"Balancing Expectations" by MSIH first year blogger Jensen Reckhow

While studying for a physiology quiz this weekend, I was surprised to learn that the circulation of the adrenal glands is asymmetrical. Let me clarify: this is not one of those quirky asymmetries like having one ear that is higher than the other, a charming but inconsequential flaw. The adrenal glands straight up drain through different routes: the left adrenal gland drains to the left adrenal vein, the left renal vein, and the inferior vena cava, while the right adrenal gland drains to the right adrenal vein directly into the inferior vena cava.

This may not be a big deal to you (and perhaps you were already aware of this travesty), but it really threw off my internal dogma of human anatomy. I was under the impression that paired structures in the body were essentially symmetrical. Each individual possesses variations on the theme, but the blueprint is balanced. The adrenal glands appeared to be fraudulent.

As a medical student, I can identify with the adrenal glands. People make assumptions about medical students, about who gets in, who succeeds, who goes on to become a great doctor: Medical students are high-achieving, moral, focused, competitive. They live in the library and if they don’t it’s because they already covered the material last week, thank you very much. I’ve heard these assumptions, and I don’t identify with them. Some days I study for an hour and spend five more on Netflix. Some days I study for sixteen hours straight, only to bomb the quiz the next day. Some days I study well and succeed, but can I say for sure that it’s because I studied, or was I just lucky? Should I be here, or am I a fraud?

Modesty is a good thing, and it is critical to being a good medical student and doctor. The knowledge we are learning now will be immensely consequential in the future; our patients will be vulnerable to us and we must be deserving of their trust. We are entering a career of lifelong learning, of questioning and revision, of mistakes and growth. Few careers rely so fundamentally on continuing education. But how can you tell when it’s healthy modesty and when it’s self-doubt?


I don’t think there is an answer to this question, and I am beginning to realize that it is not the question I want to ask. Keeping my self-doubt in check will always be a struggle, but meanwhile there is still so much to learn. So instead of worrying about whether I am up to the task, my time is better spent learning as much as I can, because it’s an honor to be here. What about the adrenal glands issue, for example? I want to ask about that.

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