there is an ancient fable concerning a farmer whose horse escapes. The neighbors lament, “What terrible luck!” The farmer simply responds, “Perhaps, perhaps not. We shall see.” The following day, the horse comes back accompanied by two wild horses. “What wonderful fortune!” they exclaim. Once more, the farmer states, “Perhaps, perhaps not. We shall see.” Shortly thereafter, the farmer’s son injures his leg attempting to train one of the horses. “What a misfortune!” The farmer replies, “Perhaps, perhaps not. We shall see.” Weeks later, the military appears to draft all capable young men. The son is exempted. The moral is straightforward: in the moment, we cannot determine whether any occurrence is intrinsically good or bad. Only in retrospect do we start to uncover significance. That fable became my anchor.
On paper, I was succeeding in medical school. Before I even attempted Step 1, I endured a car accident that ruined my dominant hand. While studying and undergoing hand therapy, I managed to tie my shoes with my teeth. I collapsed while trying to lift a Styrofoam block. I dealt with lasting loss of feeling and dexterity. Nevertheless, I took Step 1 (in pain, under medication, unable to utilize my right hand) and I passed.
I went back to clerkships resolute to demonstrate my capabilities, and I succeeded. I received honors on my first, a high pass on my second, and positive evaluations throughout. Attendings labeled me proactive, attentive, and a valued team member. My accommodations: extended time, private testing locations, telemedicine flexibility, were sanctioned in writing under ADA regulations but were never enacted.
Instead, I was reminded of a regulation: students without “full motor function” might not fit in the program. And when I found it hard, professionalism came into play. Not as guidance. Not as remedial support. But as a sledgehammer. When I attempted to return, vague professionalism allegations supplanted due process. I was expelled, not for failing Step 1 or clerkships, but for “professionalism,” despite every evaluation confirming that I met professionalism standards across the board.
That expulsion was not merely academic. Like my hand, it shattered my sense of identity. Around that same time, my partner of six years terminated our relationship. He had envisioned a dual-income, stable household. With my uncertainty, financial burden, sorrow, and dismissal, I had morphed into more of a liability than an asset. It became overwhelming for him, and it was too much for me as well.
I do not hold him accountable, but it intensified the sorrow. Mourning someone still alive presents its own brand of torture. In some respects, it is more challenging than grieving those I have loved who have passed away. At least death provides closure. Ambiguous loss does not. It festers. It redefines you silently.
I was not merely losing my hand. I was not just losing my profession. I was losing the version of myself I believed I was cultivating, along with the future I anticipated sharing.
Psychiatry provided me with terminology for this.
Grief is not a linear five-stage journey. It is cyclical, invasive, and nonlinear. It strips away certainty and identity. It leaves you questioning: Am I broken? Am I resilient? Am I evolving? Or am I simply in denial?
Yet psychiatry also introduced me to post-traumatic growth, the paradox that loss, while heartbreaking, can also generate meaning.
In hand therapy, I discovered community. We laughed about Velcro shoes, griped about our splints, and wept over futures we were unsure we still possessed. That space, raw, unrefined, and human, felt far more authentic than any “resilience curriculum.” I realized that resilience is not about evading loss. It is about integrating it into who you are becoming.
Psychiatry exists in that ambiguous territory. It encourages us to hold paradox: fragility and strength, despair and hope, identity lost and identity reconstructed.
Reflecting back, my accident seemed like the worst thing that ever transpired to me. My dismissal felt the same. And my breakup, that was the most painful of all. Perhaps each was. Or perhaps not. Maybe, as the farmer notes, “Perhaps, perhaps not. We shall see.”
Because none of these events completely shattered me. Or perhaps they all did, and that may be the essence. They compelled me to mourn an old identity and start shaping a more authentic one. They educated me to exist in uncertainty, where meaning is slowly cultivated. And they reminded me that grief, though harsh, may also be psychiatry’s greatest educator.
Professionalism ought to foster growth. However, when it remains undefined, it morphs into a projection, a Rorschach test of institutional bias. For me, it turned into a weapon. And we cannot continue to lose bright, dedicated students in this manner. Not due to their inability to become good physicians, but because