Today marks the conclusion of the MD Student Conference (MDSC), a four day event involving talks, workshops and activities relating to various themes in medicine. While the conference was held in an unprecedented online format, it was enlightening as a whole and there are many insights I’ve taken away from the event.

I’m still processing everything from the last four days, but one idea that struck me was the grey zone of medicine. For most of my schooling, I’ve grown up with a binary way of looking at things. Math answers are either right or wrong. Organic molecules either have a chiral carbon or don’t. Syllables are either stressed or unstressed. There is always a correct and incorrect answer. Things are black and white.

In medicine however, things often aren’t black and white – they’re often grey. For instance:

• What do you say to a terminally ill child who asks you if they’re going to die?
• How confident can you be in a test result with only 70% specificity?
• When do you give up hoping that a patient will recover from an illness?

These questions are difficult and there’s no straight answer to any of them. These non-binary type of problems are uncomfortable, and knowing I’ll have to confront these questions (and more) in a few years is terrifying. If someone could give me a handbook with a blanket answer to these dilemmas, I’d honestly be delighted.

Yet, it’s these situations that make medicine so precious. How can something as complex as a life have clear cut answers when faced with mortality? How do we consider connections to family, friends and the world in this decision? While I have a few issues with the inherent “reactionary” nature of medicine, the sacred responsibility of a doctor to navigate these grey zones is fantastic. And if that results in frustration and burnout, then so be it.

As Paul Kalanithi put it,

“The call to protect life – and not merely life but another’s identity; it is perhaps not too much to say another’s soul – was obvious in its sacredness… Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.”

Paul Kalanithi, When Breath Becomes Air