Finding your Dx

Recently, I wrote this email:

Hi Dr. W,

I was a patient of yours in 2006 when I started at Scripps college.

I’ve thought about you many times as the years have passed, how lucky I was to receive such wonderful care. I am proud to say I have never relapsed since, and am strong, healthy and happy. In fact, I am now a medical student at Tulane, hoping to pay it forward. 

Thank you for your work,

Alana 

I’ve heard a lot about the self-pathologizing that happens in medical school. How everyone will start to think they have the various diseases we learn about. With my own family history of hyperchondriasis, I too, have been waiting to find my rare diagnosis. Waiting to learn about the condition that pieces together all the symptoms I didn’t even know I had. Luckily, by now we’ve gone those most of the bodies systems, and my bones, blood, and organs have come out “unremarkable”.

Then we started on the brain.

Tiptoeing into the nebulous pool of personality and mood disorders. I was sitting in a cafe catching up on recorded lectures, when I finally found my disease. It was a diagnosis I was all too familiar with: Eating Disorders. The lecturer described the symptoms, the presentation, the demographics of patients affected. But I didn’t need to hear them, I knew them all to well. His case study could have described me, “A 17-year old girl, with a BMI of 16, walks into your clinic…”

As I watched to powerpoint slides move from case to another, tears surprised me as they tumbled down my face.

Perhaps these tears were my empathy for these fictitious patients’ struggle.

Or perhaps they were the residual terror of knowing the fate I narrowly escaped.

Or perhaps they sprung from the depths of a wound so deep it still hurts years after it has healed.

Or perhaps they were the painful reminder that self-inflicted cruelties are sometimes the hardest to forgive.

Or perhaps….

 

Afterward, I reread the application essay I wrote for medical school. Here are some excerpts I wanted to share:

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During my very first week of college, an electrocardiogram revealed an irregularity in my heartbeat. It confirmed the concerned comments from family and friends I’d previously ignored as I slipped into anorexia. Only then did I begin to wake up to the dangers of my sickness. My recovery process added weekly weigh-ins, health center visits and psychological appointments to my new stressful academic schedule. But after nine months I was back to my normal weight; I accomplished one of the fastest and healthiest recoveries my health providers had ever seen.

The rarity of my successful outcome was not only due to my perseverance but also to the people and opportunities helping me along the way—the emotional and financial support from family and friends and access to incredible doctors who embodied the nobility of their profession. When I wavered, they gave me advice and encouragement. When I was stubborn, they were patient but firm in their counsel. The care they offered extended beyond prescriptions and medical acumen; they treated me with compassion and approached my illness holistically. With their help, I found strength in the vulnerability my EKG results exposed: my own self-destruction had threatened the health I’d always taken for granted. Once I saw myself to be the cause, I saw I could also be the cure.

Not everyone is as fortunate when combating sickness. Not everyone fights a treatable condition. Not everyone who asks for help receives the resources necessary, like I did. Access to healthcare was a privilege I came to understand through social justice work around human rights, labor rights, and microfinance. During my Americorps year, I worked for a microfinance organization that offered its clients loans to start small businesses. This lending model sought to combat economic injustice, and by extension, empower women socially and politically. Yet financial difficulties made up only a small part of the numerous challenges its borrowers faced; many voiced concerns regarding their health or that of family members. The access to healthcare I had always taken for granted was in fact a coveted luxury many could not afford. As a basic human need, health is crucial to the foundation of any struggle for justice, whether economic, social or legal. The humanitarian work I dreamed of began to point me in a new direction: to find tangible tools necessary for helping, healing and advocating for the wellbeing of others.

Until confronted with my own illness, I watched the world of medicine closely but always from the sidelines. My parents are physicians, so I grew up surrounded by surgical photographs, cards from grateful patients, and stories of miracles and tragedies. Although I had never doubted the dignity of my parents’ work, I began to see how their practice of medicine involves the art of healing. I recall my father describing how being a physician is more than a job: it is a calling. It is the use of one’s hands as tools to navigate the world, to effect change, to bring relief and comfort to those in need. Hands can repair a burned body, create a missing ear, carry in new life, and remove a cancerous mass. They cut, sew, count, shift, and hold on in the moment of death. Nowhere is the social justice I was searching for more practiced than in matters of life, death, and everything in between.

Health must be approached comprehensively, as the doctors who treated me exemplified—taking into account the complexities of life, from the physical and biological to the psychological, and the cultural fabric weaving them together. This is the kind of doctor I want to be—providing others with the exceptional care and compassion that I once received. I look forward to medical school as the next crucial step down this path.

 

While much has changed in the two years since I wrote it, it rings just as true now it as it did then. (Although, perhaps without as much magical-realism, and a bit more grunt work.) Nevertheless, the spirit is still there.