Kindargarten, 8th grade, high school, college, medical school. Today is graduation day #6 for me and probably #7 or higher for many of my colleagues who have also completed masters programs, PhDs, and perhaps even another career altogether before embarking on a life in medicine. It is unreal to think that three years have passed since graduating medical school, a memory that is still fresh, that still warms my heart and brings a very wide range of emotions to my heart. Likewise, graduating from residency is another stepping stone, and so many different feelings are flooding the day.

It has been a challenging three years. Between the lack of sleep, the broken healthcare system and the countless impediments to giving all of our patients everything they need, the social work issues (oh, the social work issues!!!), the in-service exams, the didactics (afternoon delights, M&Ms, Grand Rounds, Monday/Friday schools, ICU reports, journal clubs, and beyond), the crazy call schedule changes, the clinics, the EPIC systems and EPIC failures, the moondogging/pitbossing/Apollo-ing/knightriding/clouding, the low wages that qualify us for some percentage of the poverty level, and the MKSAP questions that will continue to haunt us until the end of August, one might think we’re all a bunch of crazy people for choosing this as a career. These past three years have certainly been the hardest of my life.

But they have also been the most amazing. They have been the most rewarding. They have been the most life-changing. And they have been the most bearable because of the people I see and work with every day and night: my co-residents, my colleagues, my friends, my mentors, my teachers, my rocks. I think we all will forever remember every minute of this adventure, starting from residency orientation and being out when the sun rose, to the quaint graduation ceremony this evening, and everything in between. What makes it all the more memorable is the city we live and work in. Every work memory is tied to New Orleans, and every joyful experience is flavored by the city’s charm and culture. “Winter” BBQs at Wiese’s, too much king cake consumed between January and February, Thursdays with the Soul Rebels, Tuesdays with Rebirth, Frenchmen Street, backyard journal clubs, potluck dinners and Wild Turkey for the dishwashing, festival after Spring festival, parade after parade, Mardi Gras costumes, hurricane Isaac, flooded streets, water boil advisories, dudes in red dresses, roller derby girls with wiffleball bats, white linens and dirty linens, party buses, conferences, beer duels, RETREATS!, Gulf Shores, broken tables and broken glass by the pool, impersonations, new dance crazes, karaoke nights, the Gold Mine, Saints games, Bulldog glasses, koozies for A.E.’s Dr. Pepper at work, post-call team drinks, streetcars, brass bands, “towards the river” and “towards the lake,” beads in the Oak trees, Mid-City Eating and Drinking Club, stolen kayaks, burnt down cars in the parking garage, the Matrix, it goes on and on!

Not to mention all the food and drinks (and subsequent pounds) that New Orleans introduced to me: red beans and rice on Mondays, catfish on Fridays, gumbo, jambalaya, crawfish boils, crawfish etouffe, king cake, doberge, bread pudding, pecan pie, fried chicken, boudin, oysters, blue dot donuts, dat dogs, mango freeze, Angelo Brocato’s desserts, creole creamery ice cream, muffulettas, pralines, po-boys, beignets, sno balls, purple drank, daiquiris, sazeracs, hurricanes, mint juleps, Pimm’s cups, absinthe, and of course Abita!

And then of course, all of our significant life events: engagements, weddings, new births, new pets, job acceptances and fellowship matches, and sadly a few losses. Through it all, we have stuck by each other, celebrating and comforting, congratulating and consoling. I had a pretty good idea that I belonged at Tulane when I matched here; it is 100% obvious now that we all belonged here, together for a common goal, in love with a common ideal. Congratulations Tulane Internal Medicine 2013, you have made the past three years of residency wonderful, exciting, invigorating, and happy. When’s 4th year retreat?