David Liu had it made at age 26.
With a degree from Stanford, a fun job designing software for Amazon.com and a big raise on the way, he lived an enviable life. A question nagged at him, however. Could he really feel he'd done something significant after a day spent perfecting the experience of online shopping?
"What I really care about is helping people," he said this week, seven years after deciding that the answer to his question was no. "It sounds trite, but it's that feeling of coming home at the end of the day and knowing that you've done something important."
The search for meaning brought him to medicine, a field he had run away from while growing up in a Los Angeles suburb as the son of a surgeon.
On Thursday, Liu and 96 peers at the Johns Hopkins University School of Medicine waited nervously to find out where they would begin their residencies in the fall. Across town at the University of Maryland School of Medicine, 153 students awaited the same big news. Thousands of medical students across the country would have their fates revealed to them at the stroke of noon — a ritual known in the field as Match Day.
Liu, now 33 with flecks of gray in his hair, was hardly alone in following a crooked line to the moment. At both Hopkins and Maryland, dozens of students tried something else (and often succeeded at it) before beginning the long and arduous path toward becoming doctors.
"I think it's a generational ethic," said Lisa Patel, a classmate of Liu's at Hopkins who studied forestry at Yale and directed water and sanitation projects in India before entering medical school. "It used to be that you would pick something in your early 20s and just do that forever. But our attention spans aren't long enough for that."
Patel and Liu expressed few regrets that they won't begin their post-residency careers as doctors until they are nearly 40 — more than a decade after friends settled into career and family routines.
Like many of her career-changing peers, Patel ended up in medicine because she craved the feeling of helping people directly. "I would go to these small villages," she said of her previous environmental research, "and people would say, 'What are you going to do to help us.' And I'd be like, 'Oh, I'm going to write a paper.' It felt horrible."
She compared those experiences to a two-month clinical rotation in Zambia this year, where she worked under a Hopkins-trained pediatrician who had eradicated malaria in a rural village. "That's what I want to do," she said. "To settle down in an underserved community and do preventative health. That made me feel that all of this has been worth it."
About half of medical students at Hopkins spend at least a year doing something else before beginning their training, said Thomas Koenig, associate dean for student affairs. In fact, the school hunts for students with rich life experiences.
"They bring a real commitment and maturity because they have tried something else and realized it just wasn't here for them," Koenig said, tapping his heart.
Nancy Lentz, who waited out Match Day at Maryland, recognized medicine was her true calling — and knew it came too soon.
The Bolton Hill resident enrolled at Harvard Medical School after she graduated from Hopkins in 1994 but dropped out in her second year.
"I went for about a year and a half before I felt I needed to have a life," the 38-year-old Wisconsin native said. "I needed to learn some things I wasn't going to learn in medical school."
She spent a decade teaching at private schools in Boston and Baltimore, including Roland Park Country School. But she began to get restless. Then, when Lentz was about to turn 33, a friend told her to give herself a present and take a look at some medical school websites. She fell in love with the idea of medical school, and particularly Maryland.
But it wasn't easy. Lentz gave birth to her daughter, Carmen Sofia, in November of her second year. For weeks, she had to catch lectures on the web in the two-hour gaps between feedings.
Being a parent and teacher has really colored her approach to patients, Lentz said. She definitely respects the time and effort required to get a child to a doctor's appointment, for example. "This is very stressful if you're a working parent," Lentz said.
Her daughter was there Thursday to help open the envelope revealing her match: internal medicine at Duke, her first choice. Lentz hopes to pursue a cardiology fellowship there.
Lentz and her classmates collected their envelopes at Davidge Hall, the oldest medical teaching facility still in use in North America. When their names were announced, they came down one by one to individually selected tunes, including the theme song for "The Price is Right" and "I Wanna Be Sedated" by the Ramones.
Each also dropped $5 into a University of Maryland piggy bank, and the pot was collected by the last student whose name was called.