There was a point, this past summer, of no return. I’m not quite sure when it hit me. Perhaps it was as I skirted Cambridge Common on the way home from my night lab section, praying I wouldn’t end up like that kid they told us was mugged last summer as he wandered through the park at night. Some part of me doubted the truth behind the mugging story, but it certainly worked to frighten us into using the buddy system or darting from shadow to shadow around the outskirts of the Common until we reached the safety of our dorms. Perhaps it was as I lay strewn across the bed in my tiny off-campus dorm—off-campus because I hadn’t been clever enough to conjure up a dust allergy or severe asthma like my friends had in order to get the much nicer, on-campus, air-conditioned, medical housing. Or perhaps it was after the fourth or fifth grueling “midterm,” a complete misnomer for a test administered every week (and certainly not in the “middle” of any “term”) of my seven-week program rom Hell. I am convinced that if Satan were to take human form, he would make his lair in the depths of the Harvard Science Center.

What seven weeks of organic chemistry at Harvard meant was that I was committed—I was going to medical school. It was implicit in my parents’ decision to fund my foray into chirality and carbonyls. While it now seems ridiculous, I didn’t make the connection that this also meant that I was committing to becoming a doctor. There’s some disconnect in my mind between pre-med classes and actual medicine, maybe due to the lack of applicability of much of what we learn to what we pre-meds think of as “real medicine.” It wasn’t until I was actually at Harvard, lying on the bed in my dusty, allergen-infused dorm, that I realized that I had made a decision about the next decade of my life.

This threw me into a sort of quarter-life crisis. I spent endless hours staring at the wall in the Starbucks that I’d made my home-away-from-dorm-away-from-home, wondering if this was the right choice. I bought every clichéd “book that made me want to become a doctor,” by everyone from Atul Gawande to Abraham Verghese, devouring them in search of clarity. I think I was waiting for some tiny, imaginary being to pop up out of the pages of each book and reassure me: “you are making the right decision.” I ended the summer six seasons of Grey’s Anatomy and one Harvard report card richer, firmly set on doing my parents proud.

After two months of focusing on nothing but the journey to medical school, returning to Dartmouth meant being plucked from my little world of big dreams about the future and dropped haphazardly back into reality. Suddenly, the other facets of my life came back into play; most importantly, I jumped back into my role in the sustainability community. I spent all of freshman orientation working for the Sustainability Office, surrounded by people who were much more passionate about climate change than curing cancer.

I’ve always considered myself an environmentalist—I grew up along some of Illinois’s last remaining old-growth prairie, the vestiges of the majestic, sweeping grasslands that used to blanket the state. I still have vivid memories of dashing through the bluegrass so tall that it hid my entire body from view, pulling up flowers of violet, scarlet, and gold to wear in my white-blonde hair. I could not help but fall in love with the land so essential to creating the person that little blonde girl grew into. One afternoon back at Dartmouth I was getting coffee with a friend. We were discussing how modern medicine essentially fights nature, messes with the natural order of things. As I let this seep in, I came to realize that by committing myself to medicine I was playing into the system—every life that I might someday help would be one more life that our planet could not support. I brought it up to her, hoping for some sort of reassurance, for some indication that this choice was justified in the face of disease and suffering. Fishing for validation, I conceded a bit.

“I know; I’m part of the problem.”

“No,” she corrected, “you are the problem.”

The painful, lying-awake-at-night part of all of it is that she was right. Medicine’s whole pursuit is counter to what is natural; it saves people that nature would have let die. It aids the weak, lengthens the lives of the old, and brings people into this world that nature did not intend to let live. Our growing knowledge of medicine is the driving force behind our unsustainable population growth. I could not accept that, by wanting to help people, I was only going to hurt people in the long run. It left me distressed, confused as to how I was someday supposed to make decisions not only about the life and death of people, patients, but about that of the planet as a whole.

I often wonder why this isn’t something that everyone is talking about. Am I the only one who is consumed by panic when I think about what we are doing to our planet, what we are doing to our future? I know that I’m not. But I am also no longer afraid, no longer too timid to voice the fact that we're on a one-way road to ruin. Our planet cannot sustain what we are forcing upon it, but still, we march on. Fear drives us to keep our mouths shut. How can I become a part of something that will only destroy us in the end?

I wish that I had the answers. I wish that I could end this with the same commitment to my path that I ended the summer with. I see the beauty in medicine. But I cannot help but see how it may also be our destruction. I want to save the world, but I cannot decide which I want to save more: the world, or our world. I think what frustrates me most is that human nature does not seem to want to let these two worlds coincide. We cannot live on a planet without exploiting it, without turning it to ash. Our collective failure to see the consequences of our actions, and my inability to resolve them internally, leaves me wondering if I have made a grave mistake.

I know that someday I will return to wander the streets of Cambridge, maybe even while visiting for a medical conference a decade from now. It will remind me of the passion I felt that summer, of the joy I harbored in knowing that I was going to become a doctor. Yes, this passion was blind. But the acknowledgement of this blindness has committed me to an even greater cause. I will find a way to make these two parts of myself work together, to save both the world and our world. If I am to go on, to wake up each morning and be proud of the path I have chosen, I have no other choice. As I wander through the Commons, past the Science Center, and down to the river, I will know that giving up is not an option.