Growing up, any opportunity to eat out was truly a luxury. We just didn’t have the money for it.

Occasionally on birthdays or a special trip, we would be treated with a big fish sandwich from Burger King, or my personal favorite, a $20 party tray of shrimp fried rice from the local Hong Kong Express takeout spot.

As trivial as these fast food places were, they were special because of how rare of an occasion it was.

A few months ago as a medical student on my neurology rotation around lunchtime, there was a woman in her 40s who was exiting a patient room and walked passed the staff break room on her way out. A pharmacy representative had brought party trays from Olive Garden for lunch that particular day, to which she commented on how us doctors are living the good life eating Olive Garden every day.

I thought the comment was silly and hyperbolized, yet I simultaneously resonated with the emotions behind it. The truth is: I was in a completely different situation than where I found myself nearly two decades ago. And I remember when having even the simplest things seemed like a luxury.

This moment was typical of the strange position I had begun to repeatedly find myself in — remembering my memories of growing up in a low-income household while making my transition to a high-earning profession.

If there were a single moment that could represent this tumult, it would be the day of my white coat ceremony and officially being cast into the role of “doctor.”

That day was an emotional roller coaster. It directly represented this internal struggle of mine that I would soon no longer be in such close proximity to a life of missing out on what so many others financially enjoyed.

A part of me was excited, yet a part of me could feel heavy guilt weighing down my psyche. I was soon to emphatically “make it” — to officially enter the world of being entrenched firmly into the financial middle class if not more.

During the day of my ceremony, I had the words of J. Cole’s “Chaining Day” running through my head:

“My chaining day. My last piece, I swear, my guilt heavy as this piece I wear.”

For me, my short, white coat was my “piece.” It was my symbol of tremendous achievements, of aspirations that once seemed unimaginable and simultaneously of worry and guilt that one day soon I would no longer be able to relate to the woman in the neurology clinic or scores of other patients I am to encounter that need me to understand the unspoken nature of their situation in a manner only experience could bring.

At times during medical school, more often than I would have liked, I felt out of place culturally and economically. I couldn’t relate classmates speaking of how their father played golf with billionaires, how their parents bought their younger brother in high school a new BMW or the elaborate thousands of dollar vacation they were gifted upon being admitted to medical school.

As I progressed through medical school statistics of what an average medical student looked like matched my everyday experiences.

Extrapolating data from studies breaking down the demographic profile of medical students, approximately 77 percent of medical students come from families in the top 2 quintiles of earning (>$74,870), 40 percent have a parent with a master- or doctorate-level degree, and 16 percent have a parent who is a physician.

As many institutions have just completed holding white coat ceremonies for this year’s batch of students, I remember once again the weight of the piece of clothing I wear. I hope to use this weight as a constant motivation to not forget where I come from. While I do my part in helping to develop more diverse medical school classes, I will continue fighting to hold on to all the parts of me that remember deeply what it means to not have and help that guide my practice.

Nasir Malim is an internal medicine resident and can be reached on Instagram @thedoctornas.

Image credit: Shutterstock.com