My Identity Crisis

“We are sorry, you did not match into any position.”

I had stepped out of the cardiac intensive care unit just a few minutes before noon, searching for a peaceful place where I could find out if I had matched into a hematology/oncology fellowship. I found an isolated corner in the hospital, feeling anxious as I accessed the NRMP webpage. As I refreshed the page at noon, a wave of emotion washed over me as I read the words: "We are sorry, you did not match into any position." Despite all the effort I had put into reaching this point - 4 years of medical school, 5 years obtaining a PhD, and 1.5 years in residency - I never thought this would be the outcome. This unexpected crash after 10 relentless and devoted years towards becoming an oncologist effectively laid waste to my dreams. I had never felt such intense disappointment or failure as this moment brought upon me. In the days and weeks that followed, I did think about why I had not made it into fellowship this year, but I also deeply pondered why I was so strongly affected by this setback. More specifically, it compelled me to ask questions about how much of my identity was based on what I do rather than who I am.

During my years as a PhD student, I was fortunate to be mentored by some of the giants in the field of cancer immunotherapy. Most notably, my doctoral mentor was Drew Pardoll, someone I admired deeply for his profound sense of purpose and drive to cure cancer, and who is credited with multiple breakthroughs in the field of cancer immunotherapy. I remember early on in my PhD, I had asked him the question: "What does it take to become Drew Pardoll?" Over the years, as our relationship grew, he came to answer this question in a very real and meaningful way. While Drew's story is crowned by some of the largest successes in our field, there were decades of struggle and perseverance that are often not appreciated in his journey. He ultimately became my role model, and I dreamed of following in his footsteps and leaving a legacy such as his.

Throughout the coming years, I found that my identity was becoming increasingly founded in my successes, accomplishments, and contributions to the field of cancer immunotherapy. As I was invited to give oral presentations at some of the largest national conferences in the country, had multiple manuscripts accepted in prestigious journals in the field, and became a rising expert in the use of artificial intelligence in cancer immunology, I poured more and more of myself into this identity. It was a source of pride and fulfillment, and I was driven to achieve more in order to maintain and enhance this sense of self. I came to realize that this identity, based on these external factors such as my career achievements, was not sustainable or healthy in the long term. This realization was brought into sharp focus when my world seemed to crumble upon failing to match into fellowship. It forced me to go back and re-examine what I so admired about the legacy of Drew Pardoll. As many will tell you, Drew is not only a brilliant and visionary leader in the field, but he is also one of the most personable and loving people you will ever meet. His legacy will be so much greater than his accomplishments in the field of cancer immunology, but instead, will reverberate through the relationships he has built over the decades of his career. My admiration for Drew goes beyond his contributions to the field; it is in who he is as a mentor, and more importantly, as a friend. This realization gave me a moment of clarity, reminding me that while it is noble to pursue great things in our careers, our sense of identity is best rooted in who we are and the relationships we surround ourselves with. And it is within relationships, where we can find a stable sense of purpose and meaning.

As someone who desires to continue to pursue a career in the field of cancer immunology as a physician-scientist, I have come to terms with the reality that my career will be filled with more failures than successes. The problem of cancer is not an easy one, and science is a difficult pursuit. Often, being successful in science is influenced by many factors beyond our control, such as luck and good fortune. And while hard work and dedication are certainly important, they do not guarantee success. With this in mind, I know now that being able to continue forward in such a career will require a radical shift in where I ground my identity as a physician, scientist, and ultimately, a person. This shift is not only important for finding a stable sense of purpose and meaning in my own life, but I truly believe will prepare me to withstand the inevitable challenges and setbacks that will surely come in my future career as a physician-scientist, hoping to advance the care for cancer patients. By finding my identity in deep and meaningful relationships, I will not only be better equipped to handle the ups and downs of my career with resilience and grace, but I will be a better scientist, physician, and happier and more fulfilled human in doing so.