The Courage to Keep Going

When I was little, I thought adults were superheroes. I thought the older you got, the less afraid you'd become of the world, the more you knew, and the more put together your life would become. However, little did I know, it's quite the opposite of that.

No one really knows what they're doing.

There's more time for things to go wrong, there is more to be afraid of, and there is more you realize you don't know. I can guarantee that the people you see walking down the street do not have their lives completely "together". We've all got skeletons in the closet, secrets we'll bring to the grave, and struggles that we have or will face at some point in time. Some of us go our whole lives carrying these secrets, burdens, and fears, and you'd never know it. You'd never know that inside those people, they're struggling. They want to scream. They want to quit.

If you're familiar with my blog, you'd know that it has been my dream for years and years to become a doctor, which I am now pursuing. What you wouldn't know is that I endured one of the hardest seasons of my life this spring. I finished up my second year of medical school, but before I could officially say so, I had to take my first board exam. USMLE Step 1.

Step 1 is a comprehensive 8-hour exam that encompasses everything that you are expected to learn in the didactic years of school. It's brutal, it's relentless, and one of the hardest exams I've taken to date.

I don't even know where to begin with what I endured. I ended 2025 celebrating one of my best friends' weddings on New Year's and felt so motivated and ready to hunker down and study for this exam. I had all the confidence that I knew what I needed to do in order to prepare for this exam.

For the entire month of January, I woke up, got ready, and spent 10-12 hours that I would dedicate to studying. I lived alone, saw minimal people, and grinded the shit out of my days. I felt good about where I was in the process, and by the end of the month, it was time to take my first practice exam that would predict how ready I was.

Those practice exam results sent me into a severe two-month regression that resulted in me moving home, getting medicated, and seeing a therapist for the first time in my life.

The results predicted that I had actually done worse over my one month of studying, and the crazy thing was that I actually believed it.

From there on out, I completely panicked. It started a spiral of self-doubt that I had no idea could tear my life apart as badly as it did, or as fast. I started looking into nursing and PA programs that night, and cried, and cried, and cried, thinking I wouldn't have what it takes to even get into them.

My mom was out of state when I got the results, and I needed her so badly. I wanted her to drop everything and come back to take care of me, to comfort me. But she was away, taking care of her mom, and I felt like such a selfish person - adding to the list of people she needed to take care of. So I painfully waited for her to come back.

It no longer became a healthy studying pattern, but 12-16-hour days, where I was starting to lose sleep, I stopped seeing my friends, and I stopped eating. Anything that took away time from me studying was cut from my life. Scarily easy, too. As a result, I lost a lot of weight and became exhausted, but I did not stop. The stress and anxiety kept me going.

I studied harder.

I studied longer.

I studied more.

and more...

and more.

My medical school friends came to visit me and tried to comfort me to no avail. No one could tell me anything that would change my mind that I could pass this board exam or that I was fit to become a doctor. All I could do was cry.

My mom got in late a week later, and the moment she walked through my door, I broke down. We sat on my couch for hours, and words poured out of me:

"i don't know if i can do this.

i am struggling so much.

i am such a failure.

what if i can't actually do this?

i think i've made one of the biggest mistakes of my life.

what am i doing here?

why did i think i could do this?

i've messed up so badly.

i don't know what to do.

what do i do?

i don't know if i want this anymore.

why didn't i just listen to you and dad and go another route?

what was i thinking?

i'm not smart enough for this

i want to quit."

I was scared, plain and simple. The idea that I would not be able to get through this board exam was all I thought about at this point. I ruminated on the thought day in and day out.

I could no longer take care of myself, and the decision to move home was made after several days of my mom staying with me. I emailed the school and told them I couldn't join in-person pre-clinical classes due to my mental health, and I packed a suitcase and left.

On the way home, I had a virtual doctor's appointment, which ended with me picking up four new prescriptions. I was met by my dad when I got home, and I cried out the same things that I did to my mom.

The next two weeks, they took care of me. They looked out for me and tried their best. While I cried, and cried, and cried. I woke up and cried. I cried when my parents looked at me. I cried as I retreated to my desk after dinner to keep studying. I cried during my advising meetings. And I couldn't stop.

On one particular day, I sat at the dining room table studying, and I started to cry. My parents and I retreated to the couch to talk, and I just couldn't escape my thoughts. This was one of several conversations where I seriously talked about dropping out of medical school. It felt so shameful to even talk about quitting. It felt like I was dying inside, and studying for this exam only ignited my depression more and more. It felt like Groundhog Day every day, and there was nothing I could do to stop it but take this damn test. Or not?

Was it ok to give up on a dream?

Reality was difficult to decipher, and after a time, I couldn't tell you what it was that would make me happy again. Would just quitting and letting go make me happy? Did I really want this life for myself? Did I find relief in quitting? Would I regret not taking this board exam and continuing on with medical school? Would I be happier doing something else?

I didn't know.

I didn't have the answers.

The days and weeks went on, and there came a time when I had to go back to school for clinical orientation at the hospital. It was something that I had been dreading, and rightfully so.

My mom was leaving town again for another trip, and I feared her leaving the most. I was worried I wouldn't be able to function alone in my apartment. She left for her flight, and as you'd guess, I cried. I thought I was going to be ok, but I didn't even know how to be ok.

To add to the matter, it was time to take another practice test while she was gone, and I was scared shitless.

I took my practice test and immediately packed a bag to stay with my friend for the rest of the week. Each new person that I encountered during this time in my life, I could not keep my eyes dry. It was torture having to explain what I was going through, and terrifying having to explain that I might be giving up my dream. I knew I didn't have to tell people, but it felt like it was written all over myself that I was a struggling wreck. I was always met with support and kindness, and no one cared more than I did about the optics of giving up on a dream.

Over one phone exchange with my mom, she told me about a woman that she met while hiking, who told her, "If the door isn't closed, it's not over," after sharing my story with her. It was small things, such as those words, that helped me get through the days.

The morning of the hospital orientation, I thought I was going to barf. I was so nervous about seeing any of my classmates and having to talk about the fact that I hadn't taken the exam yet. How foolish I was to think no one would bring it up. I left halfway through because I couldn't stand to be in a place I didn't deserve to be in. All I could do was stare at the credentials on name cards that I'd never have.

When my mom got back, we drove back home together, again.

And I got back to studying. Again.

The medications were slowly starting to help, and the crying, anxiety, and depression lessened. I still cried myself to bed most nights.

My testing date was nearing, and I'd never know the kind of day it was going to be when I awoke. Some days became easier than others, and I'd have to study upstairs so I wouldn't be alone. Other days, I'd have to give up because I couldn't think clearly, couldn't focus, couldn't bother to be motivated.

The conversations surrounding quitting continued, and my final take on my future sounded like, "I am just going to take this, and we'll take it from there", and I'm sure some medical students out there could not fathom this take. My future looked like russian roulette.

A week out, I postponed the exam after realizing internally that maybe I did want to try my very best on this, if I was going to take it. I was momentarily happy with putting it off, and it allowed me some room to breathe again.

So, I kept on.

I started studying less, partially because I wanted to give up, and I couldn't keep doing this anymore. Also, because maybe there was some validity to retaining more when I wasn't studying 16 hours a day and took a goddamn break. So, we'd all wind down at the end of the night watching the Olympics or our TV show.

The days leading up to the exam were oddly calm. At this point, I had been studying every single day for THREE MONTHS. I still, to my dismay, felt nowhere near ready or that I was competent enough to pass this exam. It was symptom control the last few days: beta-blockers, antidepressants, anxiolytics, and sleep aids.

My mom came to stay with me the night before the exam, as it was in another city. We got dinner, watched TV, and I still continued to study until the very minute that I went to bed.

I woke up, got ready, and we drove to the testing center. I looked over several study materials and did the damn thing. It felt like a fever dream. I sat in that chair and answered question after question without any confidence whatsoever, and after 8 hours, I left feeling emptier than I've ever felt. Apathetic. No room for feeling anymore. Numb. I couldn't even cry when I got back into the car with my mom. I just stared out the window and said, "There's no way I passed that," and knew this was the end of my medical career.

And we drove home.

I think my parents thought that after taking the exam, I would magically get better. The depression persisted because even though it was over, what was I going to do with my life? Did I even know how to start over if that's the route I chose?

Like any standardized exam in medicine, they make you wait millennia for your test results. If I didn't know better, I'd think the rationale behind this was to actually increase rates of medical student depression, anxiety, and suicide, given the HIGHEST amount of stress I have ever endured. Yes, even after all that ^^^^.

So here's the thing: after taking that board exam, I started my first clinical rotation a week later. Without knowing my score. So I showed up every day, wondering what the hell I was doing because I knew I failed that exam, and I was not going to retake it. I tried to be interested, and I tried to have a positive attitude, and I just couldn't do it. The thought was that this was going to be my only rotation, because once I failed the exam, medical school would no longer be in the cards for me. That I would have to quit. That there was no way I was taking that exam a second time.

The weeks passed, and then it was finally the day of the results. By this time, I was starting to realize that I really enjoyed school on the other side of the exam. That finally getting to clinicals was what I had been looking forward to for so long, but the results of this test were going to determine my future. Results were open at 10 am, and I had classes on campus that morning and afternoon, and I had it in me to look at the last possible minute of the day. I am notorious for just not looking at test results due to the anxiety that they give me. Unfortunately, Step 1 is pass/fail, and to proceed with school, you have to pass, which meant I had to look.

I got home from class, and in a very "fuck it" manner, I pulled my laptop out and pulled up my test account. I debated for several minutes whether I was ready to be disappointed. If I was ready to give up everything that I had worked so hard for.

If I was ready to be sad again.

In "me" fashion, I started crying before even seeing the results, because this was it. The end of my dream. And my test results would tell me so.

With my hand covering the screen, several deep breaths and tears streaming down my face, I rashly clicked the "see results" button and slowly uncovered the screen. Not two, but one word in bold at the top of my score report read:

PASSED.

Exit out.

Refresh.

Reopen.

It says the same thing: PASSED.

Exit out.

Is this the right report? Or just an example of how to read it?

Reopen.

Exit, refresh, open, PASSED.

Exit, refresh, open, PASSED.

Exit, refresh, open, PASSED.

Immediately dial my mom on the phone. No answer.

Try again. No answer.

Dial dad. He picks up.

"Dad".... I'm crying, I'm sobbing, I'm.... "I passed".... and all hell breaks loose, and we sit there on the phone crying together. For the first time in months, it was tears of happiness, tears of joy, tears of disbelief.

I had really done it, and I finally felt PROUD of myself. I finally felt worthy, smart, and deserving to be where I was.

I felt happy.

---

I finished the end of my general surgery rotation today, now four months out from taking my board exam.

I have often thought back to earlier this spring. How, if I'd given up, I wouldn't be where I am today. I wouldn't have the privilege to be in patient rooms or the operating rooms that save lives.

My life might have looked a lot different than it does today, and I'm so grateful for the friends and family that believed in me to get to here. I'm always grateful to them. I know the hardships in medicine aren't over, but at least I know I can do it and I belong here.

I'm happy I stayed, and I find solace in the fact that if I changed my mind, it would be ok. I will be ok.

I just needed the courage to keep going.

Yours Truly,

Kitty