“Unlock, press down on the green button and wait 10 seconds.” I read the instructions for the subcutaneous injection over and over again for what seemed like hours. With clammy hands, I finally took a deep breath, positioned the injector, and heard a loud “click.” That “click” would turn my whole life upside down, but in the best way possible.
We’ve all heard the cliché sayings about medical school: “it’s like drinking from a fire hose” or “it’s a roller coaster ride that won’t let you off.” Although I can relate to these to some degree, my medical school career was complicated by more than just complex cardiac physiology or biochemical pathways. Little did I know that at the end of my second year I would go from knocking on a patient’s door during a clinical session, to sitting in an exam room myself, waiting to be officially diagnosed with psoriatic arthritis.
For two years, I spent almost every day in pain. I would physically struggle to get out of bed most mornings. I strategically planned to leave my apartment at a certain time, knowing how long it could take me to walk through the hospital, past the library and to the classroom.
I was able to hide my symptoms for the most part — the skin lesions on my face with makeup, my limp by walking slowly, my knee pain by avoiding the stairs. It was surreal to see images in textbooks and read the specific medical terminology used to describe my chronic condition, while comparing it to how I actually felt. The buzzwords that were supposed to serve as learning tools only seemed to reduce me down to labels. I did not look at my skin and think “silver scale,” I did not look at my joints and think “pencil-in-cup deformity,” and I did not view psoriatic arthritis as simply a “seronegative arthropathy.”
I began immunosuppressive treatment just weeks before the pandemic hit the United States. While still processing my diagnosis and adjusting to new medication, I was now at a higher risk of getting infected. After being pulled out of my first clinical rotation after only three weeks, I felt conflicted. I wanted to be able to help care for patients and the community at large, but also knew that I needed to take extra precautions to take care of myself.
These experiences throughout the past year have shaped who I am as a medical student, future physician and person. I have spent a lot of time thinking about how having a chronic condition and being on an immunosuppressant could impact my career in medicine. Although there have been and will be challenges, I also see the benefit of the unique perspective I gained.
I learned to never take anything for granted; biologic therapy has truly transformed my life. I am thankful for my physician for helping me weigh the pros and cons of going on biologic therapy, and my support system of family and friends for offering their unconditional support when I was struggling to decide if I would go on this medication. Since starting, I feel more like myself both physically and mentally. I am now able to exercise and stay active. Before biologic therapy, I would have never imagined being able to stand for nine consecutive hours during my surgery rotation or running up and down multiple flights of stairs during my medicine consult rotation.
I also recognized that it is okay to ask for help. Everyone needs support, and I am thankful to have patient and understanding colleagues, senior residents and attendings who always took the time to check on me. I strive to pay forward the kindness I have received to my future medical students. I plan to continually actively seek a network of healthcare workers with chronic illness, because there is comfort in knowing you are not alone.
Lastly, I realized that I do not want to hide anymore. I want to share my experiences with my future patients. I understand firsthand what it means to have chronic pain. I also understand what it’s like to feel reluctant about trying new medications. I believe I can use my vulnerabilities to better connect and empathize with patients enduring a similar struggle.
As I look forward to a career in internal medicine, I strive to study not only the complexities of the illnesses my patients may have, but the complexities of their lives. I want to truly learn about who my patients are, and not just focus on the buzzwords associated with them. I am humbled and grateful for each day I have in medicine and am excited for what lies ahead.