Whenever I consider my time in medical school, I am surprised by how quickly I have been able to cultivate a sense of belonging at the University of Wisconsin-Madison, far from home and in a very unfamiliar setting. After all, I grew up in a single-parent household with my dad in a small, weary mill town in central Massachusetts called Ware. He was a carpenter who always carried at least two jobs to make ends meet. I did not really thrive in medical school until my first rotation on the wards, where I was reintroduced to “my kind of people” — patients. I saw aspects of my father in one of our “frequent flyer” veterans with resistant hypertension and substance abuse. I saw my grandmother and her 100 pack-year smoking history in my first patient admitted with a chronic obstructive pulmonary disease exacerbation. I saw my best friend’s deceased father in the lineman admitted with idiopathic pulmonary fibrosis. My past has allowed me to quickly relate to and bond with my patients. My love of these relationships has solidified my career choice of internal medicine.
Upon reflection, I can start to see why I have felt comfortable working on the wards. I have worked in restaurants since I was old enough to have a job, and I am all too familiar with the chaos of the kitchen during a dinner rush or the complaints of difficult patrons. Although the setting has changed, many of these situations are not that different. The rush of a busy call day, juggling the issues of old and new patients and prioritizing what needs to happen next, does not feel foreign to me. The skills I learned at a young age when soothing upset customers — remaining levelheaded, communicating clearly and collaborating to address their concerns — now seem as effective when applied to my patients. Because my father has always struggled with his own chronic health and substance abuse issues, I naturally feel at home working with patients with medical conditions like resistant hypertension, diabetes or addiction. One morning my dad and I discussed making dietary choices for better control of his blood glucose, and he seemed willing to make an effort. Two hours later, he walked in the door eating donuts stating, “See? I got the ones without the sugar on ‘em!” Through these instances I have learned not be frustrated by, but rather be supportive of, my patients through their setbacks, whether it be their dietary indiscretions, medication compliance issues or relapses with drugs and smoking. I can be understanding of many of the problems internists encounter daily because I have grown up with them with people whom I deeply love.
Being away from my little hometown gave me the space to carve my own path within the field of medicine. I love many things about internal medicine. It fits well with my analytic and contemplative nature. I enjoy the collaborative environment created by my peers, residents, and attendings. But most of all, I love the patients. When I consider all of the patients I have cared for during my time on the wards, it becomes clear that my favorite patients have a few things in common: they are elderly, they struggle with management of many chronic conditions, and they are full of stories to share and things to teach. These people come with their needs, pride, hopes, desires and frustrations. I think I can make a difference in each of their lives, and I take joy in every accomplishment we achieve together. I contemplate my years in medicine and feel so much pride and gratitude for where I am now and how far I have come. While I greatly miss the people I grew up with, I love that I get to see parts of them every day in the patients I meet. A real home can be many things, and I have never felt happier or more comfortable than I do now, settling into my new home in the world of internal medicine.