Which is funny that I preface it like that, because I've felt that for most of my academic first year as a medical student, I've adopted a frame of chronological reference whose parameters are defined by which exam is impending, which has passed, which exam I ought to prioritize over the other, which exam is going to impede on my social life, which exam is going to be cause for celebration, which exam warrants indulging in 3 pints of Ben & Jerry's while I lay in fetal position on the ground with/without half empty bottles of wine.
And I start off this way not as a prelude to lecture anyone about "don't forget the little things," which is obviously important/implied. You should do your best to remain as human as possible. You are never too good to wish someone happy birthday just because you have to "study." You are never above calling your friends, or your parents, or whomever, just because you lead this taxing life of a voluntary education with the promise of career and are simply forced to learn about the wonderful and dynamic and evolving aspects of clinical and scientific medicine. All of those things, you should know. One year ago, you were (I was) a pre-medical student. Today, I am a medical student. Apart from chronic fatigue and more scrupulous financing, I have not changed. Or maybe I have, but I have made an earnest attempt not to compromise that person who began in August 2013.
Which leads me to the meat and potatoes of this entry. The other day, someone asked a very difficult, but also, very valid question. "How do you stay inspired?" And it's funny because, you constantly remind yourself that a medical education is a privilege, not a right. It's earned and not indiscriminately granted. And yet, we whine. We whine about everything. And I'm equally guilty of it. "It's hard. This class is hard. That exam was hard. Figuring out how to study is hard. Figuring out how to not get bored is hard."
And it IS hard. It is incredibly difficult to get up in the morning, for the 290th day in a row, and say, OK, today, I'm going to go to lecture for 4-6 hours, and pay attention, and then study what I hopefully paid attention to, and then self-assess and hopefully not feel like an idiot, and then probably get distracted, and then feel bad about being distracted, and then forcibly study some more, and then go to bed. And then tomorrow, I'm going to do that again. And the next day, I'm going to do it some more. And then I'm going to do it for 4 more years.
Because in the preliminary stage, what we learn is fascinating. But it is a lot. And it is challenging to varying degrees, regardless of your background. It is especially challenging if you do not speak with clinical ease just yet, or if the first time you ever saw a cell under a microscope was here, amongst some folks who have graduate degrees in the very class you're barely passing. That is very, very hard.
But what's harder, and in many ways, even more important, is remembering why you are here. Yesterday, I read a lecture...probably 3 times. And I just...couldn't. I didn't want to. And I know myself well enough to decide when to stop, when I'm too mentally fatigued, or whatever. But that wasn't it. I just couldn't see beyond the number, beyond the exam schedule, beyond the "number of questions per lecture hour." I couldn't see that I take this exam, and god-willing, I pass it. And then I progress to second year. And then third, and fourth. And then, I'm your doctor.
I'm your Doctor.
And I put away all of my notes, and my books, and I emailed an Attending EM Physician I met a couple years ago that spearheaded an outreach program I did in the Bay Area.
Perhaps it was the borderline-weepy-nostalgia, the flaring stress hormones, or my baseline hyper-somnolent insanity, but I sent her an email. I thanked her for her pipeline program, and for letting me volunteer for a year. I thanked her for all of the resources she provided to my Ambassador Program in Oakland, and for the residents, Clinical Faculty, and even the life coach she brought in. I rolled my eyes back then..."I don't need a life coach." (I totally needed a life coach). But what she did was so remarkable. She took 30 or so students-pre-med, postbaccalaureate like myself, some allied healthcare professionals- most of which were lacking the grades, or the income, or the confidence to successfully apply to medical school-and she showed us how to fish for ourselves. How to take information at the clinical level and disseminate in the community with efficacy and empathy and cultural awareness. How to remember to be functional human beings, not robots, when we taught sexual education at the East Oakland Youth Development Center. She taught us that, for every person that tells you "no"...there is always at least one person who will say yes. Above all else, that person should be you.
Today, she responded. On a logistical networking level, it stressed the importance of keeping contact with those that have helped form the person you are today. Polite exchanges of words aside, it facilitated a conversion about contacting her when the time came to complete a rotation, something that, at Highland General Hospital, fills up very very quickly and is first come, first serve at the "discretion of the Director of Medical Education" (UCSF students often get priority, as the elective calendar is affiliated with their institution). So for this, I am very very grateful.
But in our conversation, what struck me most was less of a prospective "favor" and more of what she opened with. "Of course I remember you. It makes me so happy to see MIMS Alumni with stories of inspiration to share with others."
And it's funny, here, in my frequent self-pitying or self-induced chaos that I remember, this is exactly what I wanted. It's what I hoped for. And this exam, this passing of time dictated by Test XYZ, that's not what I'm living for. It's essential, and it's an objective measure of competancy, but those aren't what I live for. I live for moments where I can say,
"Hi, I'm your doctor."
And in my weird, naive fantasy, I can shake Dr. Garrick's hand on rotation, and even if I never step into the Alameda County Medical Center again, I can truly say "Thank you", because it set a precedent for the necessary diligence of my future. I wasn't complacent then, and like others, I am tired, but I am not complacent now.
To close, I thought it would be nice to share with you something that, maybe during it's inception, a lot of us hated. When I wrote my personal statement, I was actually just arriving to the 24 Hour fitness in Hayward, CA. And it was about 20 minutes into the elliptical that the words just came to my head. And I ran, and grabbed my bag, and marched over to the Starbucks next door. And 3 hours later, I had my personal statement. I take a lot of pride in my writing, not because of any sort of verbal finesse, but because I write exactly how I speak...honestly. My personal statement was just that, personal. And on occassion, I read it, to remember why I get up, why I wouldn't trade any of this for anything else. Even today. Even on June 6th.
AACOMAS Personal Statement
No
rehearsal could desensitize me from that utter exhilaration-a pulse-racing,
electrifying elation consuming me every time a curtain rustling in darkness
gave way to rising colors of Fresnel lights and, as is often the case in
musical theater, cheers and applause preceding Act One. I pursued drama with an
intention of metamorphosis-to evolve as a storyteller
and therein a healer. Whether I was Rizzo in Grease, director of Hairspray or a
fly-system-pulling lowly production assistant, I had an appreciation for the
social responsibility of actors. Thespians may assume a show revolves around
their talent or reward in recognition but in reality, it’s about enabling an
audience to recognize themselves in you. I was attracted to a dynamic,
comprehensive aspect of drama: projecting a social x-ray of a world on stage
where players enlighten viewers to problems of a people outside.
But it was the ephemeral nature of theater, a performance here and gone, that left me thirsty to make a more tangible impact in perhaps another avenue. Coming home from late rehearsals, I often encountered my roommate Lauren absorbed in a biology textbook, toiling upon an arduous pre-medical path. I knew little of healthcare and initially avoided sciences like the plague, preferential to singing and dancing, knowing my GPA was safest where I was gifted. It was one Uncle Vanya dramaturgy meeting that gave a final impetus to leave the familiar, where I learned the playwright Chekhov was both physician and dramatist, equally passionate in both disciplines. I was inspired by the way Chekhov's work as a doctor enriched his writing by bringing him into intimate contact with all parts of Russian society; how he reflected health disparities witnessed firsthand among peasants in his stories. The parallels between actors and physicians as entities in a unique place to use their credibility, advocacy and talent to oversee community wellbeing seemed irrefutable; I dove into a slew of prerequisites, resolved to cultivate a new, almost accidentally, realized dream of medicine.
A near-cliché embodiment of starving artist, my goal was not without the difficulty of financing it. Undergraduate years were spent striking balance between competing obligations of schoolwork and paying tuition while contributing to the income of a single-parent household. Imposing an unrealistic deadline on my dream-impacting my schedule only to yield subpar results-caused my grades to fall. I saw a need to divert attention to academic aptitude versus overwhelming work hours, even if I had to surrender what little control I had over financial security. Living out of the backseat of a Hyundai parked behind Albertson’s to save for summer school proved impressively uncomfortable, if not mildly demoralizing. Examination of my transcript after graduation put priorities into perspective; I had graduated but not excelled, demonstrated competency, not competitiveness. As a post-baccalaureate student, I attenuated study habits and focus to meet demands of rigorous science while clinical immersion and experience as an EMT, ER Scribe and community health outreach educator in Oakland provided ways to cultivate hands-on skills and affirm a passion for healthcare. Even more insightful were similarities observed between a theater and the clinic; just as the stage manager needs rapport with a costume or lighting designer to create a cohesive production, so does the physician need collaboration with a pharmacist or nurse for thorough treatment.
Medicine is a gateway to supporting human rights, and raw theater the platform that ignited consideration of the reality of human suffering. Scenes may add an insightful dimension of ethics that textbooks do not afford, but my pursuit of medical education can actuate a dream of alleviating pain in ways less transient than a show’s run. Translating the faculties of trust-building, collaboration, improvisation, and leadership used in Drama to a seemingly disparate field of medicine makes me a more capable physician, using specialized skills to defend the voices of the vulnerable, those marginalized in healthcare. My journey to medicine may be unorthodox, pursuing many auditions with infrequent call-backs or confronting skepticism in my ability. But what was perseverance for securing greater roles and thus, a greater chance to inspire those who came to listen has since fueled a relentless tenacity in becoming a Doctor of Medicine, finally ready to take center stage.
But it was the ephemeral nature of theater, a performance here and gone, that left me thirsty to make a more tangible impact in perhaps another avenue. Coming home from late rehearsals, I often encountered my roommate Lauren absorbed in a biology textbook, toiling upon an arduous pre-medical path. I knew little of healthcare and initially avoided sciences like the plague, preferential to singing and dancing, knowing my GPA was safest where I was gifted. It was one Uncle Vanya dramaturgy meeting that gave a final impetus to leave the familiar, where I learned the playwright Chekhov was both physician and dramatist, equally passionate in both disciplines. I was inspired by the way Chekhov's work as a doctor enriched his writing by bringing him into intimate contact with all parts of Russian society; how he reflected health disparities witnessed firsthand among peasants in his stories. The parallels between actors and physicians as entities in a unique place to use their credibility, advocacy and talent to oversee community wellbeing seemed irrefutable; I dove into a slew of prerequisites, resolved to cultivate a new, almost accidentally, realized dream of medicine.
A near-cliché embodiment of starving artist, my goal was not without the difficulty of financing it. Undergraduate years were spent striking balance between competing obligations of schoolwork and paying tuition while contributing to the income of a single-parent household. Imposing an unrealistic deadline on my dream-impacting my schedule only to yield subpar results-caused my grades to fall. I saw a need to divert attention to academic aptitude versus overwhelming work hours, even if I had to surrender what little control I had over financial security. Living out of the backseat of a Hyundai parked behind Albertson’s to save for summer school proved impressively uncomfortable, if not mildly demoralizing. Examination of my transcript after graduation put priorities into perspective; I had graduated but not excelled, demonstrated competency, not competitiveness. As a post-baccalaureate student, I attenuated study habits and focus to meet demands of rigorous science while clinical immersion and experience as an EMT, ER Scribe and community health outreach educator in Oakland provided ways to cultivate hands-on skills and affirm a passion for healthcare. Even more insightful were similarities observed between a theater and the clinic; just as the stage manager needs rapport with a costume or lighting designer to create a cohesive production, so does the physician need collaboration with a pharmacist or nurse for thorough treatment.
Medicine is a gateway to supporting human rights, and raw theater the platform that ignited consideration of the reality of human suffering. Scenes may add an insightful dimension of ethics that textbooks do not afford, but my pursuit of medical education can actuate a dream of alleviating pain in ways less transient than a show’s run. Translating the faculties of trust-building, collaboration, improvisation, and leadership used in Drama to a seemingly disparate field of medicine makes me a more capable physician, using specialized skills to defend the voices of the vulnerable, those marginalized in healthcare. My journey to medicine may be unorthodox, pursuing many auditions with infrequent call-backs or confronting skepticism in my ability. But what was perseverance for securing greater roles and thus, a greater chance to inspire those who came to listen has since fueled a relentless tenacity in becoming a Doctor of Medicine, finally ready to take center stage.
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