I could smell the greasy, fast food before I even reached for the door. As I entered the exam room, I caught her rummaging through her McDonald’s bag, then she quickly looked up with a big grin on her face. Without even a pause, she shoved a french fry in her mouth and exclaimed “Hi, Dr. Eisenberg!” Her T-shirt was taut over her pregnant belly, slightly riding up to reveal her chocolaty, smooth skin.

Sigh, I had reminded her before to not bring fast food into the office.

“It’s your patient. What would you like to do?” my attending asked. This question was not meant simply as a test of my knowledge; I was expected to give my opinion as a valued member of the team. A requirement for fourth-year medical students, my acting internship was more “intern” than “acting.” I worked alongside residents on the inpatient medicine service, calling consults, updating families and placing orders. There was one difference, however: all of my orders required an MD’s signature.

Buoyed by this safety net, I got a taste of the thrilling yet overwhelming influence physicians can have in the lives of their patients. Our everyday decisions regarding diagnostics, medications, and procedures can have profound consequences. In just a few years, I would have to make my own choices, without the safety net. I was and am aware that in some cases, the right decision could end up meaning the difference between life and death.

My first chemo was a year ago today. It had been scheduled to start eight months earlier, when I was first diagnosed with breast cancer, but I chose a different path and had hoped to avoid chemo altogether. My oncologist had initially recommended four months of chemotherapy to shrink the tumor before surgery, but he also mentioned that I qualified for a clinical trial that would use a pill for six months to cut off its estrogen supply.