a lot, especially because we did move for residency and the people I was closest to left.

Lina: I think just going through our whole lives, I mean, it's natural for us to always be looking for who's our friend, who's there with us, and we do everything together, and, "This is my person. This is the person that I like rely on things for other than our family." And naturally, we're always looking for, I guess, that community or that kind of closeness to people that we can identify with and that we can share things we do together, we like together. That's kind of how we go with our life.

I think with medical school, I've definitely seen how it can really be so isolating. I mean, the friends I've had before, I don't see them as much, and there are kind of a lot of differences in the time, and the schedules, and what we're doing. You want someone to relate to you on the struggle that you're going through, so it does change.

Every year it does change, and it brings me to realize more and more of how much I kind of rely on that community, on my friendships for a lot of strength, for a lot of feeling like I belong somewhere, someone that I could relate to with a lot of stuff.

And you brought it up, Harjit, people who are similar to you. Yeah, if I didn't have those friendships, I would be very isolated and it'd be much harder to go through this track that we're on.

Harjit: Yeah. Lina, I completely agree with you. Something that came to my mind is actually a question I wanted to ask. What's the first thing you notice in somebody and you're like, "Oh, my gosh, that person is going to be my good friend"?

I feel like I always realize it when I'm in awe of a person, right? I'm like, "Wow. They're such a badass. I really like what they believe, and we can have amazing conversations for hours." And I felt that with Leen when we talked about "Hunger Games" and her being in Seder. She was telling me she was Palestinian, and I was like, "Oh, my God. So cool. I just want to know more."

And then I felt that with Lina when she was a first-year and I was a second-year and she was just telling me about her experiences as a first-year, and how she thought about things, I felt, was very similar to how I think about things. I was like, "Wow. She's such a smart woman. She's also Palestinian." And I was like, "I've had a good track record with Palestinians." So that's why I was like, "Lina would be awesome."

So these are the things that I notice, is how comfortable I am with the person and how they really touch my heart because they listen to me and I listen to their stories. And I generally always say my friends are the smartest people, the kindest people, because those are the vibes I look for.

What are the things that you notice, Lina, and you notice, Leen, when you first become friends with somebody?

Lina: I mean, I'm kind of very similar in comfort. I was going to joke about, "Oh, they're Palestinian. They're my friend. Ha-ha." I mean, that's how me and Leen got. But truly, it's kind of the comfort I feel with that person. I know it's going to be a great friendship when I sit with you the first time and I'm like, "Let me tell you all about my life. Let me just load it all on you." And we're just kind of feeling ourselves and feeling good together. I think that's usually what tells me that this is someone that I really want to continue this connection with.

Leen: So that's very similar for me. I think for me on the first conversation, I tend to throw a lot of ideas on out there and I look for the realist idea, in a sense. If we're talking about corruption, if we're talking about discrimination, we're talking about real things and we're able to build off each other, I'm like, "That's it. This person is going to be my friend."

I think with Harjit, I was like, "Oh, okay. So I see this woman of color in medicine. I'm just going to see what is her thought?" So I started talking about "Hunger Games" and how it's like a political system and how they . . . all these things. Oppression.

Harjit: Yeah. And we were totally into it.

Leen: And we vibed. I was like, "Yes. Finally. Someone."

I think same thing with Lina. I went up to her. I was like, "Yeah, she's Palestinian, but what about Palestine does she retain in that sense?" And I walked into her house and I see all these Palestinian regalia and stuff. I'm like, "Hell, yes."

Lina: Yeah. I remember you were like, "Oh, wait. You're Palestinian Palestinian."

Harjit: That's hilarious.

Leen: She's like, "Ah, yeah. There's no other way. No."

Harjit: You want to feel good with the people around you because friendship really is a choice. It's not like family, which is a blood relationship. You choose these people to be in your life, to build you up, and raise you higher.

I think another really big thing that we should talk about in friendships is how there are obviously times where things can get rough. I think that's always shown me a lot about friendships too, is how people have reacted when there is a conflict. That's when I know I can clearly tell people how I feel and we both work together to kind of reach a goal that is good for both of us. I think that's something that I've been working more on.

And I really didn't think about that when I was younger. I was like, "No, friends, you never have conflicts with them." But I've realized any relationship to build trust, you need conflict because it shows you how those people are when you're probably not your best.

Leen: I think conflict is a true measure of friendship, right? If you're able to come back together, if you're drawn back together after the conflict, if you build off each other, you grow off each other, that's a really good sign that there's friendship there. If you're not, then it's like, "Maybe we were just really close acquaintances for a bit."

Harjit: Close acquaintances.

Leen: Close acquaintances, yeah.

Harjit: I love how you say that.

Lina: Passing by.

Harjit: Passing by.

Leen: And how you're able to also come back from conflict in that mannerism, I think that's the sign of you're growing mature in the idea of what friendship means to you and you're changing your ideas of what friendship means to you. I don't know. I think that's a sign of growth in my thought process because if I think back to when I was younger, definitely the meaning of friendship was much, much, much different.

Harjit: Yeah, definitely. When you're younger, I think . . . I just remember a lot of times I felt like my value was derived from the friends I had. I felt like I had to be friends with certain people so other people would like me too. I think that this is such an important point because I think I didn't understand the nuance of that when I was much older because I wasn't getting the love and compassion I wanted from my friends the way I wanted to.

Another thing I really look for in relationships and friendships is a way to get to that point where I feel like we're giving each other stuff, right? Whether it be knowledge, skills, growth, it's something that is . . . Symbiotic is the right word, I think.

But I remember when I was younger, it was much of me just being like, "I hope people want to be my friend." The emphasis more was "I hope people want to be my friend" rather than "These are my friends and I need to trust that."

The reason I bring this up is because sometimes, as someone who has struggled with depression and anxiety, it always kind of makes me second-question that. And I've realized that there are a lot of people . . . and I think medical school really taught me that there are people I can rely on and be with all the time.

I think it was because I started viewing friendships in a different light. It wasn't, "Do people want to be my friends?" It's, "I want to be this person's friend. Can we build something together?"

Lina: Yeah, there was definitely kind of a habit, like you mentioned, Harjit, of wanting to have a number of friends, wanting to be the person that everyone said, "Yeah, she's my friend." For me, when I was younger, it always made me so afraid to kind of speak for myself or speak what I think. I was just so afraid of losing these people over something or over a fight or specific conflicts.

When conflicts did happen, I took it very personally and I think that was that for me for a while just because of how we grew up and it was like, "Oh, everyone needs to like you. You need to be your best." And that comes off of a lot of needing to be perfect and all this stuff.

Harjit: Right.

Lina: But I think we . . . I don't know. With medical school especially, you just kind of find your people and you realize that we're all very different people. We all have very different ways of approaching relationships and being together and what we like and what we don't like, so we find a way to kind of exist together in a very healthy way and speak our mind when we like or don't like something. Conflict is brought up and that's okay too. And I think it took me a while to be like, "No, that's okay."

Harjit: Yeah. That's a normal part of relationships. It's not something we should be afraid of. I remember in high school I used to be so scared of bringing anything up just because I'm like, "It will take away from my likeness."

I just think about this a lot because I wasn't the popular kid in high school and I always am like, "Oh, popularity is so fascinating because it comes back to the friendships and the need to want everybody to like you." But I think as we get more in tune with our identities, it's easier for us to be like, "Okay. That's fine. This person doesn't like this thing and that's okay."

Lina: Yeah, because at that time we didn't feel comfortable in our identity. Wherever we grew up, it just felt off and it just felt like you had to kind of be what everyone else is around you and just kind of conform to what was acceptable or what was the common thing and not the weird thing, in a way.

Leen: I think it's also interesting because growing up it was like I had a thought and my parents had a thought. So, for me, my thought was . . . I mean, it depends on what stage I was in my life. I would say elementary school years, I had really just one good friend and I would stick with her all the time. And we were like buddy-buddy. We were sisters, right?

And then obviously when I got to middle school/high school, that changed. I was like, "Oh, my God. I want to be popular." Such a stupid thought, but here we are. Hormones, man. I don't know what else to call them.

But I also think that growing up in my family, friends were a school thing, right? Friends were not a hangout afterwards thing. Maybe you go to a birthday party here and there, but when I'd be like, "I want to hang out with my friends," it'd be like, "Well, you see them at school."

Harjit: Same.

Lina: Hashtag #immigrantlife.

Leen: Hashtag #immigrantlife. Oh, my God. Yeah. And it's even funnier because that idea that friends are either a distraction or lead you down to a bad path, the potential for that, kind of kept up with me.

I remember my first day in medical school, I'm like, "I'm not going to have any friends. I'm going to focus on medical school. I'm going to be the best, because that's how you do it. You can't have friends." I remember thinking this. It's so funny. And then I met Harjit and Harjit was like, "Why are you always trying to push away? Why are you always trying . . ."

Harjit: Oh, my God. Now that I think about it, yeah. Oh, my God. I just had an epiphany. This is why you wouldn't hang out with me.

Leen: Yeah. It's because I had this idea, but you and my friend group that I met in medical school really changed my outlook on what friendship is. It's no longer a school thing. You guys are a life thing to me. I'll text you at 3:00 a.m. in the morning. We're talking all the time. We're hanging. It's almost like a family at this point. It's almost like we're beyond the friendship thing.

And I'm thinking, "Wow, even the word friendship to me . . ." When we were making up this episode and we were thinking, "Oh, this is a good topic," I was like, "Ugh, this is going to sound so cutesy and I don't like cutesy things." But that's because I think the word friendship to me is now more to family than it is to the idea of what friendship is as it was as a baseline for me.

Harjit: Yeah. And I think the reason why it's so cool is this is where you can really practice those boundaries with each other, know what it feels like to have healthy and sustainable relationships.

A side note. People that I've noticed have really good even romantic partnerships, they individually have really good friends. And I think that shows a lot about a person's character and who they are.

I'm constantly working to be a better friend. And in my head, what that means is I'm accountable for my actions. I'm accountable to tell people how I feel and what I can do to make our relationship stronger because I do have that love. And so that's how friendships have really changed my life, I would say.

Also, med school was the first time I started hanging out with people because I was the same. I had school friends, right? I think that's when I really started thinking about friendships and how important and valuable they are in my life.

Leen: I was going to say I don't think I would've made it through med school without the friendships that I have. It becomes such a bonding experience. It's such a support. I don't even know how I thought I could make it without it, to be honest.

Lina: Leen walking into the door was like, "No. I'm by myself."

Leen: I was emo and then I was like, "Oh, my gosh. No way."

Harjit: No way, right?

Lina: "I need people."

Harjit: I will say one . . . maybe not drawback, but one interesting thing is because medical school consumes most of our life, that's why I also try to still be friends with people outside of medical school. I think they bring in a different perspective and thought process.

And we were lucky to find each other, but it is sometimes hard to sustain friendships in medical school because of the anxiety and stress. And even though we don't want to be competitive people, the systems create us to be competitive people, whether it's cultural, whether it's societal. I think in my own communities there's a lot of competition between genders or within a gender.

And then when you think of about American society because of maybe the capitalistic thought process, we're all kind of competitive. So what ends up happening is I think sometimes that brings a little bit of difficulty in relationships.

So it's really interesting, because medical school . . . although for me it was a very positive experience, I do imagine it's hard for some people, especially if those components are in between. It can become also an isolating type of relationship if you just are friends with other medical students.

The one thing that saved me or even us or the friends I had is they had a lot of different identities. Being a successful med student wasn't the only thing they cared about.

Leen: One hundred percent. Honestly, I'm thinking the people I tried to be friends with that ended up having that sole identity of med school being the best and only identity to have, being the most successful, I gravitated away from them or they gravitated away from me, right?

Like I said, I really appreciate people who are real. To each their own. I think life is so much more diverse than that and I think life can teach a lot more than what you can learn in medical school. And honestly, I think medical school and medicine in general is a very close-minded experience per se. It's a very boxed experience.

Harjit: It is.

Leen: And your patients are more than that.

Lina: I mean, that's very accurate. Medical school is a very, very competitive culture and high-stress environment. It's very isolating and very hard mentally, emotionally. It can be a lot. And you try to find that community that supports you through all of that because that's what you need, and if you're trying to kind of beat each other at something or be on top of each other, that's not really sustainable for your relationships with people.

And I think at the beginning, it always feels a little isolating starting medical school because everything is so different and everything is just very stressful. At least for my friendships, I found a way to kind of lean back on them whenever I need and still feel comfortable where I am, feel okay with where I am.

It's not just about medical school. It's about my life outside, my interests, the life I've lived before, my identities, and people that can relate to that and how we can get together, let's all talk, let's feel better about what's happening.

Harjit: Right.

Leen: One hundred percent. And to reiterate what you were saying, I think the experience of what a person brings is super valuable to me. What is that person's experience to make them who they are?

I think that's why now as a resident, I see myself getting along with staff. I see myself getting along with nursing, all the way to cleaning, to other residents, to attendings. I've never had this before. And that's because I realize I value that experience, right? I don't believe that you just come to work and you're this person in this job. In order to truly get along with people, to make those friendships, to make those connections, you need to understand their experiences and stuff.

Harjit: Yeah.

Leen: And so I'm always sitting down listening to other people's stories as well. I think that's so valuable.

Harjit: I've noticed the friendships that do last are the ones that are really rooted in making a person feel heard, making a person feel seen, providing love, and kind of centering your relationships around love, which is kind of hard in medical school and the culture that is bred there.

But that's us actively creating friendships and bonds of sisterhood, is us actively going against that culture that is very capitalistic and "racist" and all this stuff. It's us really centering love in our friendships and being forgiving of one another, but also pushing each other and allowing each other to grow, and giving space when needed, but being there when needed, which is something that I've really struggled with and I'm learning.

This just reminds me of things I've been thinking about recently as well, of how I can better show up for people and be a good friend. But I think that that is something that is really hard in medical school because that culture is a little bit different than the culture of centering us as people.

Lina: And it seems like there's always kind of a pattern of . . . When we started medical school, they put us into certain groups of "Here's the interest stuff together" or "What you guys like in a specialty together."

And even in your residency programs, when you guys started, you told me there were all these activities for you guys to do together and you kind of felt like you were pushed into a group because it seemed like, "These are the people that you need to be friends with and these are the people that are your community now." And it feels like, "Okay. Deal with each other. I don't know. Interact with each other." It just feels a little forceful.

I think people definitely fall into that because it's like, "Oh, this is comfortable. This is good. Yeah, this is the easy way." And it can kind of feel even more isolating, honestly.

So it's okay to kind of step out of that zone and be like, "What experiences do I want? What relationships do I want?" And that's okay.

Leen: And sometimes it's artificial and there's also an agenda behind it. "Go meet these people to make this network, to bring out this research, or whatever, and be the top of this group." I was just like, "What is this? This is nonsense." So I never went to those.

Harjit: Yeah.

Leen: And I think with that being said . . . First off, I'm so grateful to have found the Bundles. I wouldn't have made it through medical school without these real . . . how many women are we? Six. I can't count. And I think it just goes to show the importance of really trying to maintain connections, maintain that communication, be flexible and fluid in the way that you approach people, and be ready to listen to people's experiences.

I think medicine is getting very much . . . I guess you could say dried out from this, and it's more that we're focusing on one type of person and personality. I think that that's not sustainable for anybody, whether it's mental health all the way to getting through medical school. I think this is a place where friendships are very much going to be lifelong.

And with that being said . . . I already said that the first time, but I'm saying it again.

Harjit: I love that you're saying it again, my friend.

Leen: Harjit, this is a disaster.

Harjit: No, it's great.

Leen: One more time. Here we go. And with that, thank you, everybody, for listening to this episode of "Bundle of Hers." Please tune in to our other episodes as well. You can find us on . . . what is it? Spotify and anywhere you get your podcasts. Bye. Just end it. This is so painful. Bye. Just bye. Cut.