Yesterday morning, my first full day back home post-fellowship, I took a steaming hot shower for the first time in two months. I exfoliated, I washed my hair with coconut-scented shampoo, I shaved, I scrubbed in between my toes. And – I’ll admit – I just stood there under the hot water and inhaled the steam that swirls around the bathroom when the water is hot. It felt like an outside layer of skin melted off my body and slipped down the drain. For me, this is how reverse culture shock feels. It’s like a metaphysical shower or a snake shedding its skin in one, beautiful, uneven piece. It’s a physical separation from a suddenly disembodied experience, an experience that was and absolutely is transformational and central to my life.Driving home with my dad from the Toronto airport, familiar things looked a little different around the edges, like when you have your contacts in backwards. Inside the car, my dad had brought me an entire platter of raw vegetables (No 20-year-old woman has ever been so thrilled to eat raw celery by the handful). It seemed to be washed and pre-sliced and wrapped so excessively. On the drive home, I caught myself answering questions using phrases like this experience “has been,” instead of “was.” Outside the car, the roads looked so empty, so green. No one was in the street… no people, no animals, no bikes. Cars drove so silently in their separate lanes that we could’ve been alone. The silence felt deafening. I got home and filled my favorite water bottle with tap water. Yesterday, for the first time in two months, I put on makeup. I put on jeans and a sleeveless shirt. I put back on the ring I wear every day but haven’t seen in two months. I put back on my Fitbit. I went to the eye doctor and got a new contact prescription. I got my eyebrows done. I pulled the power converters off of my chargers and manually changed the time on my computer because it couldn’t figure out quite where we were. At times, it all feels luxurious: reuniting with family, friends, and the comforts of home (hot water, A/C, and wifi, a group one of my Indian friends referred to as “the holy trinity”). But, at other times, reverse culture shock is tangible and confusing and uncomfortable in unexpected ways. Things feel superficial, frivolous, and impersonal. It feels like returning to a physical skin, except that my “self” feels different in frustratingly unexplainable ways. India was, in many ways, very lonely for me. It was the first time I’ve ever been truly “alone.” I went to U-M without knowing a soul, I studied abroad in France last summer, I’ve spent time by myself, of course, but I’d always been in a bubble of my own culture. While I consider myself very independent and love that my country has instilled this value in me, I also really value social connection. Having no one who could really relate to my experience in India was lonely and challenged me in a new way. I grew more introspective and fell in love with how warm and welcoming the Indians I met were. While I felt alone at times, I also felt like everyone I encountered was family. People hustled and bustled through the streets as one, every activity was a trial in teamwork, and family was the root of everything that didn’t end with biology. The USA is lonely in a different way. I look out my window and see no life. I walk down the street and – if anyone else is there – no one is talking outside the people they’re with. You stand in line 2-3 feet behind the person in front of you and avoid eye contact. You can grocery shop for everything you possibly need and more in one stop and get out with zero words. The only animals I’ve seen are my pets. Car honks mean anger. Everything is so big and spread out. And, everyone is so privileged. How is it that five-year olds get pedicures on the same planet where they run around without shoes? These are all things I knew about the US before leaving, but they feel foreign and our privilege feels increasingly repulsive. Living and breathing and experiencing a new and vibrant culture alone was the single most empowering, terrifying, rewarding, challenging, lonely, gratifying thing I have done in my life. I want to avoid rambling into a cliched “I’m so blessed" sermon, but I’m heading back to Ann Arbor on Thursday feeling so much gratitude that I get to attend such an incredible university, challenge myself academically, and push myself to achieve. For much of my experience in India, I struggled to navigate how to respond to essentially winning the lottery of privilege and the associated sense of "survivor's guilt" I feel. Reflecting, I recognize that simply rejecting my privilege here in the US is irresponsible. Instead, I’m returning to school feeling an intense obligation to use it by working hard and speaking up. During my time in India, I saw firsthand the ways that sociocultural and economic factors shape lives and healthcare. Now, I know with increased clarity that I want to use the resources I have to become the most stellar physician I can be and the voice that I have to advocate for socially-aware and culturally-sensitive healthcare. India shaped and changed me in ways that, just two days back, I cannot understand. For now, the best I can say is how overwhelmingly grateful I am for this life-changing experience.