Off to Sea

It wasn’t excitement that gripped me that early morning in May some four and a half years ago. As far as I could remember it was this vague mixture of anxiety, fear, and optimism I didn’t trust that was swirling around in my bowels as I sat through the commencement address of a large northeastern private university. Some Ivy league banker was giving the typical “you’re a college graduate, time to improve the world” speech. Funny enough this was right after the Wall Street implosion when the government had to bail them out, so in between his words of wisdom were subtle hints at apology and explanation. Maybe he was trying to show us young kids what it was like to be humble. Who knows. I certainly didn’t care slumped in my chair sweating through my shirt and suit [that my parents begged me to wear]. As soon as I would walk off that stage, degree from my dream school in hand, it would be a 3 month march to the day my bags would be packed and sunshades bought. I was heading to medical school in the Caribbean and I couldn’t have been more afraid.

Slow Start

A coconut flew across the deck inches away from the balcony glass which my face was glued against. I reacted instinctively and jumped backwards tripping over my suitcases and landing on my behind in the process. My parents yelled angrily at me telling me to be more careful. I nodded quickly in return and resumed sullenly staring out the window. This was paradise–it also seemed to be the epicenter of tropical storms and hurricanes during the months of May through September. “That’s OK” I thought. Another coconut barreled across the window as I mulled over the definition of “paradise”. “Whatever,” I mused “couldn’t get worse than this. A couple more weeks and I’ll be too busy to care about things like weather.” In two days time I would eat those words. The bags I tripped over would be stolen out of the back seat of the rental car leaving me with nothing. I was marooned.

In The Thick Of It

My taste buds were overwhelmed by an explosion of garlic and Caribbean jerk as I shoveled a spoonful of oxtail and rice into my mouth. “God it’s so hot here” I thought. The sun was baking me alive as I balanced my anatomy books on one leg, a tray full of food on the other, waiting for my Skype call to connect me to my parents back in New York. The semester so far had been hell. More material than I ever thought was humanly possible to digest was competing with the local cuisine to make room inside me. What resulted was the addition of several pounds, a baseline cortisol level that had definitely increased, and feelings of despair as I tried to remember at which point going to medical school seemed like a good idea. Maybe there was a reason my advisor had told me to consider other options. As if it noticed my descent into introversion my laptop began beeping at me. “Connection lost” it proudly displayed. I sighed.

Seeing Light

I’m a clinical student now on my first rotation, general surgery. There are students here from other schools, some osteopathic, some American, and the rest Caribbean. We’re all splashing around in the same medical student shallows looking off into the deep end at the residents and attendings. We’re wearing the same scrubs, pondering lab results, preparing H&Ps, and wondering how long we can have off for lunch. As I’m hopping on one leg trying to fit a bootie on my left foot I catch a glimpse of myself in the mirror. Those few pounds I gained are long gone, in fact I’d probably look better with a couple of them back on. I shake off the thought and begin heading into the depths of the OR, passed disgruntled surgeons, pissed off nurses, and rule-reciting surgery technicians. “Hi, good to have you back” I hear the plastic surgeon chirp as she sees me enter through the doors. We’ve been working for awhile now and getting along really well. “So you’re the med student from NY right, and that other girl is from the Caribbean?” I shake my head no and tell her it’s the other way around. She nods and we begin timeout.

A Chance

“You can do this” I repeat to myself. It’s 11PM the night before my first residency interview and I’ve spent weeks reading up on the program, what to ask, how to ask it, and when to keep my mouth shut. I stare at my computer with the questions and their answers written out. There’s only one that’s empty, “So why did you choose to go to a Caribbean school?” I think about what my father told me a couple weeks ago.

“I was a Pakistani immigrant trying to practice pharmacy in the United States during a time when people would look down on me for not having a degree from the West. I didn’t let that get me down though, because I knew that I was just as good as the rest…if not better”.

Am I just as good as everyone else? I think about my step scores that I’m proud of, scroll past my list of extracurriculars, volunteer work, and publications, and still settle on that last question, wondering.

Full Circle

The school has changed a lot in the two years since I’ve been here, and so have I. There’s an entire new building across where I used to study, and I’m a soon to be PGY1 Internal Medicine resident at a University Hospital. A couple years ago, taking a break at the local beach bar, I couldn’t have dreamt coming this far. The commencement ceremony, this time for medical school, will be in a couple days nearby. Over there I’ll be sitting alongside my friends and colleagues, some of them attending fantastic institutions in the U.S, others in competitive fields, even more happily in their specialties of preference, and others providing a valuable service to the country as primary care providers. But most importantly, they’re all doctors. We came to the island armed with only our dreams and a lot of questions. The struggles throughout the past four years uncovered even more; many about where life had sent us and who we were. The two letters at the end of our names in a couple of days will be the final resolution to that question. Physicians, doctors, clinicians, healers, what ever you would like to call us. That’s who we are.

A Final Choice

So how do I measure myself as a Caribbean graduate, with that label hanging over my head? I think I know. Not by what I did to get here in the first place, but by the things I did to get me where I’m going now. That’s what the island was for me, a second chance for a life that was slowly slipping away. In a few month’s time I’ll be working alongside people who right now are graduating from places that I wish I could have attended. When they ask me where I’m coming from I’ll have a decision to make. Whether to proudly enunciate the name of my school or whisper it softly.

I’ve spent a good amount of time thinking about that moment. Weighed my responses both ways. In the end I think I’ll choose the former. Not because I’m trying to make a statement, but because after four years of struggle, that’s all I honestly feel–pride.

I’m proud of the obstacles I’ve overcome while I’ve been here.

Proud of what I’ve achieved.

But most of all I’m proud of who I’ve become, a doctor trying to improve the world.

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