For three years our world was the walls of a hospital. It was the beeper hanging on the waist of our scrub pants, the stethoscopes that have hypertrophied the grooves of our shoulders, the white coats we quickly forgot in the corners of our closets, replaced by Patagonias that took us an entire year to receive. These years were the jingle jangle of ID cards that read house staff - remember when we had to remind ourselves to call ourselves doctor in every introduction, how strange and unsure that tasted in our mouths. We turned those words over until our ears deafened to that sound. I remember, this past July I saw an intern physically jump from her seat when her pager went off and I laughed silently to myself, how much had gone by that we haven’t accounted for. Can you believe what we have grown accustomed to, how we took imposter syndrome and turned it into the ones making the decisions, our muscles moving in synchronized dance, finding veins and lines, and chests, anticipating every next step, morphing into a solemn confidence choreographed into existence, that when our eyes met we spoke our own language of the body. For three years our world was the hands of strangers taken into our own, our hearts clenched into fists, willing to whisper magic of healing and silently giving it back to the world.

Only two months ago President Biden signed a bill declaring the end of the Covid-19 national emergency. Life has returned to a semblance of “normalcy”. COVID restrictions have become nonexistence and even our hospital policy no longer requires us to wear masks. Three years ago we opened emails in our private match day celebrations and learned that we had matched into the epicenter of a newly announced pandemic. The moment to finally bask in that delayed gratification promised to us for so many years immediately vanished. Instead we celebrated our tremendous accomplishments and graduated with our caps and gowns behind closed doors, away from loved ones, walking across digital screens. I remember feeling conflicted – wondering if it was selfish to seek celebration while the world engulfed in suffering. We were denied that innocence, happiness, and sense of accomplishment that comes with holding a medical degree without yet grasping the full weight of what actually comes with that medical degree. Instead we carried fear of the future, trying to convince our loved ones that we would be safe, and wondering whether choosing to become doctors didn’t just become the worst decision of our lives. Then we met each other not really knowing what anyone looked like. We started our journeys as doctors with no concept of what it was like “before”. As we graduate now, we will likely be among the last to have our residency experience shaped entirely by the pandemic. Yet, in a strange twist of time, those days feel distant now. It’s finally time for our celebration.

There is a quote I often fall back on: “You have learnt something. That always feels at first as if you have lost something.” I would not do justice to you all without acknowledging that we have exponentially grown as doctors at the expense of profound losses. The loss of our naivety, our innocence, our altruism, our patients, our loved ones. The loss of our time, our autonomy. The loss of potential – the million of other lives we could have lived if it were not for the dreams younger versions of ourselves carried and the ways we have worked endlessly to make them our current reality.

While we lament the things we have lost, I hope today is a celebration of who we have become. Firstly, we owe our achievements to all the people who made today possible, the family, partners, friends, esteemed mentors and coaches, and our therapists who have uplifted us, encouraged us, carried us, cried with us. I also want to commend the ways we have cared for each other. The ways we have had a fierce compass towards justice for our patients. We have given our all to bring comfort and healing to the lives of the people we have been blessed to take care of and learn from. From planning international flights to fiery arguments and discourse with the ED and bed board, we have endlessly advocated for our patients. Our actions have also set an example to those after us: despite feeling powerless, there existed collective power in the intimate connections we made with each other, faculty, patients, and nursing colleagues. We have poured our soul into solidarity. We have navigated the spectrum of a pandemic and a picket line.  We have voted for a legacy that will continue to outlive us as a gift to all those who come after. We have been enraged, and have been so unapologetically. In all of this has been the dream that a working, equitable, just medical system is possible. We can become the leaders of that movement to strive for better. That should be something to be proud of, because it stands in direct contrast to complete apathy. To be heartbroken and to do so continuously without regret time, and time again, is to choose to be brave. It means that for some reason, after the most grueling years of our lives, we still believe in our capacity to heal and effect change.

These are the people I remember – in the CCU, on valentine’s day, witnessing a family hang pictures of a beautiful life well-lived all over the room to comfort their loved. The daughter, who would facetime from thousands of miles away, every night, and we would set up the iPad beside her father’s bed and play Buddhist spiritual chants of healing and hear her prayers across the hall. The wife, patiently and lovingly rubbing lotion on her husband’s edematous legs, tearfully reminiscing on the wonderful man and father your patient has been, begging you to keep him alive to witness his daughter’s wedding day. These are the lives we have been preciously let into, that we have been privileged with a glimpse of. They have shown us that in seeing the ways that we can love each other we are reminded of what we do and why. Of how interconnected we are and what community means beyond our walls. Despite the objective data, medical facts, the “I’ve seen how this turns out”, the people of the Bronx have taught us how to hold on to this hope and to admire the raw beauty of human resilience.

In the past three years, we have witnessed the preciousness and fragility of life. We have been constantly reminded to cherish glorious moments. We have grappled with tough questions about the impact of our actions, wondering if we did more harm than good. We have been entrusted with care and pushed to the full extent of our capabilities. I hope that when we leave the halls of the Northwest tower, when we are no longer rushing to codes in Klau, or staying up for twenty-four hours at a time caring for critical patients, or discharging the entire Aqua team, that we will have time to process what has transpired. Despite the rocky start to our careers, and whether or not medicine turned out to be what we anticipated, the doctors we have become are the doctors our younger selves aspired to be. If not, it’s okay for that dream to look different now. We have learned the hard lesson that life is filled with as much disappointment, grief, guilt, and loss as it is joy, love, exhilaration, and celebration. Choosing gratitude and grace and empathy – and even righteous anger at times -- no matter the moment -- is an act of courage. In doing so we have become exceptional physicians, fierce advocates, compassionate colleagues, thoughtful comrades, and empathetic human beings. The day will come where the experiences that have happened in these halls will become a distant memory, a fever dream in our lives. Choosing beauty, grace, and hope among all else will be the unique resilience we carry. For the rest of our lives there will always be this spectrum we seesaw, a push between discomfort, growth, guilt, acceptance, and joy. When I tip the scales of what was lost and what we have gained, I am grateful that the love, laughter, and connection we have shared, the courage we have carried and exhibited, the empathy we have cultivated, the advocates we have become, and the kindling of humanity from one person to the next that we have nurtured, will forever connect us together in the family that we are.