A Different Kind of Heartbreak: My First Year of Residency


By Farah Naz Khan

They say that “without suffering, there would be no compassion.” But during the first year of my internal medicine residency training, I witnessed more suffering than I could have ever imagined to see in an entire lifetime, let alone in a single year.

12 months of life and death. 365 days of sickness and health. 8760 hours of hurting and thriving. When I reflect on my intern year, I feel more experienced. I feel less fearful, and I feel more knowledgable. Yet at the same time, I feel the strings of my compassion stretched to their capacity by the unrelenting and puppeteering hands of suffering.

It’s hard to reconcile the layers upon layers of adversity I have seen on a daily basis with the world I knew prior to my residency. I placed my first patient in hospice care for metastatic lung cancer within the first week of residency, and since then, I have placed more patients in hospice care than I even want to count.

I advanced from hospice care placements to performing death exams and signing death packets for patients who succumbed to their critical illnesses in the intensive care unit. And, ultimately, I graduated to caring for patients who found themselves medically decompensated because they struggled to access or afford the medications that could help them.

I entered the field of medicine to help people, and as cliche as that sounds, it has always been my biggest truth. But when I periodically contemplate my personal helplessness within my own field, I realize that I could have found a path to “help people” through any line of work.

So now I find myself asking, why medicine? Why this business of life and death? Why this field of harsh realities and bitter truths? People can’t always afford their medications. People often make horrible lifestyle decisions. People can’t always beat their illnesses. People can’t always overcome their personal demons.

And perhaps this is where I’ve found my calling in this medical journey thus far: on a playing field with my patients, where we search for even ground and try to negotiate the best quality of life possible within certain unavoidable circumstances.

What are these unpredictable, yet inescapable circumstances?

Addiction, ignorance, poverty, misinformation - just to name a few.

But these formidable foes don’t always have the last laugh, because I’m learning how to better understand these enemies of health and wellness. Through this constant push and pull, I try to work with my patients. I work with my metastatic cancer patients to help them live to the end on their own terms. I work with my overweight patients with hypertension and diabetes to help them set feasible plans for exercise, weight loss, and health maintenance. I work with my financially struggling patients to find cost-effective treatment strategies to best optimize their health care. And, I work with my often still-smoking patients with ravenous chronic obstructive pulmonary disease to help them maximize their quality of life despite their perpetually declining lung function.

I now understand that I can aim to match my patients, stride for stride, in their lifelong marathon. And in my own lifelong marathon as a healthcare provider, I’m learning how to best care for myself while working in the business of caring for others. Through the support of my family and friends and through my myriad of pastimes, from writing to Bollywood to DIY furniture projects, I’ve made sure to prioritize my work-life balance during residency thus far. And while I may never be able fully understand “why medicine,” I’m still here to help people. I’m still here.

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Farah Naz Khan

Farah Naz Khan is a freelance writer and second year internal medicine resident at Emory University. After graduating from college in Boston, she returned to her Alabama hometown to attend medical school, and was reunited with the mix of Southern hospitality and South Asian culture that had shaped her childhood.