One of the Most Difficult Pieces to Write ...

Lately, two very simple words have put me on edge and made me anxious in ways that not many words do ... one wouldn't think that writing a "personal statement" for my residency application would be so cumbersome and unwieldy, but believe me, it can be! I struggled with my angle and started probably three or four different versions this past weekend ... and here is what resulted from my chicken scratches. Feedback is most welcome! Thank you in advance for reading --- it's a rather long post!

On my desk sits a faded sepia photograph beginning to curl at the edges, the black cardboard on which it is mounted torn at the corners. In the basement classroom, five men stand primly behind a metal table with their hands folded gently on the exposed cadaver stretched before them, illuminated only by gaslight. Two women in floor-length dresses and white lab coats flank the men; the one on the right reads from a dissection text, and the one on the left, a short woman with a gentle expression, studies the feet in front of her. The lady to the left is someone I never had the pleasure of meeting, but I remind myself fairly often that if she survived training to be a family doctor in the early 1900s, I can surely do the same nearly a century later. Dr. Forrest Odessa Phillips was one of three women in the Hahnemann Medical College Class of 1910. I know of her only through her daughter’s stories, remembrances of my great-grandmother.

No one since in my family has entered medicine until I came along --- announcing to my relatives at the age of four that I planned to become a doctor, simply because I had received a toy stethoscope, thermometer, and reflex hammer for Christmas. I am the product of multiple influences, largely due to my family’s unflagging support. My mother, on a rather fortuitous whim, enrolled me in the local 4-H club as a child from which sprung my interest in leadership, service, and being connected with my community. With my two younger sisters in tow, we camped our way through nearly all of the continental states by the time I graduated high school, instilling a sense of independence and a genuine ability to respect and interact with people from different backgrounds and beliefs. My career passion was forever altered, however, when I committed to an AmeriCorps volunteer position in a community health center after college, packing my van and moving to California one week later. I fell in love that year with public health, caring for underserved populations, and social justice, gaining patience and a creative approach for providing services across language and cultural barriers and with few dollars in hand.

Medical school has been much of what I expected it to be … humbling, frustrating, and exhilarating, often simultaneously. During the first two years of coursework, I looked forward in earnest to my time on the wards. I quite frankly underestimated how much better teachers my patients were for me than I ever was in return. One of my first patients, a forties-something African-American man, is someone I will never forget. Robbie lived with his partner Tom, a large white man, and a handful of foster children a half hour up the road. Their tenderness for one another was undeniable even while Robbie lay confined to a hospital bed dying of complications of AIDS, and Tom was able to come and go, virus-free.

On morning rounds the first day, my attending briefly reviewed his history before we entered Robbie’s room. “Any questions before we head in?” He looked pointedly in my direction.

“Has he been referred to Hospice?” I asked. My entire team of men looked at me rather quizzically. Apparently, I was supposed to have inquired about the proper amount of fluid to push through failing kidneys.

The next morning, Robbie rankled about his tubing … his NG kept clogging, and his Foley irritated his bladder to spasm. More than anything, he wanted the Foley pulled. The attending refused.

Another broken promise … Robbie slowly ground his jaw in defeat, and his sad eyes seemed on the brink of more tears. My staff directed the intern to gather a group of students and show us how to insert the NG tube, but as he turned to leave, I noticed Tom pull his t-shirt away from his belly, cross his arms on his chest, and turn away from us in anger. “You don’t need all of these people to do this,” he spewed under this breath.

I walked around the foot of the bed, squatted down to his eye level, and whispered, “Tom, would you prefer that I leave so there’s not so many of us here?”

He studied me for a few seconds. “No, no that’s all right. You stay.”

The next afternoon I stopped by to visit. I heeded all the warning signs at the door and made sure to gown and glove. I found Robbie dozing lightly in his bed, cemented to his sheets in sweat. He appeared peaceful despite the alarms and tubes and bed rails. I stood quietly for a few minutes by his side, comfortable in his presence and uncomfortable in my protective equipment. I knew for a man as sick as Robbie, these precautionary charades were more for his benefit than mine, but my heart overrode my head.

I removed my right glove and placed it on his bedside table. I reached over the bedrail and gently cupped my bare hand in his. Robbie cracked one eye open in my direction and closed it after a few moments. The following day, on my day off, Robbie died alone, accosted by strange people and attached to machines. I can only imagine how he felt. He taught me about dignity and autonomy, how to truly listen, and the power of touch, important lessons in my great-grandmother’s day, as well as my own.

I feel at home within family medicine and at peace with both my future goals and core values gleaned from my family and experiences I’ve gathered along the way. Family medicine to me is exciting, and the opportunities are endless. I plan to practice in a community health center serving the underserved and conduct health policy research and advocate for my patients, all the while giving back to the community in which I live. I also hope to volunteer overseas, teach, and mentor students. But no matter what ultimate path my career takes, I will follow my great-grandmother’s footsteps in caring for people, one life at a time. I may never receive a side of beef or a bag of oranges for payment as she did, but being afforded the occasion to effect change in circumstances surrounding my patients’ lives and wellbeing is payment enough.

A couple of years ago, I stumbled upon a snapshot of a little girl in gold ringlets and a red, polka-dotted dress. In the picture, she is listening to her uncle’s heartbeat with her brand-new toy stethoscope. She now resides on my desk next to the lady with her cadaver and serves as a reminder that I cannot let either woman down --- the pioneering doctor from long ago or the four-year-old within me.