S8E16: Making Space for Joy in Medicine

Austen: Welcome back to "Bundle of Hers." For people who are new, my name is Austen, and I'm one of the regular hosts. For people who are joining us again, thank you so much for tuning in and listening. Today, I am going to be joined by some of my best friends from medical school. Collectively, we're known as the Pizza Girls. So hey, Pizza Girls.

Together: Hey.

Austen: Oh, and just a heads up, I'm not really going to be calling on you guys. So if you have something that you want to say, just speak up.

We are going to be having a discussion about growth, and joy, and what that can look like in an environment that oftentimes feels like there isn't much space for joy, especially when we're making mistakes, especially when we're going through difficult times of growth, and change, and evolution.

I think a lot of the reason why I wanted to have this discussion is because this is actually a terrifying week for med students across the United States. We're recording this the day before Match Day. So that's exciting and terrifying. But also, it's been a surprising moment of joy, I feel like, and something that will be exciting for us.

So, just like always, whatever we discuss, our opinions, this discussion is in no way a reflection of our medical school or any affiliated hospital systems that we work with, nor will it be a reflection of our future employers. And so our opinions and our thoughts are our own, and I'm just so excited to have this discussion with some of my best friends.

So since this is the last episode that I'm recording as a medical student, which is kind of crazy, I've been thinking a lot about the beginning of med school. Coming into med school, it was interesting finding each other in med school. And I think I had a lot of assumptions about what med school was going to be like, and I think some of those assumptions have been misproven.

But I'm curious to know, and maybe, Jade, starting with you, what assumptions did you have about med school coming in? Were any of them right or any of them wrong?

Jade: Thanks, Austen. I think my assumptions of med school were that it was going to be hard. And I don't think that was misproven. I think that was very much proven. But I also think that the scale of joy and hard was magnified in both directions over 100 times. And I think that was probably one of the biggest things that I learned going through med school, was how hard and how exciting med school could be.

Austen: No, I think that's fair. Did anyone else have any other assumptions? Because I feel like going into med school, I also was like, "It's going to be hard. I'm going to be sad." But did anyone else? Was anyone like, "You know what? We're just going to have a fun, silly time"? Did anyone have that kind of perspective?

Taylor: I did not have that perspective, Austen. I feel like I was under the impression that it would be different from other school experiences where we're making friends, and chit-chatting, and complaining, and hanging out outside of school. I thought it would be more like a job-type environment where we go in and do our little work, whatever that means, and then everyone goes home to their families, or whatever, and there wasn't as much camaraderie.

Austen: Taylor was like, "I'm clocking in and out. I'm doing my 40 hours, and I'm going home, and that's it."

Taylor: I'm sure that came across in my clearly professional attitude that I always maintain.

Rachael: I think, Taylor, a lot of what you said resonates with me in terms of finding friends and things. I think an assumption that I had was that med school is full of very serious people. And not that everyone isn't . . . Everyone's really smart, and everyone is serious when needed, but everyone is also really multidimensional and interesting, and lots of very fun and silly people, and particularly the women in this group. I think I was not expecting to find that.

Gracie: I agree, Rachael. And I think that, as Taylor often says, we found a group of outrageous women who are so much fun together. And so I agreed that that was something that I didn't expect.

Austen: Do you feel like any of these assumptions that you guys had about med school affected your view of what growth would look like, or even about when you're allowed to experience joy?

I feel like going into med school, whenever anyone before starting med school would ask, "What are you excited about? What are you nervous about?" it was almost like a scripted response that I had. I was always like, "Well, I know it's going to be terrible, and I'm going to be sad, and I'm going to feel lonely, but it's only four years."

And so I feel like pre-medicine, I had this very narrow view of what it was going to be like. I don't know. I think I just was like, "I'm going to be sad, and it's going to be fine because I'll get through it."

And then when I was in it, I think oftentimes I was like, "Surely, I can't be growing. I'm having too much fun. Surely, I'm just as silly, and I've got the brain of a potato that I had coming into this. I'm having a good time."

So I wonder if anyone else experienced that or if I'm just kind of alone in having my, I think, misperceptions kind of guide my growth a little bit, at least in the beginning?

Anna: No, I think that makes sense. I feel like, especially when you're learning in the classroom, it's a little bit easier to see, "I learned these things I didn't know before, and I passed the tests." And that kind of feels undergrad-esque.

But then when you go to the hospital and it's like, "I'm still having silly fun time with this team of people, and we're joking around," it's a little bit harder to be like, "Is that allowed? Am I learning? Am I doing a good job?"

Especially I feel like a lot of times I tried to continue that fun, happy vibe in the hospital, but didn't know if that was allowed, or welcomed, or if you were supposed to be super serious all the time.

And I think looking back, it's always easier to see that you grew than in the moment anyway. And so I think we all did grow and learn so much. But it was great that we had a fun time doing it. And I think that is almost just as important as learning so much.

Jade: I fully agree with Anna. I think it was so telling to be able to navigate a different type of growth. I think in the classroom you are growing in a lot of our knowledge base area, and how to understand and work through things. But I think one thing that I didn't see in medicine is the ability to build relationships with people professionally and not.

And what better way to build and practice building relationships with our future colleagues and even perhaps patients who are, when it comes down to it, just humans. And I think that's one thing that's been amazing about this group of friends, is the way that we are learning to build a relationship with each other and how we can use all of that to enhance our relationships in the workplace in the future.

Austen: I think that's beautiful, Jade. That was very sweet. And I think you're right. Any time that you can have human connection, that's only going to be able to deepen your ability to connect with other humans in other spaces.

Maybe I'm not gabbing with the patients and making pizzas with them once a quarter like we get together and make a pizza. But I still think that my ability to care for that person rests heavily on my ability to connect with that person, right? To build trust with them, to find joy with them, and also, when the time comes, and if it comes, to share in their sorrow and in their grief as well. So I think that's a perfect point.

Kind of circling back to something that Anna said, she talked about finding joy in the clinical space and how sometimes you don't know if you're allowed to be silly or to have joy in the same way that we do in the didactic space, in the classroom setting. I'm curious to know if you guys have any thoughts about kind of this feeling that maybe you're not either allowed to have joy in the clinical space in the same way, or maybe you have to kind of earn your joy in the clinical space.

I feel like oftentimes, I correlate being happy in the clinical space with kind of clinical outcomes and how patients are doing. And I think that can be kind of a damaging mentality to have because there's so much outside of our control.

Rachael: I feel like in terms of whether it's allowed or welcomed in the clinical space to be happy, to be silly, it makes me think of how often, as a med student, I think it can feel like being an outsider because we are moving around so much and in so many different clinical spaces for short periods of time and getting to know new people who already have sort of established relationships with each other.

And so I think it can be hard in situations like that to let your personality come out and to know what sort of the social norms are around that and different specialties or among different groups.

And I think that's one thing that can feel emotionally a little bit hard to navigate, is wanting to be yourself and be true to yourself and not know how much of that is okay, I guess.

Taylor: I feel like I resonate with that a lot, Rachael, because I am very loud often, and I have a hard time not being loud and trying to be silly. There were multiple rotations where I got feedback . . . and maybe it was positive or negative. I guess you can pick how you perceive it . . . of, "Oh, Taylor is funny." Those were on my whatever, the actual evaluations, and also when you would do feedback one-on-one.

I feel like, for a while, that made me self-conscious because I was like, "Is all I am funny? And is me being funny and trying to bring levity to the team and make the day more positive compromising my ability to be impressive in other ways? Am I not smart because I'm funny? Am I not doing a good job because I'm funny? Is this the only positive quality that they can come up with for me?" And so I was like, "I'm not trying to just be the class clown of the group."

And so I think for a while, I was like pretty . . . I mean, I wasn't self-conscious enough, I guess, that I changed that. For a while I was like, "I guess all I am is the court gesture of rounds." And I guess I just had to get over that and be like, "If this is what I am contributing, then great. I have to just be certain that I'm doing the best job I can medically-wise. And if this is what stands out to them, then I'm okay with that."

I think I've come to terms with that now. But at the time, those first few rotations when I got that feedback, I was like, "Is this who I'm trying to be? Am I trying to present as this person who isn't smart, but is funny?"

I just had to decide for myself, "I know what I should know as a whatever year medical student, and I have to affirm that for myself because I might not get it outwardly in feedback and things."

Gracie: Taylor, you are a famous comedian in our class.

Austen: Truly.

Gracie: And I think something I've noticed about this group of friends and how much they've helped me in med school is humor is kind of what we use to find the joy in medicine and to deal with the hard situations in medicine.

I've had so many times that I've made a mistake on rounds or something embarrassing happened, because something embarrassing happens every day in med school. You get to your friend group, and you talk about it, and it just brings a little bit of lightness to the situation and reminds you that it's really not that big of a deal, and it's not that serious. So I think that should be something you're proud of, is your humor.

Rachael: I totally agree with that, Gracie. And I think maybe the reason that it stands out to people when you're funny or show your personality is because not enough people are doing that.

Probably a lot of people feel similarly and aren't showing a lot of their personality in clinical spaces. And the fact that you are, I hope, gives other people permission to do it. And also, maybe that's why it's noticeable.

I also think what you said about the relationship between being funny and being smart, and how it feels that being funny somehow would make you be perceived as less smart, is interesting, and it shouldn't be that way.

Anna: I totally agree, Rachael, that idea of no one else is really showing their true personality. I remember getting this advice, I guess, going into third year of, "Just match the personality of the team, or go into surgery and just mirror what they're doing. Be quiet and be intense." And I was like, "That's so silly. That sounds miserable to be putting on this new face every few weeks just to match the vibe of the team."

And I think it's kind of harmful that that's the advice that can get passed down to people, as opposed to . . . I would give the opposite advice of, "Show your true colors and show up and make the most fun out of it as you can, because you're not going to love every rotation."

But I do feel like the common thread is you're going to find people in every rotation that you get along with. And so you're sacrificing that ability to make friends and enjoy the time you're there, even if maybe you're not loving what you're doing so much, by just trying to put on this face of seriousness and that you know everything and that you're just trying to learn as much as you can, which you still are doing, but you can have fun doing that.

Austen: Anna, I'm so impressed that you were like, "Bump that. I'm just going to be me." Because I feel like when you first get into the clinical space, it is kind of . . . I don't know. At least for me, my internal dialogue was always like, "I'm an idiot. I don't know who let me into the hospital. I've got to be as serious as possible so they know that I'm taking things seriously. And if the room is intense, then I'm just going to keep my head down and whatever."

But I think looking back on my rotations where I enjoyed myself the most, where I had the most joy, it was when I felt like I could be myself.

And I feel like during my surgery rotation, I was on a subspecialty that is historically very intense, but I feel like I was with a group of people who I could be myself with and I ended up having so much fun and really loving it.

I think the people around you can sense when you are comfortable with yourself. They can sense when you're confident. They can sense when you are happy to be there, and they respond really well to that.

And so I think if I could go back to MS3 Austen at the beginning of the year, I'd be like, "Girl, it's okay to be happy. It's okay to be silly. It doesn't mean that they won't take you seriously. It doesn't mean that you're not smart if you're cracking a joke or whatever, talking about Katy Perry, whoever. You can have fun and be a normal human being and still be an impressive med student, and still learn and grow."

I wish that was something that I had internalized earlier during clinical training. But I guess we've all got to learn it at some point and I was just a late bloomer, if you will.

Well, insightful, outrageous woman. Loving this. Something else that I've been thinking about recently, and I think Gracie touched on it a little bit. She talked about how sometimes we will spiral, we'll kind of freak out, and maybe we'll make a mistake, and it'll seem really big. And then we talk to our friends, and we can be like, "Girl, that's nothing. Guess what I did?" And then everything feels silly and fun again.

I'm curious if there's anything else that you guys feel like has been helpful for you to kind of hang on to joy and hang on to happiness, even in difficult situations, even when it might feel like you've made some grave mistake and the world is crashing down and you can't possibly become the physician you want to be.

Every now and then, I feel like that, but I feel like it's been helpful to have friends to lean back on and to help me through the crises. But just curious if anyone else has any beautiful, wonderful insight.

Taylor: I don't know if this is insight per se, but I think obviously getting to say what happened, admit your mistakes to your friends, and be reassured that that is normal and happening to everyone is obviously so helpful and so important.

And even people who are not your friends and who you sort of make your friends as you're just yapping to them and they are just forced to listen like your other peers, they even begrudgingly are like, "Yeah, girl, it's okay. That happened to me, too."

But I think something also that has helped me be okay with . . . I don't know if mistakes is the right word because I don't have enough responsibilities to make mistakes yet, but errors or oopsies, foolishness, that helped me get through those has been observing doctors do kind of bad jobs sometimes.

And not with medical decision-making, because they're usually doing great. But I think it's helpful when you can observe an attending really F up a patient conversation, and the patient leaves, or they leave and you talk to the patient or something, and they're like, "I do not like that doctor. They're not listening to me. They're weird. They're this or that."

It doesn't make me agree with the patient because I'm always like, "Dang, that was a tough conversation." But nothing magical happens to you when you become an attending that you have all of these answers and special insight and special key phrases to how to navigate awkward situations or difficult conversations. And it kind of takes the sheen off of them.

In front of me stands a 45-year-old man who happens to have a job as a doctor on this unit, and he is not a magical MD. And I don't know why I'm picking a man. It could be anyone. It could be any of these people.

But it just kind of disillusions it a little bit and I think helps take the stress, the pressure off of once you become an attending or even a senior resident, or I guess even a resident for us going into next year.

You have to have learned everything you need to know about not only the medicine, because I feel like you're okay with not knowing everything. At least I am. That's what training is for. But how to navigate conversations and build rapport, and even that can still be difficult when you're 20 years into your career.

And it's like, "This is just a human person trying to make this other human person agree with the plan, etc." And sometimes it is just not going to work.

That has helped me be okay with when it doesn't work when I'm doing it, because it's never going to always work. And you're not going to be able to do it perfectly every time because these attendings aren't as well.

Silence. Resounding shock.

Austen: I thought it was fabulous. I feel like I just keep yapping, and so I want to give space to everybody to respond if they want to.

But normalizing and humanizing these people who represent the culmination of our goals and aspirations . . . They are human. They are still making mistakes. There is not going to be any stage of our training when we're not making oopsies or mistakes, when we're not learning and evolving, especially within a field that's constantly evolving.

I think that's another driver of . . . We are always going to have to be growing. We're always going to have to improve and refine our skills. And even if we are the best patient advocate and communicator, we are still going to have patients who are like, "Girl, what the hell did you just tell me?" We're still going to have people who are like, "I do not jive with whatever you just said," and that's normal. It shouldn't be something that holds us back from having joy, that holds us back from being able to really enjoy this process that we're a part of, because it's inevitable, right?

I think once we normalize that and normalize these people who are just people, this 45-year-old man or 60-year-old woman who is an enigma in herself, I think it makes learning feel more approachable, less overwhelming, and I think it puts a little bit of joy back in the process because I think our self-expectations are normalized.

Anna: No, I agree, Taylor and Austen. Nothing about what you're saying is shocking.

I think it just proves this very mature way of thinking to be able to see through the hierarchies and all of these formalities of medicine that have been established to be like, "Oh, yeah, you're not this god that I am now so afraid to interact with, and you're evaluating me and perform in front of," instead of just saying, "Oh, hey, this is a human who has done the same things as me and also doesn't know the answer or what to do at every single turn of this."

And I think that takes a little bit of the stress off of medical school, because I think you see that hierarchy at every step. I remember last year, as a third-year, the fourth-years talking about their sub-Is and how much work it was to put in the orders and be the first person to be answering the pages and all this stuff. And at the time, I was like, "Whoa, I don't think I can do that. That sounds so hard and scary." And then you get there, and you just do it, and it's like, "Okay, it's not that bad." I feel like that's kind of just every step of the way.

And so to be able to see that, 10 years in the future, you're going to be an attending . . . And it seems so far away, but just every step happens. And so you've got to be able to see that realistically and grow and learn, but also not take yourself so seriously, like, "Oh, now I'm an attending and I can't make any mistakes." Because if we're already kind of feeling that there's no room for error, then it just adds so much pressure every time.

So I think what we've been talking about, being able to laugh at the silly mistakes or debrief the ones that feel a bit more serious, it helps to train that resilience of, "You're going to make mistakes, and it's okay. We all make mistakes."

And so I think, Taylor, you're just that much more mature and insightful for seeing that.

Taylor: Oh, thank you for noticing.

Gracie: I'm surrounded by the most mature and insightful ladies. And I think those are really good points about kind of looking up in the hierarchy and kind of helping yourself put things in perspective.

And I think the other thing that helps me is kind of looking parallel to myself and looking at my classmates and the things that they're doing. Because sometimes when you look at yourself, it's hard to really give yourself credit for what you're doing, or really tell how well you're doing, or how bad you're doing.

But when I look around at my classmates who are in the hospital with me, I just get so excited to see them talk to patients and do cool things. And it helps me get excited about myself, even though I don't maybe have the same confidence in myself that I have in them.

I just always am thinking about this day in Primary Children's when I watched Jade do a lumbar puncture. And it was the most perfect lumbar puncture I've ever seen. She was just so calm and confident and did it perfectly. And I just remember feeling so proud of her, but also proud of me that day. It was just so cool. It's so fun to see my friends do amazing things and it makes me feel more confident about what I can do.

Taylor: Oh, yeah. She's a champagne tap queen. That's for sure.

Anna: She is.

Gracie: Everyone was talking about that tap.

Jade: Well, thank you. That was a great tap. But also, I think . . .

Austen: I love that. She said, "I'm going to recognize my wins." And I love that.

Jade: It was. It was so fun. And I think, for me, that was one of the moments where I was like, "Hey, I can actually do something."

And thinking about that experience, the patient we were taking care of was mine and Gracie's patient. One thing that I loved about that whole experience was we were both taking care of this patient, and I was in the general team and Gracie was on the specialist team, and it was so fun to consult my best friend, or one of my best friends, for this patient. I was like, "This must be what working with friends is going to feel like. How amazing." It was so fun.

Gracie: It was so special. And we would just go see them together every day and talk. We were both on the bottom totem pole, the lowest hierarchy position of our teams, but we got to consult each other and talk about this patient. It was so special. Very joyful.

Austen: Beautiful. Jade and Gracie, that sounds like a joyful experience. And I think it's no coincidence that this joy was tied so closely to your relationship with each other and your connection with each other, right?

I have said this I don't know how many times. So people who have listened to me talk before, I apologize. But I feel like we are not meant to walk this earth truly alone, and I don't think that we're meant to be in this field alone.

Medicine is a team sport. And so if you have members of your team who you love and trust, if you have members of your team that at the base, at the very least, you respect hopefully . . . I'm just keeping it real . . . I think that only increases your success and increases your joy.

And so I think it's very telling that this was such a great experience for both of you because of your shared connection and friendship.

I think just kind of how Gracie alluded to, Jade's success was also exhilarating for Gracie. Maybe Gracie didn't do the lumbar puncture, but she was still so jazzed about it. And I remember you coming back to the apartment and telling me about it. And I was like, "Oh my gosh, Jade?" It was so exciting. And so I love friends sharing in each other's successes because when one of us wins, we all win. And that's so fun.

Taylor: I really resonate with both of that for what Jade and Gracie said. I feel like a misconception, if we can harken back to that prompt, if we dare, was that going into third year, I was like, "I never want to be on the same team as another med student." Because I'd heard about the peds, whatever, where you're with a bunch. And there are other rotations where you're maybe with one other med student.

On my first rotation, I didn't have anyone with me. And I was like, "This is what I want. No one can see me, all my errors. It's just the team that sees it and none of my peers, because that would be so embarrassing for somebody to go report back to their Pizza Girl friends and say, 'Hey, Taylor was an idiot in front of everybody.'" And so I was like, "This is how I want to do it for the rest of third year."

And I think whatever rotation it was, the next one . . . or maybe it was a few later. Who knows? I had med students on the team. And it was so interesting how wrong I was in wanting that, or not wanting that. Having one other person who is in the same sad Chungus role as you just makes you feel so much less isolated.

And even if it is not a known ally and pal, it could be someone you had never talked to before, but you lock eyes across the workroom, and it's like we get each other, and how embarrassing and awkward this whole experience is.

And so I feel like it makes you become sort of . . . I guess it depends on the situation, but the vast majority of the time, it builds a connection with these people that you are not always friends with, and it also sort of bolsters your confidence in doing things.

If I was scared to go see this patient that was having a whole situation and have to go talk to the ER about something and the actual attending, I'd be like, "Oh," tremulous walking down the stairs to go do that. But it's like, "Hey, you, come do this with me," and now we're walking together.

I agree with what Austen said about we are not meant to walk the wards alone. I think that is a big misconception I had, and I was very happy to be wrong about how much I enjoyed having any other med student on teams with me.

Rachael: Oh, I love that, Taylor. And I agree with that so much. I don't know. I feel like at the end of second year, I didn't know that much of our class that well. And I feel like maybe just coincidentally on a lot of rotations, I've been paired with other students who I didn't know very well and it has been so fun to get to know those people in those situations. You can get to know people pretty well and pretty fast on a rotation and just find things to love about them and to laugh about and be embarrassed together.

And now I feel some really close bonds with people that I have interacted very little with before or since that rotation. But now, if I run into that person in the hospital, I'm so glad to see them. I think it's been a surprising thing that's been really great, and I think also it makes me feel more normal to the point that you are making too.

I think often I also worried about being compared with the other students on the team. And I think often it works in our favor when we're together because it's like, "Oh, yeah, neither of us know that. We have not been taught that. This is not just a me thing."

So, yeah, I was a little ambivalent about it, but it's been really good.

Taylor: Yay.

Austen: Yay, friends. Shout out to all the classmates that I've forced to listen to me yap at various hours of the day.

This idea of connection and allyship with maybe people who you never really interacted with before, I think that's a universal experience. I think going into third year, I was just like, similar to Taylor, "I don't want to be with anyone else. I don't want them to see how silly I am. I don't want them to see that I have two brain cells that I'm working with trying to make magic happen."

And I also was just like, "And I don't want to have the attending comparing me to them, thinking about them, looking at us side by side and being like, 'Austen's lacking and Anna is a rock star.'" Shout out to Anna. She is a rock star. So that's the truth.

But I think the most kind of impactful moments that I've had on my rotations have been with peers. It's been when I'm having a hard time, and I turn to [D-Wass 00:31:30], shout out D-Wass, and I'm like, "Dude, I'm an idiot. I don't know anything." And he's like, "You're fine. What? That was so normal." I have somebody who's like, "Girl, get a grip. It's not that deep."

And then I think also the times that I've had the hardest time is, one, either when I'm alone or, two, when I'm with other people and I'm comparing myself to them. Then, in reality, I'm stealing the opportunity to have joy because I'm so focused on what other people are thinking when they're not thinking that to begin with.

I think sometimes, yes, the people who are evaluating us are probably comparing us to our peers. But in reality, I think it's far more minimal than how much I'm comparing myself to the people around me.

But anyway, having friends on wards is such a blessing and truly can change your whole day, your whole experience.

As our time together comes to a close today . . . at least our virtual time together. We'll see each other at dinner. I'm sure everybody at home is really wondering what our plans are tonight. But anyway, if you could somehow give advice to your MS1 self, or even people who are listening who are going into med school, going into the clinical space, just in a different part of their training, what advice would you give that person?

I think for many people going into med school, we're kind of at the top of the mountain. Tomorrow, we find out where we're going to have our first med jobs or physician jobs, and that's exciting. But we've climbed up this damn mountain. So what advice would you like to give people who are also starting the climb or at a different point in their climb?

Anna: I'll kick it off. This is going along with everything we're talking about of having friends on the wards and being afraid that everyone, even in the first-year class, is so serious and so smart and so much better than you. I feel like my advice would be don't automatically think those things about people, or try not to assume anything about your classmates.

I think the more you get to know people, you're always going to see the best in them. And then when you end up on wards, you're going to learn something about their lives that's going to change everything you ever thought about them.

That's the advice I wish I could have given myself, is be open-hearted to everyone, and be open to making friends with everybody, and don't seal yourself off because you think XYZ about someone that you don't even know. That's ridiculous. You are just stealing the opportunity to have joy and also to share joy.

I've worked with people who I'm like, "They seem ultra-serious," and I crack a joke, and they're going to laugh along with me, and you're like, "Wow, you can be funny too." And so you can share that with everyone.

Try not to get so in your head about the interpersonal relationships because you can get along with anyone, and that's just part of the job, and you're going to have fun doing it.

Rachael: I think, similarly, I struggled with comparing myself to others and maybe making some assumptions. And so I think, for me, I would tell myself to have confidence in myself and my ability to grow and to remember that the whole point is to learn and grow and that you're not supposed to know everything or even anything at the beginning.

And I think comparison is the thief of joy, and that we all have more fun and do better when we're not as caught up in those comparisons. And I think that's something that I was worried about, that I was not keeping up or not doing things or learning the same way that everyone else was. And so I think just have a little more confidence in my own right.

Gracie: That's beautiful, Rachael. I would want to tell myself that I should lean into the things that feel natural and happy to me, which took me some time in med school to start doing that. And once I kind of started doing that, that's when I made my closest group of friends, that's when I found what specialty I was going to end up doing, and that's where I felt like the most whole person as a med student. I just wish I would have started that from day one.

Taylor: That's beautiful, Gracie. Advice for people going into the beginning of med school, like MS1, I think try to give people grace, similar to all of what Anna said. They are probably just as scared as you are, and their fear response might look different. They might put on this front of, "I'm super confident and I know everything," because they are so afraid of the reality, which is that they don't, coming to light. And your response might look more timid and quiet, and you don't speak up in groups because you don't want those things to come out about you as well.

And so I think the people that lean more the other way tend to look with disdain upon the people who are super cocky and confident, maybe falsely so. But recognize that they're putting on a front because they're scared, just like you are being more quiet or whatever it might look like for you because you are scared.

And especially in those first years or in the first TBLs, everyone is acting bizarre and not like normal humans, and that will get better because everyone is so scared.

Jade: Yeah, I agree with that, Taylor. I think everyone is so scared, and I think for me, too, I was so terrified at the beginning of school. I think ultimately what I could have given myself now that I'm thinking of it is to lean into the joy of not knowing and to be confident in not knowing.

I think the more that I've seen people, residents, attendings, all of that stuff, working in the workspace and realizing that they are also still learning. And if I had known that earlier, I would have been a little bit more confident in saying, "Hey, I don't know, and I'm here to learn. Will you teach me?" Just being excited about that, I think, would have made a whole lot of difference for me, at least.

Austen: I think looking back on my whole experience, the advice I'd give to myself is this is going to be so much better with other people. Involve other people in your growth, in your joy, in your struggles, because they help give you perspective. And just build human connection because it'll enrich the experience tenfold, truly.

Well, ladies, thank you so much for joining me today. I am so glad that we had this conversation. Shout out to Dr. Rooney, who couldn't join us. Eliza. She was here in spirit, and she is another crucial member of the Pizza Girls crew.

But thank you, thank you, thank you so much for your time. For people listening at home, I encourage you this week to try to find joy in whatever you're doing. Whether you are in training, in medical training, or you work in a completely different field, we hope that you're able to build genuine human connection, share in the joy of your peers and your colleagues, and find some joy for yourself.

For those listening at home, this is a sweet reminder that we have episodes . . . Well, this is the second-to-last episode, so really just one more episode after this. But you can listen anywhere you podcast. And we will see you next time.