Dear intern,

It will be the best of times, and it will be the worst of times.

But what a special time this will be…


Internal medicine resident Muthu Alagappan is only a year or two removed from his first year post-medical school, but his letter to those just starting out this month on their long and arduous journey of becoming true healers betrays a wisdom beyond his years:

In the beginning of the year, you will find that although internship is about learning the secrets of disease, it is equally about learning the secrets of yourself. When an insurance company refuses to cover an important MRI, you will witness the intensity of your anger. When your hearing-impaired patient misses her appointment because she cannot find transportation, you will feel the depths of her sadness. And on the eleventh day of a twelve-day call block, you will wonder why anyone would choose to do this work under their own volition. Why would you attach your life to the suffering of others, why would you hide yourself in the shadows of illness? But then while cleaning your desk on a quiet October night, you will come across your medical school application essay. You will be struck by the curiosity in your voice and the excitement in your thoughts. But you will be saddened upon realizing that in your relentless pursuit of tomorrow, you have forgotten that today contains everything you have desired.


An intern can choose awful, or, remembers young Dr. Alagappan, he can choose awe:

By March, you will have learned to never underestimate the recovery of the human body or the resilience of the human mind. You will have repeatedly observed that the best predictor of a sick patient is a worried nurse. And you will have found that when you are tired, anger comes easy and kindness takes effort — especially kindness toward people who are not kind toward you.


Good times, bad times — important lessons and memories are made all the same:

As the sun returns in April, you will begin to feel burdened by the looming expectations of a new year and a new role. Some mornings, you will walk into the hospital feeling like an imposter — as if you stole your badge, stethoscope and medical degree from someone else. You will inevitably make mistakes, some of which may harm patients. And when this happens, you will hate every cell in your body. You will promise to never see a patient again. But hopefully, you will remember that time as a medical student, when Ms. G, the homemaker from Santa Rosa California, told you that you will make a kind and thoughtful doctor one day. You believed it then, and it is important that you believe it now.


Read more of Dr. Muthu Alagappan remarkable and touching essay, “Dear intern: Some advice about your first year” here.