Becoming a Refugee Medical Student

Growing up in Miami, I became desensitized to annual hurricane threats. Before Hurricane Maria, the last time I experienced a Category 5 storm I was merely a month old and too young to remember. So naturally, when a Category 5 storm’s projected path pointed toward my home in Puerto Rico, where I attend medical school, I was not afraid.

I thought the storm, like so many others I’d been fortunate enough to dodge, would simply reroute. But the storm stayed steady on its course, and new projections expected it to be nearly twice the size of the island. Three days before the storm was scheduled to make landfall, provisions like food and water were in high demand, but low supply. Since I had pinned my hopes on a storm’s dissipation, I was unable to purchase sufficient water and batteries. My school had issued a notice on Monday afternoon cancelling classes until further notice. They advised students to seek shelter and stay safe.

On Tuesday night, Hurricane Maria’s force began to shake the island. Fortunately, a classmate’s family opened their doors to me, and I finally felt safe. When the howling winds and pounding rain finally subsided after 20 hours, I realized that though the storm had passed, the hardships had just begun.

I was among the lucky few – though Maria had robbed me of my sense of security, I was physically unharmed. Like almost everyone else on the island, we were left without communication, electricity, and running water. The town that welcomed me, where my classmate’s family resided, was destroyed. Most families lost their homes, and several were injured. Roads were obscured by debris and fallen trees; essential concrete bridges had crumbled underneath Maria’s wrath.

While I sat helplessly in the dark, my family in Florida – that just weeks before had been affected by Hurricane Irma – had no way to contact me. The hurricane cut off all forms of communication to and from the island. I could only imagine how frightening my forced silence was to my family. I was frustrated, desperate to communicate to them that I was OK. Of all the emotional chaos I endured, not being able to make contact with my family was probably the worst of it.

Seven days later, when word spread across town that the highways and roads were safe, I was able to drive back to Caguas, the town where I live and attend medical school. I met nothing but destruction. My school, my apartment, my town – everything was unrecognizable. We would learn later that the school’s library’s ceiling had flown off during the storm and was flooded. All the computers where we take our exams were ruined by the rain. All the study rooms were flooded; the floor was damaged. The school had no electricity, running water, or internet. The student lounge, thankfully, was open and was operating with a generator, so students were able to charge their phones and make use of the microwave. Most hospitals were closed. But there was a silver lining: I was, at last, able to make contact with my family.

With the entire island in ruins, I contemplated a plan to leave the beautiful island I have called home for more than three years. At my apartment, I had no running water, no electricity, and little food. Lines for gasoline moved at a glacial pace, ice (in order to keep the little food I had left somewhat fresh) was nowhere to be found, and supermarkets were closed. More than two weeks after Maria had swept our island, I still felt the storm’s impact. I struggled to find water, to keep my apartment safe from potential intruders, and to keep my food from rotting. Medical school and my rotations were still definitely on my mind, despite the fact that I was in survival mode, but the island’s unlivable conditions forced me to find a way out.

After difficult and intermittent communication with my family and numerous cancelled flights, my father was able to secure a spot for me and three other classmates on the Royal Caribbean Humanitarian Cruise. For the first time in two weeks, I heard good news.

Royal Caribbean Cruise lines funded a pro bono humanitarian cruise, which picked up passengers that were seeking to leave islands affected by the storm, including Puerto Rico, St. Thomas, and St. Croix. The cruise also dropped off food and additional supplies. More than 4,000 passengers were afforded food, entertainment, shelter, medical care, and most of all, a way out.

I stood in the sweltering sun for more than 8 hours waiting to board the ship, and while we were grateful for the opportunity to leave the island, we were taken aback by the environment we faced in line. We did not have access to restrooms or water. All around us, many people were either fainting or fighting with each other, trying to get a spot in line. But among the chaos, I was able to count my blessings. I met a woman and her family who, just weeks earlier, had fled St. John after losing everything to Hurricane Irma. All of the belongings for this family of four now sat in one small suitcase that was light enough to carry. Their future seemed more uncertain than my own.

As soon as we boarded the ship, my classmates and I spoke to the ship’s medical director and offered to volunteer. The opportunity to help and share my medical knowledge with others who had just undergone experiences similar or worse to my own was beyond any recompense. We worked with closely with the ship’s doctors, nurses, and staff members who were all donating their time to heal passengers.

It was heartbreaking to see so many patients who had been directly affected by the storms, many who had not been able to see a doctor since Hurricane Irma, and who were now in even worse condition due to the devastation left in the wake of Hurricane Maria. My classmates and I were given the opportunity to evaluate patients by taking medical histories and we also served as translators. In this way, we were able to help passengers with both medical and emotional support throughout our 6 days on the cruise ship.

While I was lucky to be safe and on my way home to Florida, where the ship was scheduled to make its final stop, I couldn’t help but reflect on the chaos and destruction that surrounded me those final days in Puerto Rico. The uncertainty of my education and future medical career haunted me. In medical school, I tended to schedule my life around exams, rotations, and my patients. I realized I’d been isolated from “reality,” since, realistically, I only had time to focus on school. Having the privilege to embark on a medical career is not one I take for granted. Still, it is definitely an immense challenge that now seemed insurmountable because of the uninhabitable living conditions on the island. My already intense medical training had become severely stressful and uncertain. My school’s future seemed ambiguous – and, consequently, so did my third-year rotation schedule. I was unsure about whether mainland medical schools would be willing to open their doors to me so that I could continue with my medical training until the situation back home in Puerto Rico ameliorated.

Luckily, the University of Florida opened their doors, providing four of us with the opportunity to continue with our training in November. The faculty was more than accommodating, offering us a comfortable place to both study and sleep. Though we were uncertain about how to successfully integrate ourselves into the Gator society and curriculum, we were welcomed with open arms. Gainesville gave me a home, while other classmates went to New York, Chicago, and Boston.

As I write this essay more than three months after Maria wreaked havoc in Puerto Rico, my future still seems rather uncertain. The hospital where I was to do my surgical rotation reopened in January, so I had to return although the conditions are still not optimal. We face the challenges of very few areas with functioning electricity, and water. A chaotic traffic system with no working traffic lights, and a lack of police presence. I am now behind one rotation, since it took a while to relocate me to Florida. My fourth year rotation schedule has shifted so that I now have only a very short time to study for my STEP 2 exam.

Recently, a classmate, who resides in nearby Ponce, shared footage with me that grossly depicted maggots inhabiting her living space. The situation in Puerto Rico has not significantly improved. Political debate still surrounds the island’s uncertain future. But despite all the hardships and challenges I have faced throughout the past month, I am still hopeful. This might seem like naivety to others, but this time, though, my hope is different. I no longer hope that this new “storm” will either deviate or dissipate, but I know that after any storm, there is always a way to pick up the pieces.

Above all, this experience has fortified my love for medicine, my desire to help others, and my thirst for knowledge. I know I am on the right path, even if a hurricane has seemingly thrown off my own. Although the first month after the storm was one of the hardest I had ever experienced, I have grown immensely as a person. I have had experiences that supersede any knowledge I could have obtained by just reading or studying from books or research articles. Thanks to Hurricane Maria, I’ve grown to become a more emotionally intelligent individual, newly and fully equipped with both physical and emotional survival skills, the virtue of patience, but above all, the ability to practice resilience. No hurricane could stop me from continuing to pursue my path to the medical profession.