Just Passing Through: On Training, Transition, and Everything that Doesn’t Last

In just a few short weeks, I’ll finish fellowship. It’s not my first goodbye — far from it. But it’s the first one that might be my last. The last rotation. The last ID badge with an expiration date. The last institutional email address that will vanish the moment I step out the door.

Then again, maybe not. I’ve done this enough times to know better.

For the past six years, I’ve been in training. Which means I’ve also been leaving — constantly. Four major moves, three different states, countless rotations, and more logins and locker combinations than I could ever remember. Every space was temporary. Every system required re-onboarding. Every community came with an asterisk: not yours, not forever.

That’s just how training works. We are a profession built on transience. You adapt quickly. You learn which bathrooms are cleanest, how to label your samples so they don’t get lost, which attendings want you to speak up and which don’t. You settle in fast, because you won’t be there long. And eventually, you learn to stop unpacking fully — not just your suitcase, but yourself.

Some things I expect to miss — the bespoke patient care at the NIH. The way consults end with research questions, not billing concerns. The handful of people who made the day easier, who made you smarter without making you feel small.

Other things I won’t miss at all. That’s part of it, too.

But the grief that sticks with me isn’t always about the work.

It’s the friendships that faded after the group chat went quiet.

The cities I never really got to know.

The long nights trying to decide what to throw out, because it wouldn’t fit in the moving truck.

The Dresden doll from my grandmother — broken in one move.

The journals I kept when I was 15 — lost in another.

The people I was in those places, with those objects, doing that work — gone, or at least out of reach.

I’ve spent six years learning how to leave. Sometimes gracefully, sometimes frantically, always carrying a little less than when I arrived.

But for all the things I’ve lost, some things stayed.

A few friendships, kept alive through effort and luck.

A favorite pen.

A writing ritual.

The conviction that my voice matters, even in rooms that don’t expect to hear it.

That’s what transition teaches you, if you pay attention: how to find meaning in borrowed space. How to build a life in 4-week blocks. How to say goodbye before it feels finished. How to carry forward what matters when most of it can’t come with you.

This next move — to a faculty job, a new home, a place with no scheduled end date — is supposed to be permanent. But I’ve lived enough life in medicine to know that permanence is a story we tell ourselves to feel safe.

I’ve moved too many times to believe in permanence. But I believe in showing up — even when the future is uncertain. So I’ll show up. I’ll care. I’ll build something worth keeping, even if I might have to let it go.