By Deena Gifford, MD

It took four tries, but we synchronized the newest episode of Outlander perfectly. Just outside of Philadelphia, I’m watching the same scene in lockstep with my best friend, Corinne, one thousand miles away in St. Louis. We make all the same faces in response to the dialogue. We roll our eyes together when someone dares to suggest that Claire won’t be able to heal someone who’s sick.

“I’ll honor you until my dying day, Claire,” Jaime says in his sexiest Scottish voice.

“He can honor me any day,” Corinne mutters over FaceTime.

We giggle like teenagers, just like we used to in college, watching reality TV until late in the night instead of studying for our lab presentations, and the ache that constantly lives inside my heart swells.

There was a time, not too long ago, when we were sitting together on the couch. I would throw my bag down on the kitchen table in our apartment and tell her everything that happened to me that day. We would exchange juicy gossip as we boiled pasta together. Today, I have everything I ever hoped for. I have a nice home where I live with my adorable husband, and three kids who look just like him. My husband listens to my stories, and my kids make me belly laugh constantly, but I miss my friends.

I’m not talking about friends in the general sense of the word. I have friends. Great friends. I get invited to parties; I drink wine and gossip at barbeques. My kids run around and catch fireflies in neighbors’ backyards, but those aren’t the friends that I mean. What I’m referring to are the friends who know the name of every boy I ever kissed. The kinds who know I have a stuffed dog named Mutsy that I’ll never give up. Friends who pick up the phone at two in the morning because they know I’m driving home from a shift and I’m so tired I might crash into a tree. The types of friends who I’ll never have to explain my hatred of country music to.

Because there are friends who know you, and friends who have grown with you.

When we graduated from college, my two best friends and I followed each other to the same medical school. Of course, we did. I don’t know if I would have survived those four harrowing years without them. Other med students knew we were inseparable from the start, nicknaming us the Trinity. We added some others into the group along the way, but Match Day sent us in different directions. Studying to become physicians had irrevocably bonded us together, but in the end, our careers tore them away from me.

I stayed in Philadelphia with my husband for pediatric residency. Liz moved all the way to Chicago with her fiancé. Corinne eventually moved to St. Louis to be near her new husband’s family. Suddenly my inseparable, core group of friends went from living in the same eight-hundred-square-foot apartment to inhabiting a thousand-mile triangle.

I was the first of us to have kids while they were finishing residency and fellowship. I met my first “mom friends” when we moved to the suburbs—the ones who commiserate over missing baseball gloves, snap photos for you at Halloween parades, share a charcuterie board to celebrate fall break. My new friends—my grown-up friends, as I like to call them—are my rocks. They build me up when I try something new, encourage me, send updates when I can’t make it somewhere if I’m late seeing patients. It just feels strange that there were so many versions of me they never knew. My new friends didn’t know me in my emo artist phase. We can’t laugh about the time I tried to dye my hair red, and the box dye turned my head orange.

They weren’t there in my formative years, but when do our formative years end? To be honest, I don’t feel fully formed, and I wonder if I ever will be.

Eventually, all three members of the Trinity had children of their own, and between the three of us, we have ten kids now. As the pediatrician in the group, I still get the middle-of-the-night frantic text messages about poop color and how to suck snot, but it never feels like an annoyance. I long for these updates. Wish I could go back to a time when I knew everything going on in their lives, and that Liz will still text me a picture of her baby’s growth chart makes me feel like maybe I have that again.

What can we do as we get older, and our friendships change? Our childhood friends had memorized our phone numbers. Our college friends knew to wish us good luck when we were studying for our biochemistry finals. Medical school friends and residency friends are like no other—nobody can understand the sleepless nights, the terror of being grilled on rounds. I think the best thing we can do is hold on to the ones that transcend time, the ones that have watched us grow and stuck with us. Even though the space between us has grown, we’ve allowed the distance to strengthen us.

I think the key is to hold on to those moments that formed you, the ones that formed your friendships. Allow yourself to watch the same television show from a thousand miles away. Instead of being sad that you’re not on the same couch, be happy that you’re still in the same place.

Deena Gifford is a pediatrician.