In the months of my final year of school, the question of ‘Why’, of ‘Why medicine’ occupied my mind with an almost irritating intensity. I was in two minds regarding this question, seeing it as both deeply important and as yet another obstacle during that frenetic period, something for which an appropriately polished response had to be crafted. From the paranoid searching on annoyingly cheery sites with titles such as ‘What med schools love to see in applicants?’ to a final medentry ‘workshop’ before the impending interview, I’d formed a rigid notion of what the ideal reasons ought to be. Perhaps mistakenly, although I would say not uniquely, medicine seemed akin to a fortress of sorts, to which admission was reserved for the near saintly, those of faultless moral character, to those fuelled by purely unselfish motives, in short to those among us for whom this was a vocation, an intense, abiding calling.

In the face of these rarefied ideals, I felt the sharp sting of unworthiness, the feeling that I was an alloy of jostling motivations that couldn’t possibly be allowed entry. As I look back now, I think that arriving at the decision to really pursue medicine was, at least in the beginning more of a process of subtraction and elimination rather than one arising out of a deep-seated conviction. I knew what subjects I enjoyed and tended to do well in, and those, to put it charitably, in which my aptitude left a little to be desired. Considering this, I knew I had little interest in pursuing a math heavy field such as engineering or something similar. My passions and perhaps just as importantly, my strengths (I hope your eyes haven’t just glazed over) resided in the bio-chemical domain, in that ‘soft machine’ of the human body. It was this fascination, part scientific and part motivated by a certain paranoia about the inevitable propensity of cogs within this machine to malfunction that impelled me, to commit to the path of medicine. However, this interest was the original impetus, by choosing medicine, I wanted this nascent passion to intersect with humanity. To use the little knowledge I had or perhaps I should say still have, and build upon it, in hopes that ultimately it may be of some use to someone, that it may ease their suffering or sickness, in hopes that perhaps it may make – and I use this well-worn phrase unashamedly- a difference.

However, this doesn’t represent my motivations in their entirety, it would be wrong of me to cut out the less lofty reasons for my decision; in this case let us not separate the wheat from the chaff. To admit that one might in some small part be driven by the likelihood of a monetarily rewarding profession (eventually) or by the prospect of healthy career options, although after an ominous lecture concerning the internship crisis I am not so sure, was close to profane. Yet I recognise motivations such as these along with a subtle familial encouragement did play a role, a junior one but a role nonetheless and I would venture to say that these more material considerations may have in part influenced others too, at least judging by the number of biomedical memes we make. However, I don’t mean this as criticism, we as medical students or as prospective medical students do not live in a vacuum. Instead we’re shaped by the environment around us, by familial expectations: hopes that their children might enter a few select professions are so common in certain families, perhaps in some of those from a migrant background that they border on sociological phenomenon, by professional aspirations, by financial prospects, these can all seep into us via a sort of osmosis as we decide what it is we want to do with our lives.

Yes, it’s true that being solely or largely motivated by more worldly reasons, those of security or prosperity would be unwise in the long term as the path to and of medicine is lengthy one. A path of training followed by more training, of assessments succeeded by more assessments, in short, one of ultimate deferred gratification and if someone doesn’t feel a degree of passion for the material and its application in aiding others in their time of need then they’re at risk of deep dissatisfaction. A worrying prospect for both the individual and especially their patients.  However, I maintain to ask that we completely void ourselves of those prior concerns is requiring, in my opinion, the impossible. It is asking us to be a little more than human.

On a final note, I would add that although I still hold the core of those same motivations, I did prior to beginning medicine, in the months since then, something else has been added into that original foundation. Through seeing and interacting with patients if only in a rather limited capacity, I am at times filled with a terrible, and I don’t mean that in the pejorative, sense of responsibility at what will be expected of me in the future. That I will be privy to individuals at their most vulnerable, through sickness and malady and that they will place a dizzying amount of trust in my and the profession’s ability to steer them through their illness. It is the knowledge that at this moment there are people, some well and some ill, some young and some old and some who are as yet unborn, none of whom are known to me but whose paths may one day cross with mine that impels me to continue. It may be a brief encounter or a more prolonged liaison, however in that time I will have to honour and live up to the trust that has been placed upon me.