the hope of healing

As I reflect over the past six months on learning to become a doctor, I think of how my perspective of illness has shifted. As a healthcare worker, you see people at their most vulnerable, when they are in the greatest need. Yet throughout illness, each patient retains their identity as someone who exists outside of the hospital walls—this, to me, has become some of the most important work I do as a medical student. Looking past, reaching out, and seeing people for who they really are and what they really love. Not only seeing those attributes but also allowing people to bring their dignity, identity, and personhood into the hospital room.

I see mothers, fathers, and young people who have faced life-changing illnesses that prevent them from doing what they love in life. I see women in their 50s who have scars from breast cancer or who can’t speak in full sentences because of COPD.

I see a 70-year-old man who had an intracranial hemorrhage that damaged his sense of memory and self; I see his wife transform from a lover into a caretaker, and I hear her yearnings for a husband who once walked 30 miles with her in Europe.

I see a man, struggling with substance use, silently cry out for help behind a composed, stoic face as he searches for a solution to his suffering and pain. I hear him talk about suicide ideation in one breath and his two daughters in another.

I see a girl, near my age, who has been in the hospital for 3 months now, and I see pictures she’s painted posted up around her room with a view that spans the Charles River. It’s a beautiful view, but she wants to see anything else in the world.

I see a mother, with her two toddler sons running around the exam room listening to cartoons on iPhones, as she mourns the loss of her sister to sudden cardiac arrest. She went to sleep and never woke up.

I see a grandmother start crying as she describes the pain she feels after a fall she endured. “You can’t even understand the pain I am in!” Honestly, I can’t. I’ve probably never felt a pain like hers before—physical pain mixed with loneliness, uncertainty, and fear. She’s way stronger than I’ve ever been.

That’s where my fear comes in, the awareness of the fragility of life. I see my mother, sister, brother, boyfriend, niece and nephew, dad, grandparents, best friends, and future children in the faces of all those who suffer openly in front of me. I try to dip into their pain, to feel what they feel if only in that moment—to protect myself—but find myself overwhelmed by the emotion they bring to the conversation. I fear how a single moment can transform everything—the moment a cell becomes cancerous, or a fall becomes a brain injury, or a goodbye becomes the last one.

This confrontation with illness is new to me, and I’m still learning how I will embrace the reality that life is fragile yet somehow malleable. In the context of my own existence, it makes me realize how precious life is right now, at this moment. It encourages me to take walks, read books, call those I love, and, honestly, it sometimes makes me wonder about choosing a career that separates me from my family and hometown. There is no doubt about it: medical training is hard emotionally, socially, and physically at times. There are days of studying unimaginable hours. There are disparities and heartbreaking realities in medicine. There is powerlessness and emotional warfare.

Despite these considerations, being in medicine gives me hope. It gives me an understanding of humanity. Amidst all the suffering, pain, sadness, and illness, people are relying on their providers to give them hope. That is why the woman with breast cancer is sitting in front of me with scars that gave her cure, or the man with the intracranial bleed can walk 2 miles with his wife now instead of being confined to a chair, or that the woman with the toddlers is learning of her genetic cardiomyopathy so that she doesn’t leave her own children behind. They are given hope through the medical system, research, and intervention. More than anything, my patients teach me to have hope. They remind to align my life so that I can do those things that I would being doing if I woke up tomorrow with a life-changing illness—enjoy the sunshine, prayer and community, the arts and humanities. They also encourage me to be a part of the system that provides hope to those who feel hopeless. Yes, I see life as more fragile now than I did six months ago, but I’m also much more appreciative of what it means to be healthy and alive. I hope to continue evolving my understanding of illness, suffering, and death as I meet more people, gain more perspective, and realize the blessing of medical care.

 

the sun

It’s an early Saturday morning and the sun tries to pour in through the cracks in my window curtains. My heart leaps at the sliver of light that finds its way in, and I don’t think of the things I have to do, the upcoming exam, the assignments due, the distance from my family, the laundry I need to clean, the run I need to go on, the emails I need to send, or the million actions I need to do. My heart rolls over with my body as I anticipate the bright, vibrant sun that bathes the earth in wonder, and the small part of that beautiful wonder I get to enjoy today. It is a small, simple, remarkable feeling of joy that the little sliver of light gives me. Daily I encounter–in myself or others–suffering, pain, illness, hopelessness, hurt, injustice, separation, and fear. It is easy to be bathed in the hurt of this life. In this moment, though, early on Saturday morning, in a corner of Boston, on a small bed in a small dorm, I feel hope and joy for all things ahead.

Thank you God for this beautiful day.

It is yours.

poems from seaside

I think

there are so many poems

about the ocean because it is

simultaneously violent

and peaceful.

At the same time it

crashes against the coast

destroys a weak vessel

and carries away debris

It

smoothes the rocky shore

coos the frightened bird

and hugs your planted feet.

It somehow reminds us

gently

chaotically

simply

subliminally

of that violent yet peaceful

love

that roars as it sings.

That kind of love that lives within you and within me.

——

If each day is a fresh page

Then I want mine to be

Inked with words of prayer

Stained with drops of coffee

Smudged with chocolate fingers

And scented with smells of you.

If each day is a fresh page

Then yesterday doesn’t matter

And tomorrow can’t be viewed

So I’ll sit here and

Think

Today, what good can I do?

——

prayers are like raindrops except you send them up instead of let them fall. everyday you send a raindrop up to heaven to join the puddle pooling at God’s feet. everyday you wonder, did my raindrop reach the stars or did it break along the way? then one day, you realize your raindrops were never supposed to go up all the way and stay. you just forgot to look around and see everyone soaked and smiling by the rain that wiped away their tears. your tiny little prayers were falling all the while, and finally you learn, prayers are a lot like raindrops,

they fall on those who are near.

sacred places

“There are no unsacred places; / there are only sacred places and desecrated places.” — Wendell Berry
I’m starting to understand that there truly are no unsacred places — this is a bold claim. Some may perceive the site where a white American minister burned himself alive in the name of racial reconciliation as unsacred, or the home of hundreds of incarcerated men and women as unsacred, or the doctor’s office where an abortion has been performed as unsacred, or a strip club where infidelity puts food on the table for women employees as unsacred. I am guilty, as I predict we all are, of having passed an opinion on each of these cases and many others without considering the human lives involved. And while yes, I do believe that there are very uncomfortable aspects in each of these places and scenarios, I’m starting to see that life is much more complicated than the simple dichotomy of sacred/unsacred or right/wrong or good/evil. I didn’t coin this distinction, though; that was Wendell Berry. Luckily it wasn’t me, because Berry importantly includes the alternative to unsacred: desecrated. I looked up “desecrated” in the dictionary to see exactly what he meant. Something desecrated has been violently disrespected, or possibly perverted, violated, infected, polluted, vandalized, debased, or degraded. Berry is onto something here. People — the most critiqued in society — are likely to have been victims of many waves of desecration in their lifetimes. I imagine people as those beautifully painted Russian nesting dolls. We may look whimsical and pleasing on the outside, but within each of us there are many unseen, hidden layers. These mysterious, unknown layers may be what have shifted some of us from the sacred to the desecrated. We’re all damaged, polluted, degraded in some way. Some of us are just better at hiding our layers than others.
So there are no unsacred places, only desecrated places, and those not yet desecrated, or the sacred. There are no unsacred people. There are people who have been cheated, lied to, abused, hurt, neglected, abandoned, scared, dishonored, gossiped about, rejected, and shamed; they are simply damaged. If someone we love is damaged, do we abandon them? Give up, toss them to the side, move on, and hope for better luck in the future? I hope the answer is no. At least, I’m hoping no one gives up on me. I’m damaged, just like you are. I want to see people as the complicated, multi-layered, dynamic living souls they are. This world is far too vivid and beautiful to see only in shades of black and white. That place we call harmony, sympathy, and understanding is all gray.
—–
How to Be a Poet by Wendell Berry
(to remind myself)
i   
Make a place to sit down.   
Sit down. Be quiet.   
You must depend upon   
affection, reading, knowledge,   
skill—more of each   
than you have—inspiration,   
work, growing older, patience,   
for patience joins time   
to eternity. Any readers   
who like your poems,   
doubt their judgment.   
ii   
Breathe with unconditional breath   
the unconditioned air.   
Shun electric wire.   
Communicate slowly. Live   
a three-dimensioned life;   
stay away from screens.   
Stay away from anything   
that obscures the place it is in.   
There are no unsacred places;   
there are only sacred places   
and desecrated places.   
iii   
Accept what comes from silence.   
Make the best you can of it.   
Of the little words that come   
out of the silence, like prayers   
prayed back to the one who prays,   
make a poem that does not disturb   
the silence from which it came.

self-talk

I recently heard a story from a beautiful, African American woman who wore a stylish black cardigan and dark red lipstick. Her dark, silky hair was perfectly curled, and her smile illuminated our faces like a flashlight exposing the darkness. As she began to speak, her deep, rhythmic voice reverberated off our concrete classroom walls; her voice and its warmness filled the room like blowing breath into a balloon. I was touched by her presence even though we were separated a considerable distance. She held a sweet sense of humility, a knowingness and experience, in her voice. She told us a story.

This kind and gentle woman had been incarcerated for 14 years. Her story starts as a child, when she experienced domestic sexual trauma that continued into her teenage and adult life. She got wrapped up in some bad relationships which propelled themselves into criminal activity. Her story is not unlike many others; when trauma starts this early on, it isn’t a choice. It is a lifestyle given without any permission or consent. Among her triumphant stories was a small detail about how she began to tell herself lies and believe them. Her identity was built on false narratives, destructive words that shaped her, and a lifetime of untruths. She said eventually, she didn’t even know her real birthday.

Although I am very different from this woman, I share many of her same vulnerabilities. We all do. We are all capable of telling ourselves lies that become truth and this truth becomes our reality and this reality becomes our life. We can tell ourselves that we are worthless, purposeless, hopeless, that we have no friends, no choice in our life trajectory, and no control, or that we’re unattractive, disliked, stupid, or meaningless. We can say these things, and they will become true. I spent a lot of time in high school convincing myself that I needed to change; that I needed blonde hair and tan skin before I could be loved. Or that I needed bigger muscles and a smaller waist before I could be attractive. Or that if I spoke and acted a certain way, I would fit in. I began to believe myself. These lies became my reality and that reality became very grim and oppressing as I tried to fit into all the images that society tells us are important. My saving grace came when I began to tell myself something else: I am smart, I have importance that goes beyond physical appearances. I am loved exactly how I am. Then I began to tell myself something even more radical: Maybe I could even change the world. These things I told myself changed my life perspective. Our self-talk matters.

You may truly think you are worthless or unloved or a failure. I am not condemning your feelings or telling you that you are wrong. The thoughts you have about yourself are valid. That is really how you feel and that must be recognized. What I am saying, however, is that you should start telling yourself a new narrative. Every day wake up and tell yourself the truth that you want your reality to become. Roll out of bed and tell yourself, “I am loved. I am important. My work is meaningful. My life is valuable. I am kind, lovable, and gentle. I am free from addiction. I am free from sadness/anxiety/depression. I am in control. I am loved by something much larger than me. I was created with purpose. I was created with passion. I am fearfully and wonderfully made.”

Or maybe just tell yourself one of those things or maybe all of them if you need it. Some days I do.

This week my mantra has been “I am strong, I am capable, I am confident” because each of those words touches on an insecurity I’ve felt this week. On Monday, I told myself this phrase as I walked to class, practiced a speech, worked my job, went about life. On Friday, my mantra became my reality: I endured the week with strength, competence, and self-assurance. My positive self-talk came true.

As you read this I ask you a simple question: What do you need to hear?

And I implore you to take on a simple task: start telling yourself that. Today, right now, this week. It may save your life.

breaking down

As I’m enjoying my morning coffee, with sunshine flooding into my small but comfy shoe-box of a bedroom, I google “how to show Christ’s love as a doctor”. It may be obvious how doctors have a platform for showing compassion, love, equality, and integrity towards their patients, but I’m a practical kind of gal so I wanted some real-life tips. One thing that stood out to me in an article that I read is the call to honor God with our lives – a seemingly simple task – but to avoid making medicine/success/accomplishment/money/etc. an idol before God. I started reflecting on my own life and realized how important and hard this is.

Avoiding idols is a slippery, hard-to-detect fine-line that I’ve even experienced as someone who is not a doctor yet. I find a sense of belonging and contentment in feeling like I’m making a difference, even if small, in someone’s life at this stage in my journey. I take pride in my accomplishments that I work so hard for, and I celebrate the opportunities that come to me throughout this journey. When I studied for the MCAT, I felt like that exam was truly determining my future, and I had to step back (or have others around me) to remind myself that God is in control of my destiny. There have been times where this career has become an idol in my life that I worshiped and thought about constantly, and it takes daily, continual action to break down that idol. My support system at my church reminds of the temporary nature of this life and how everything we do should be good but is truly only transient. When we break down those idols, liberation from anxiety, worry, and defeat ensues.

Idols don’t always look like golden calves. Sometimes they look like the pursuit of money so you can live a little more comfortably, a cute boy who you devote all your time to, the success and accomplishment of your children, perfection towards a hobby or skill, or the more deleterious but real-life idols like addiction, mental and physical illnesses, and sexual immorality. The hardest thing about breaking down idols is remembering to wake up every single day and chip away at that thing you think gives you worth in life. Whether or not we like it at all, those things will fail us and we will leave them behind us when we enter the kingdom of Heaven. I try to remember that although I want to be a physician more than anything, my life is worth so much more than that. My God has given me, and all of us, specific ways and tools to impact and gather his Kingdom. That may not be as immediately flattering or boast-worthy, but it is way more important. Every day, in a small but consistent way, start chipping away at the idol you’ve built in your life. You probably already know what it is. The effects are liberating in so, so many ways.

“You shall have no other gods before me.” – Exodus 20:3

cancer

Today at work I got emotional.

I work in a cardio-oncology lab, and I spend most of my days writing and reading about cancer therapies, cancers, and heart disease. Sometimes, I write and read so much that I dream I actually have breast cancer, and I wake up gripping for reality and feel overwhelmingly thankful that I do not. I read about it so much that sometimes I forget that actual people get cancer, not just numbers and statistics published in journals, and I’m humbly reminded of this when I see patients in the clinic who cling to an unwavering hope. I don’t typically get emotional at work, because when I’m not sitting at my computer planning things or shadowing in the clinic, I’m working with mice that I’m treating with immunotherapy. While I do get attached to my mice and I’m thankful for the role they play in scientific discovery, they don’t typically make me emotional. Sometimes, they even bite me and claw at me and elicit a response very opposite of thankful. Today, though, I had a conference call with the physician I work with and a group of our collaborators from MD Anderson Cancer Center. We all got together to talk because we are interested in understanding why and how the immune system can fight off cancer. We as a cardio-oncology group are interested in the heart, and why some patients develop fatal heart disease when they receive immune-checkpoint inhibitors (a cancer treatment). This is what all of my research projects are focused on, and I’m very passionate about this topic. I think one day I may become a cancer doctor, or a cardio-oncologist, or continue asking questions like these, but that’s too far away for me to speculate. The other group, hailing from one of the most prominent cancer centers in the world, discovered immunotherapy and specifically how the immune system can attack cancer cells in the body. While I was a bit star-struck to be talking to people who have literally saved hundreds of thousands of lives, something every doctor or scientist dreams of doing, I was even more touched by their sincerity and care for patients. I think a lot of times people think humanity is heading in the wrong direction, but moments like these tell me differently. I’m reminded that biomedical research is truly a selfless act of love for humanity. If you have cancer, or if anyone you love has cancer, please know that there are scientists, physicians, pharmacists, students, and every part of the biomedical research industry who are out there working for you. Day and night, there are people thinking of how to combat the disease that maliciously steals our children, parents, friends, and neighbors. I’ve heard people jadedly and suspiciously tell me they believe that there is a cure for cancer that the government is holding it from us. This is incredibly discouraging to me, because I see the hearts of scientists and doctors who are diligently searching for cures and treatments. I see them behind masculine, poised faces, behind white coats and dress pants, behind strong words and distant demeanors; I see people who care for humanity and spend their lives working to cure someone they will never even meet. While most days I just let these encounters go unnoticed, today I appreciated that there is something incredibly powerful and moving in that reality.