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.

 

identity

What if your identity

Is not found in the big city

But in a small town

Where few people are brown or black

But mostly different shades of white

And every day the sun shines down as they

Continue to fight the good fight

To pay the bills

And maybe some buy the pills

Just to get the thrill

To survive.

Not thrive, because that would mean breaking out

Of the shell that looked like hell

But to others looked like a quiet Main Street

And a few stop lights

And county fair nights

And a simple, little peaceful town.

Sometimes your identity is not in

Prestige and honor and fame

But in the sincere scene of a gathered team

To pray before a game

Or a group gathered to cry

Over a blown out flame of someone loved

Who just lost the fight.

The good fight.

What if your identity isn’t in big city skies

But catching fireflies

In the evening light

And yelling hey to the neighbor who just passed by

And leaving your doors unlocked at night.

I’m learning, though,

Your identity isn’t where you are

It’s who you are

It’s the stories you carry within you

Not the culmination

Of your awards and accreditations

But your soul

Your sense of why

Your sense of who you are.

No matter how far away you go,

Hold onto your identity,

like a rope,

steadfastly.

soul-work

Two days ago, I packed by bags and moved to Boston, MA. The night before was full of tears, happy ones and sad ones, long hugs, prayers, and motivating words. Honestly, I was completely terrified. And I’m working through those emotions and trying to allow God to guide my life, to dictate when and where I need to go to become the person He designed. It’s hard. I’m two days in, and I’ve already had to confront topics and conversations that challenge my thinking and address new ideas that I’ve never seen before. I welcome new ideas, and always have, but I trust that my roots are planted deep in my values—believing that those things that are critical to who I am are unchanging, unwavering. Some of the most important work I’ve been doing the past 8 years or so is establishing who I am, what I believe, what is important to me. It’s truly a dynamic process to lay down our foundations, to articulate what we find meaningful and important in life, and I’ve spent many nights, days, moments, and experiences trying to define those things for me. I’ve made mistakes, jumped into situations that eventually didn’t feel right for me, tried out a habit that was popular but didn’t speak to me, and made mistakes I want to forget forever. But all that soul-work was way more important than anything that I was studying in school—that stuff lingers long after the organic chemistry mechanisms fade into the dark crevices of the mind, never to be recovered. My advice to those younger people: focus on soul-work as much as “real” work. You will be challenged, confused, and overwhelmed as you transition into adulthood (am I there yet?) and that soul-work will root you to what’s important.

I’m doing a program called “Justice, Advocacy, and Activism in Medicine” or JAAM where we’ve discussed topics like racism in medicine, reproductive rights and justice, substance use disorders, abortion, transgender/intersex identities, and many more really heavy and difficult topics to grapple with. I was/am certainly overwhelmed, but I pray every night that God reveals himself to me over the next four years in ways I never imagined or anticipated so that I can better serve those people whose care will be entrusted to me. I pray that he surrounds me with people who will lift me up and challenge me, and that my relationships at home will be fortified because of a shared understanding and belief system. I’m incredibly thankful for Avery, my boyfriend, for being so supportive through everything we go through together and being the person I can debrief with when I need to. He is a wonderful life partner. I’m thankful for my parents and sisters for keeping me stable and showing me such strong love as I left home, reminding me how blessed I am to have people who care deeply for me. I’m thankful for this journey, even though I’m scared, nervous, and uneasy, because I’m also curious, excited, and hopeful.

I think my word for this year is “change.” Change can be hard—it’s supposed to be, though, or it wouldn’t be a transformative process. So much in my life has already changed, and I feel many years older now than I was at this point last year (and I did just turn 23…). I’m ready for the change, for the challenges, for a new adventure, for a purpose that is bigger than myself, for taking care of myself, and for never giving up hope that I can make a difference in some way. I’m immersed in a city that looks and feels quite different from what I’m used to, but I welcome the ways I can interact with its people, bring my own background and belief system, and engage spiritually with this place—hearing people, listening to their stories, meeting new friends, trusting that God puts people and places in my life at critical moments of change. I believe that every serendipitous encounter, conversation, thought, phone call, message or interaction is a part of a mosaic that eventually reveals the plan that God designs for us. That plan may be fixed before we are born or may be one that changes as we move through life—either way, I’m ready. I’m here, ready to learn, grow, change, transform, love, and hope.

thankful for the moment

I’m sitting in a hip, jazzy cafe in Palo Alto, California. I’m sipping on some water because I just indulged in a milk tea with boba that was absolutely delicious. I arrived in California this morning around 11:00am, after leaving my apartment at a shockingly early time of 3:30am (shout out of appreciation to my boyfriend, Avery, for waking up and driving me to the airport). All day, I’ve jumped from plane to plane, city to city, to finally land in this spot. This comfortable spot of sitting in a worn-out leather chair in a young and busy coffee shop in a beautiful city.

It is no accident that I’m here; it took years of hard work, focus, dedication, sacrifice, and perseverance to get to this place. It took planning, purchasing a plane ticket, organizing accommodation, and a lot of thought to get here. Yet, I keep thinking to myself, This must be a mistake. What if I show up to the interview and they say, “Sorry, we have no records of you. It must have been a miscommunication.” At least then it would all make sense. I don’t say these things to self-flatter or to self-deprecate, only to give a voice to my darkest fears in this moment. Tomorrow, though, I’m interviewing at Stanford Medical School and that is a reality I never dreamed of coming true. Flying in, over the beautiful city of San Francisco and after coming in from Los Angeles, I thought about my hometown and how drastically different this is from that. I feel like I don’t belong here, like it is all a big mistake and I’m the butt of the joke, but somehow I know this is where I’m supposed to be.

I’m overwhelmed with appreciation at how far I have come and how beautiful this moment is, like finally letting air out of a balloon that has been way too full for way too long. I never expected this moment, but I know I worked hard for it. I never felt entitled to anything but felt indebted to giving this dream everything I’ve got; I reflect on everything I’ve worked diligently for and how I have sacrificed some of the ordinary joys of a 20-something to make it this far. Those moments lost are worth it, because the feeling of accomplishment in this one is so, so sweet. I reflect back, and I feel grateful.

Grateful for the people who helped me get here, financially, emotionally, spiritually, and physically. Thankful for the people who have continuously believed in me, even when I was down on myself. I’m thankful for the people who pushed me to keep going when I wanted to give up. I’m thankful for the people who let me cry on their shoulder when I needed to. I’m not in medical school yet, and I’m certainly not a doctor, but I think it is worth celebrating this moment, no matter what happens in the future.

I have no idea what will occur in the next few weeks, but right now, in a warm and inviting cafe in Northern California, I am so happy. Happy for opportunities, for growth, and for truly having the chance to chase my biggest dreams.

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.

experiments

There’s this fleeting moment during an experiment, almost every time, where I stop and think I have completely messed up. I spent the past three days preparing to run an RT-qPCR (real time quantitative polymerase chain reaction if you’re interested) to see if our gene of interest is overexpressed in certain heart tissue. After 15 hours of work, today I put my eyes down, made sure I was ready to go, and began working with the tiniest volumes to prepare the final reaction. I manually pipetted into 96 wells twice (so 192 times). I was so focused on not messing up (this was my first time doing qPCR solo and they gave me the big experiment. . .) but that malevolent little thought rushed in once again. About halfway through the entire process I thought, oh no, you’ve messed up. What was the last sample used? Did you put the right primer in? Is the volume correct? Literally, every worst-case scenario entered my mind. In these often-had moments, I question my process, my accuracy, my proactive thinking, even my basic skills. No matter how confident I am, in these moments I lose all confidence and question things I know to be true. This happened to me today, and I’ve been experiencing this long enough to have mechanisms to mess-up-proof my experiments (like labeling everything, being very intentional in where samples are placed, and using my pipette box as a roadmap for where I’ve already been on the plate). Importantly, I catch my mind while immersed in this doubt and assure myself that I haven’t made a mistake, that I have been very cautious and attentive, and that I am doing just fine. If you’ve read this far despite nonsensical lab stuff, thank you. I realized that this self-initiated doubt is not confined to research but is universal in all of life.

How often am I moving right along, doing just fine, everything is working out, and my mind says to me, Oh no. You have really messed up. You’ve made a big mistake. Everything you’re doing is wrong. I’ll admit, very often. We have experiences, trials and errors, that guide us in life. We make decisions based on knowledge and feelings that we have previously experienced (either in hopes to feel or not feel that way in the future). For the most part, I’d say we are not blindly navigating through life without any guidance (like that cherished from friends, mentors, learning from past mistakes, intentional thinking, etc.). We live like skilled researchers, already filled with the knowledge of how to do our task or with the capability to obtain what we need to know to carry on. It is not that we are taking the wrong path or doing the wrong thing. It is that our minds are telling us that we are. Self-initiated doubt is a destroyer. In the middle of my experiments, it causes me to question what I know is right. In the middle of my life, it causes me to question my actions and pursuits. I so often am living my life, completely satisfied and happy, when that deceptive voice urges me to question everything. Unlike my research skills, I’m not as disciplined to channel my confidence and squander the doubts. This parallel became so clear to me today – doubt creeps in everywhere and to everyone (well, to me at least). Instead of worrying about everything I’ve done wrong or may do wrong, I hope to instead take a note from my laboratory self and remember that I’m capable, skillful, and perfectly fine carrying on in the way that makes me happy. While this example is very specific to my experience, I feel like anyone can think of a place they are skillful (on the court or field, in a job, as a mom or dad, in any hobby) where they don’t let doubt affect their ability to do that skill well. My hope is to live my life a little more like that so the nagging worry and unnecessary questioning don’t invade my happiness and peace of my mind. I guess I hope to live like a crazy scientist that trusts her hand, her skills, and her process – because we all deserve the peace of mind that comes from confidence and self-assurance.

who you are

Your life experiences unquestionably define who you are and guide where you belong in the world. We are each given unique stories – challenges, triumphs, memories, passions – that aid us in figuring out what type of life we are to live. Since I’ve been in college, I have met people from SO many different walks of life, and it has been one of my favorite aspects of moving out of a small town and into a more culturally and ethnically diverse city. The people I’ve become very close friends with come from all over the world and from every background – Russian, African, Indian, Egyptian, Irish, Ukrainian, American, Muslim, Christian, Hindu, atheist, agnostic, poor, rich, sick, and every quality or descriptor in between. The love I have for each of these people is specific and unique to the friendship that we share, and I’m so glad that I’ve come to know them and their story. Along this journey though, I often found myself asking “Who am I? Where do I come from? What characteristics define me?” and yesterday I again happened upon this internal self-discussion after a conversation I had with a friend in my lab. He very casually told me, “Mary, I can finally hear your Southern accent!” which lead down a rabbit hole of conversation on the lifetime struggle of talking with a “twang” and how “cute” it is (Ha). I told him that sometimes people assume others with a Southern accent are less intelligent, less capable, or have certain ideologies. For this reason, I had become accustomed to avoiding phrases that make me sound more Southern. What I have learned though, through encountering others that embrace and welcome their cultural identity, is that I am Southern and I do have a Southern accent. I was raised in a small town and my identity is comprised of those memories that I created as a child. I had this unnerving feeling when I entered college of not having an identity at all, not belonging to a defined “group” with certain values. I often felt like others were very different from me (because, well, they were and still are in many ways) and didn’t share a lot of the experiences I had while growing up. Instead of shaming away from this I began to cherish my own culture. I shared with people what it was like growing up in a small town in Tennessee (as compared to Chicago or Memphis or New York City). I delighted in the fact that I had (and have) certain challenges different from others and that those things make me, me. This acceptance and confidence has permeated into other aspects of my life. Previously at work, I sought to make myself very . . . uniform. I dressed simply and didn’t feel comfortable sharing the intricacies and details of my personality. This was largely in part because I worked with male supervisors and male colleagues and didn’t want to be perceived as less intelligent or less focused on my career. I’ve learned though, by being surrounded by team members that fully accept and cherish who they are, that who I am doesn’t negate my abilities but encourages them. Speaking of my passions and my childhood memories, wearing the clothes that make me feel confident and feminine, and accepting that I am an empowered, capable female, has strengthened my work ethic and confidence, not taken away from it. Yes, I wear eyeliner and like to do yoga. I didn’t take ten AP classes or go to a private, preparatory high school, but I do have the capability to learn and to succeed just as my peers do and have demonstrated that learning is more important than formal education. This is so important, because I really feel like people who may not fit into certain groups need to be encouraged to come from a position of strength instead of weakness. Don’t let the influence of those around you – their maleness (or femaleness), intelligence, appearance, or success – alter the way that you view yourself. What I have learned since accepting that I have a past that makes me better, not worse, and a future that is as bright as the person next to me, is that people love me and appreciate my work for exactly who I am. They like that I can have a conversation about growing up in a small town and how I like to enjoy myself in Nashville. Just because I wear makeup and have my hair fixed doesn’t mean I don’t get called on during meetings to answer hard questions or given hard tasks to complete. I no longer feel like I have no identity because instead of trying to create one that didn’t exist, I accepted the one I already have. There is great power in knowing who you are, growing in who you are, and loving who you are. Not only is there power, but there is indefinite peace.