Monday, April 6th, 2015

The Long Road to Medical School

Caronae Howell

I spent the first 21 years of my life telling anyone and everyone I met that I was not going to be a doctor. That I was not going to wind up like my parents. That I was going to be different: artistic and creative and fun. I would become a poet or a photographer or a fashion journalist– something a far distance from the rigidity of medicine, the banality of routine. On sick days when was a young child, I went to my parents’ offices and spun around in the rolling exam chairs. If I was lucky, my father let me dial the knobs on his microscope. If my sister and I were both ill, we held drawing contests, stealing the fresh white paper straight from the printer and tearing off the hole-punched edges.

We sketched out birds and fish and trees with as much precision as we could; afterwards, my father would hang the drawings on the mini fridge he used to store lab samples. When I was in middle school, my mother took me on rounds with her a few times at the big Catholic hospital nearby. I would wait at the nurse’s station while she visited her patients. I was not allowed to wander around and find her if I had a question, but once or twice she took me into the room of a beloved elderly patient and I watched as she walked around the bed, gently examining the person and making notes in the chart. I recall being struck by how tender the whole process was.

On the last day of each month, my father saw patients at the nursing home. He would buy me a chocolate bar from the vending machine to appease me while I waited. When we drove home, he would drone on about the many varieties of bed sores and the nuances of morphine dosing. Usually, I half-listened, one ear turned toward him, the other part of me thinking about how late we were for gymnastics practice.
I first considered the possibility of becoming a healthcare professional one cold February morning the year after I graduated from college. I had studied history and human rights, and I dreamed about going to law school or starting an MFA program. In the mornings I wrote; in the afternoons I processed archival books at the public library for $15 an hour. I remember sitting in the bowels of the stacks, looking up at all of the ancient books around me: there were tomes from the 15th century and volumes whose covers turned to dust when I tried to open them. Some of the books were three feet tall.

All of it made me feel dizzy. I wore blue latex gloves and a white surgical mask while I worked on the books, updating their information in the computer, sometimes transliterating their titles or publication years from Cyrillic to English characters. There wasn’t much of an ‘aha’ moment; I simply woke up at 6am one day, as usual, and thought, “Well, I’ve never considered becoming a doctor before, have I? Maybe it isn’t too late.”
The idea nagged at me: it crept up behind me while I waited in line at the grocery store. It bounced around in my head while I did laundry. I spent a lot of my free time that year walking around Manhattan. Sakura Park and below 14th Street and up Park Avenue, I couldn’t help but notice all of the hospitals. They seemed to rise out of nowhere, great big pulsing hives of doctors and nurses and researchers, swarming the campuses with their coffees and stethoscopes and pagers.

My eyes opened as if for the first time: I had never seen this side of medicine before. Doctoring had always struck me as stale, something that my parents did twelve hours a day. Something very separate from myself. But now I realized that maybe it could be exciting and investigative, even thrilling. Perhaps I had never looked close enough at my parents’ profession: perhaps there was something je ne sais quois about the composition of their lives after all.

Later that spring, as I wrote my applications for post-baccalaureate pre-med programs, I found a used copy of Phantoms in the Brain on sale for a few dollars. I devoured the book, fascinated by the mysteries and conundrums the author described. He wove narratives about his patients that were not simply road-maps to their diagnoses: they were living, breathing tales about the very real nuances of the human body– how the mind is different from the brain, how the eyes have peculiar blind spots.

When I finished the book, I wrote a bit of a love letter to the author. Then, when my classes in chemistry and physics began that September, I started in on Atul Gawande’s writings, then House of God. Reading narratives of health and disease drew me in to the unique world of medicine, and I found myself writing my own memories about my upbringing by two physician-parents: the first time they explained to me what Internal Medicine was; when my father’s father died of lung cancer. I can still remember what the oxygen tubing looked like as it snaked around the dark green canister.

All of this is to say that, while I may have taken the long road to medical school, I could not be more excited about learning my patient’s stories and seeing how they intersect with my own. Medicine is a very different profession than it was 30 years ago- we know what causes AIDS; we can excise the most complex tumors-but the patients that we see are the same human beings. Evolution takes a bit longer than half a century. People will still come to us with their wounds and their aches and their personal disasters.
I will do my best to remember this.

About Caronae Howell

CaronaeCaronae Howell is a writer and pre-medical student living in New York City. She is a 2011 graduate of Columbia University and a 2014 graduate of Columbia’s post-baccalaureate pre-medical program for career changers. Since completing the program and applying to medical school, she has worked as a Clinical Research Assistant on an adolescent asthma study. Additionally, she is hard at work on her first novel, a fantasy book for young adults, and a collection of essays about the process of becoming a physician. Prior to pursuing her pre-medical studies, she worked in the non-profit sector with education and library organizations. Caronae hopes to matriculate to medical school in 2015.


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