Published 3 years and some weeks ago, as I finalized my list of applications into the match for residency. Now, I get to interview prospective residents and walk them around. Deja vu much!

I stood on the edge, and felt terror rise in my chest. I took a deep breath, and forced it down, screwed up the courage for that one step and I took it. I stepped out of an airplane door, with instructors holding onto my shoulders and hips and jumped into space at 15,000 feet. I thought the hard part was over- how wrong I was.

Today, I’m a fourth year medical student. I’ve completed four years of college with a thesis in biochemistry and philosophy each. I’ve survived the two years of classroom learning of medical school and all of my core rotations. I’ve taken all the dreaded Step exams. I’ve spent 4 dedicated months in the Emergency Room, taken care of dying patients, saved lives and had people die under my hands. I’ve intubated people, put in chest tubes, and made decisions that could save or kill people. Why then do I feel that same terror rising in my chest now?

Perhaps it’s because I’m on another precipice. I’ve submitted 23 applications for residency and I have 15 interviews scheduled. I’m deciding where I want to be for the next 3 years of my life and I’m trying to pick a place that will make me an excellent clinician, researcher, possible academic physician, and writer. Not just that, the place has to work with my significant other’s job and our plans to move in together. And I have to choose the place that will let me do that.

I hold my future in my hands, and I’m rudderless in the competing currents of each possibility. Each place gives me compelling reasons to come there, shows me visions of who I may become through them, and touts the successes of those who were in my shoes just 3 short years ago. The magnitude of this decision and its effects on my life and my future are dizzying and terrifying. Though I have a gut feeling that I will make my own luck and my own future at whichever place I end up.

As I fell from 15,000 feet with my instructors on either side I felt sheer terror. I fell at 120 miles an hour, screaming towards the earth. Fifty of the longest seconds later, and my parachute had opened somehow. My terror abated, I began to breathe again as my trembling hands reached for the cords and attempted to steer me towards where I needed to get on the ground.

Perhaps then this rising terror is from who I’ll be when the parachute opens. For as I step into the abyss I am a medical student- now bereft of responsibility and blame. A few short years later when the parachute opens I will be an attending physician sailing on my own steam. I’m stepping into the abyss in a few short months- I suppose my choice, as I step, decides who my wingmen (and women) will be when I’m free-falling with the terror rising in my throat.

Geronimo!