Throughout the past year, I knew I would write this blog post at some point – a blog reviewing my clinical rotation experience. I didn’t know I would be writing it while on a bus from Spain to France but here I am.
Today, I want to reflect with you and share some of the journal entries I made throughout this year. A year ago, I published my blog sharing that I was about to start clinical rotations – I re-read it and can feel my excitement and hesitations flowing out of the pages. If I could go back to myself when I wrote the blog, I’d simply give myself a hug and tell her “you have no idea how strong and capable you are.”
While I knew I was beginning a difficult year, I had no idea just how much I was going to be challenged and almost reached a breaking point just to be put back together for the better.
Grab a cup of tea or coffee, this is a long one so feel free to read this in pieces. I broke it up into little chapters for this purpose.
Thank you for allowing me to share my journey with you.
My First Rotation – Internal Medicine
September 27th 2023.
I walked to Brigham and Women’s Hospital with a smile on my face to hide my nerves. My very first day on the wards – mama I made it! I had woken up an hour ago at 5:45am to get ready for my first day and thought about the many first days I had leading to this point – first days of school, first days at research internships, first day at the NIH, first day of medical school, and now my first day at the hospital. I of course was wearing one of my favorite pink tops, my middle part buss down mindfully tucked back, and threw my stethoscope around my neck while thinking to myself “damn was aortic stenosis a systolic or diastolic murmur again?”. I shrugged the self-doubt away and looked in the mirror “you know what you know, you don’t know what you don’t – but you’re going to learn it.”
“You are enough.” I whispered to myself. This mantra that had taken me through undergrad now carried me through medical school.
I got to the elevator and stood in line to head up to the inpatient floors – thank goodness I left with enough time – if everything else goes wrong on this first day at least I got showing up on time in my favor. I knocked on the door of the resident workroom and opened the door.
“Good morning, I’m Kyeisha the medical student on service”
I would say that same sentence countless times in the next year as I rotated through various specialties, clinics, hospitals, and services within internal medicine, pediatrics, obgyn, surgery, psychiatry, primary care, radiology, and neurology.
November 2023 – Internal Medicine Continued
I was sitting in the Faulkner internal medicine workroom when I saw the message pop up on my phone from my mom. “It’s positive.”
I didn’t know it was possible to feel so many emotions at once and somehow also feel nothing at all. I got up calmly, excused myself to the bathroom, and looked at the message again. I called my mom, and she told me she can’t really talk right now because she’s waiting for a call back from the doctor but for me not to worry, not to cry, “everything is going to be alright.”
If you would have told me a couple months ago that my 2023 would end with my mother being diagnosed with breast cancer, I just wouldn’t have believed you. I don’t think anyone is ever prepared for a cancer diagnosis and although being in medicine we know the statistics and the likelihood of someone we know being diagnosed, that doesn’t seem to matter to me.
She’s not a statistic – she’s my mom.
As my mom has begun her fight against breast cancer and as I have started this PCE journey, I can honestly say that this has been one of the most challenging times for me. I’ve always been quite resilient, someone who cries maybe 3 times in the year maximum, someone who is solution focused, positive, and glass half full and I keep it moving. But being in the clinical year has been emotionally draining that I felt as though my tank was already on E, and then my mom was diagnosed with cancer, and the car stopped. I went through the first week or two after the diagnosis pretty much on autopilot,
I wasn’t sleeping well, my appetite was gone, I was crying myself to sleep, I felt dissociated like I was present but not fully, especially once I got home from the hospital for the day and having no energy to try to be ok, forcing a smile to my roommates, and escaping to my room to try to study through the tears that were falling. I had never felt so low.
It was as if the driver in me had called it quits, gotten out of the vehicle, and let the car cruise onwards on neutral – doing the best it could.
But when I accepted that I was not ok and asked for help, I felt in control again, back in the driver seat and feeling like myself again. I don’t know how to put it into words, but just experiencing the relief I felt when I accepted that I wasn’t ok reaffirms to me the courage that it takes to move past the denial phase of grief and processing. I still wasn’t ok but I felt that I was at least back in the driver seat and holding the wheel.
I had just a couple weeks left until my medicine shelf exam and the end of this first rotation. I had signed up for therapy, done my intake meeting, and was ready to start healing. I turned to God, praying and reading devotionals and felt God’s grace over me reminding me that I am not alone and Jesus is with me.
My experience admitting that I was not ok and needed help reaffirmed to me how much courage patients have when they show up to your clinic room or to your ER. In that moment of first meeting, you don’t yet know their story, and it is so important to use that first moment to greet them with empathy, respect, and curiosity. For some, they might have been in “autopilot” for so long, ignoring symptoms out of a fear of the diagnosis, or fear of judgement from the healthcare system, or perhaps they are a caregiver and put their own health to the side. There are so many variations of stories that bring that patient in front of you in the moment – and each of these story’s is unique. And each story matters.
My favorite part about medicine has been getting to know people and their stories and to have the privilege of a medical education to support them in being their heathiest and best versions of themselves that they can be. It is truly an honor to have people be vulnerable with you and share their life story, their hopes, and their fears.
When I first started PCE, I felt as though I was a burden to patients. Starting on internal medicine, it was a very overwhelming and demanding clerkship to start on and I felt that I didn’t know anything and didn’t know what I was doing. And suddenly here I was waking patients up at 7am to ask them questions and do a physical exam while they are in the hospital as one of the places they would most rather not be. I was struggling to find confidence in my role on the team when I felt that there was so much knowledge to be had and so much experience of treating patients with these cases that I didn’t have.
But as I got to know my first set of patients and move through my first internal medicine clerkship, I started to see how important my role was. Since I didn’t know how a case of diverticulitis presents, it allowed me to not have premature closure, to ask the patient questions and explain to them that I am a student, and they happily would walk me through their condition from the start of their history. Since I had a smaller patient panel, I could spend more time with each patient in the mornings and circle back in the afternoons. I remember one patient who opened up to me about her trauma history and I was able to advocate for trauma-informed care for her. Or another patient who’s family was visiting when I stopped by to tell the patient I was ending the clerkship and wishing him well – and to my surprise his family was like “oh you’re the medical student he was telling us about, thank you for being so caring.” Or my non-English speaking patient from Turkey who held my hand on her discharge day and smiled telling me how I was so warm it made her feel at home and didn’t make her think of Turkey – and as an immigrant myself that meant so much because I know how it feels to miss home constantly.
In addition to this, one of my favorite experiences has been being able to be that representation for patients as a Black medical student – another important way I contribute to the teams. In almost all of my teams thus far, I have been the only Black member, and I can say from my experience and from talking to patients that it truly makes a difference for the patient’s level of trust and comfort they feel. It’s not a difference in treatment or attention, but as one of my patients said it “its just the presence of knowing there is another sister in the room that just gives you extra ease”. And my Black patients give that extra ease right back to me, them saying “I’m proud of you. We need you in medicine, keep going” has always come at a time when I needed it most.
These patients kept me going through my internal medicine rotation. It was now December, and I was finishing out the rotation at our community hospital which meant waking up at 5, catching the early shuttle to get to the hospital in time to pre-round on my patients. It was wintertime in Boston, dark and cold. I would use the shuttle ride to read my devotional books – at this time I had started re-reading a book I had bought earlier in the year. “The Purpose Driven Life” – this book was like a “how to get to know Christ” manual and it helped me think about God’s purpose for me. I had to keep going.
My phone was filled with algorithms for workup for weakness, to AKI management, to antibiotics for pneumonia. I was getting more and more confident in my patient presentations and having more autonomy over my patient panel. And when I left the hospital for the day it was right into a workout and then into studying for my exam. I was pushing through!
For those not in medicine – a quick aside to explain what I was studying and learning. Internal medicine is adult medicine that comprises almost every organ system such as cardiology, pulmonology, hematology, infectious disease, dermatology, renal, rheumatology, and more. The exam I had to take covered all these topics and it was also my first NBME shelf exam.
I had my end of clerkship feedback with one of my assistant clerkship directors – she had been my attending when my mom was diagnosed. “Before we get too far into this call, I wanted to be the one to tell you that you passed the medicine shelf.” I started crying and she began to tear up too – “you did it Kyeisha!”
The relief I felt in that moment is hard to describe, I had honestly accepted to just do my best and accepted the possibility that I would have to retake the exam. But with God’s grace I had passed. We then went over my collective feedback from the residents and attendings I had worked with in the past 3 months and the feedback was stunning. They noted my passion and advocacy for my patients, my helpfulness to the team, my curiosity and willingness to learn.
My internal medicine rotation came to an end. It really set the tone for the rest of my rotations with one simple sentence “I can hard things.” I knew I had so much more ahead of me to learn and experience, but I knew I could do it. I was on this journey for a reason.
Video of me reacting to passing my exam
January 2024 – Pediatrics
Bring me the babies! I returned to Boston after a beautiful Christmas holiday in St. Martin with my family to start my next rotation: Pediatrics! Being home was the ultimate refresh that I needed, and I was so thankful my mom, brothers, and I were all home together.
I was so excited to start at Boston Children’s! After 3 months of internal medicine, two of which were inpatient services, I felt ready to expand my skills now that I had the basics of pre-rounding, patient notes, presenting and working with consultants. I truly had the best time on pediatrics. Kids are so amazing and they remind you of how precious life is.
In my personal life, I started the year off with finding a church in Boston. I tried a few different services and found a church I really connected with. I created my goals and prayer board for the year and started therapy. My goal was to not only succeed as a medical student, but to be a supportive daughter for my mom’s cancer journey, a wonderful friend, and caring and loving to myself.
After my first week of pediatrics, I headed to Maryland for the weekend (one of the many weekend trips I would make for the remainder of clinical year). On this trip, I was going home to be with my mom as she did her “big cut” before starting chemo. I arrived to Maryland late Friday night and Saturday morning we were up bright and early and drove to the barber for a 7am appointment – this way the shop was empty as my mom took this important first step for her treatment. We spent the weekend cooking, looking over family albums and laughing, and I soaked up every bit of family time I could.
Delayed flights and little sleep later, I returned to a snowy Boston around 2am. At 5am my alarm rang, and I was trying not to slip in the snow on my way to my first day of inpatient pediatrics. With a cup of coffee and a smile, I got through morning rounds, learning the new charting system, and how to best contribute to my team. At the end of the day, I felt the exhaustion fall over me and realized how challenging these weekend trips to Maryland would be in my ever demanding rotation schedule, but I was determined to make it possible.
In the next two weeks of hospital pediatrics, I learned how to care for patients with bronchitis, Kawasaki disease, asthma exacerbations, pneumonia, and more. I learned how to connect with the kids while also gaining the trust of the parents – it is truly a skill! I loved that during this time I truly took on the identify of a pediatrician. I wore my fun and colorful earrings with my scrubs and had a little toy on my badge. I also saw how much I was growing in my clinical skills.
I elected for a week of pediatric infectious disease – wanting to challenge myself to improve my knowledge of bugs and drugs. I didn’t realize I would challenge myself in a new way – patient loss. In pediatric infectious disease, I was on a hospital consult service for the first time and many of our consults were for patients who were very sick, immunocompromised, and in intensive care units. I had not been in an intensive care unit before and to do so for the first time on pediatrics was very emotionally demanding – it was incredibly difficult seeing little kids intubated as their parents stood at their bedside holding their little hands.
I selected a patient from our consult list to “carry” – this means I act as the primary caregiver for the patient and come up with a plan to present to my team and am the spokesperson to the parents for this patient. The patient was a 12 year old boy who was in septic shock from a group A strep infection.
When I saw the patient on rounds, I had to suspend my emotions to focus on learning to provide the best care. I asked his father who was standing at the bed “We are from the infectious disease team, we’re helping to care for your son. May we examine him?”
I blinked away my tears and approached the patient bed. He was sedated and intubated, his extremities cool and dark, his abdomen edematous. Out of respect, I will not include the rest of the physical exam findings.
His father watched on from the other side of the bed. I covered the patient back up and we stepped to the side to discuss the plan with him. I explained the antibiotics we had his son on, our rationale for choosing them, and that our team would be monitoring closely.”
“Did you have any questions for us?”
“Why does he look like that?”
My pathophysiology from preclinical year taught me how septic shock presents with low blood pressure as the inflammatory response causes vessels to be leaky resulting in “third spacing”, decrease in venous return, and thus insufficient perfusion. I knew this is why his skin was cold, I knew that his tissues were dying. I saw his lab values, I knew his organs were dying….
But what was it like to see your loved one be intubated, sedated, changed physically and not understand why. This is just one example of how much trust is placed in the physician – not only to treat but to communicate and explain the medicine to our patients and their family.
I wanted to study harder, to – so that when I said to someone’s loved one in the future that “we are doing everything we can.” That I know this is true, that I will have the knowledge and skills needed to provide the best care.
My attending had stepped in at this point and explained septic shock to the parent. In clinical year – there are times when it’s appropriate me to speak on behalf of the team and times like this when it is best for someone with more experience to take the lead.
The next morning, I got into the work room and began reviewing the patient’s chart when my fellow came up to me. “Kyeisha, you may want to choose another patient to follow – the primary care just let me know that they talked to the family and will be moving to comfort measures only.”
I checked the chart later that day to see the declaration of death and I felt numb. As I sit here reflecting on this moment, I still struggle to find the words – I still see his little body some nights when I close my eyes. I still think of the pain in his father’s eyes.
I think I’ll always remember this patient.
The strange thing about medicine is that my daily work is often someone else’s worst day. I began to feel this dichotomy more and more as the year went on and I got more accustomed to the hospital – there came a day where everything felt so familiar and just so “day to day “– and I had to remind myself to hold onto the nerves, unsureness, and fear I felt in the beginning of rotations because that is what so many of my patient’s around me are feeling.
February and March 2024 – Peds and OBGYN
I finished my pediatric rotation with even more glowing evaluations than internal medicine and passed my shelf exam. It was time for a rotation I was really excited for – OBGYN! I have always had an interest in women’s health – honestly one of my first memories that hints to my future as a doctor is that my mom’s pregnancy book was one of my favorite books. I would study the pages and see how the body would change through each week of pregnancy. I was really excited to go through the rotation – but I was nervous about the surgical aspect, I really hadn’t had any exposure to surgery and wasn’t sure if it was for me.
Now my 3rd rotation and months since I had accepted that I needed help and support, I was accustomed to letting my clerkship directors know that my mom was undergoing chemotherapy and what – if any – accommodations I might need. I am so thankful for the support and so grateful for the many ways God has blessed me. I started my OBGYN rotation on labor and delivery nights – this meant I had a post call day on a Friday before a Monday holiday, this allowed me to have a four day weekend and go home to Maryland to be with my mom. There were so many examples of favor and support from my clerkships throughout this year.
Labor and Delivery (L&D) nights were my favorite of this entire year. This was my first overnight shift and in typical virgo energy I overpacked my backpack with everything I might need. From the moment I stepped into the labor floor I knew this was about to be very different than the other services I worked on in the hospital. We got sign out from the day team and made did our patient rounds introducing ourselves to all of the laboring patients – before we could sit back down it was time to check a patient’s cervix, another patient had a concerning fetal tracing we had to look at, and patients started arriving in triage. There was never a dull moment.
I prepared for my first birth the way I would assume an athlete prepares for a game. I watched videos on how to be a helpful medical student during birth, reviewed the stages of labor, and read all the chapters on labor and delivery before my shift.
After pushing with a patient for three hours, at about 1 in the morning, it was time for action! “Ok Kye – game mode!” I told myself as I started putting on my gown and gloves. Of course with the nerves it took me like 2 minutes to get the gloves on but I eventually got them on, stood between the patients leg with my resident and was ready to go! We instructed the patient when to push and I could barely believe my eyes as the head came out – oh there are the shoulders! “Kye put your hands on top of mine” my resident calmly said to me. I got my hands on just in time as we guided the baby out and onto mom’s chest. The energy in the entire room was mesmeric as the baby started crying and the parents looked at their newborn.
All I could think was I am so glad I was just an extra pair of hands cause I was not ready for that baby to come out that quickly – I surely would have dropped it! The videos did not prepare me for that!
Me after my first births
The night went on and more births occurred between 3 and 5 am. I had never been so sleep-deprived yet so awake and alive. I helped deliver with “hands on hands” which helps me get a feel for the movements and delivered the placenta (hint pull smoothly and if it is not coming forward try changing your angle before pulling too hard).
My first shift was almost over and the sun was beginning to rise when we got a page “Stat C-section!”. My resident started running out the door shouting behind her “Kyeisha you should come too”. I had never been in the OR before and the next thing I knew I was standing there watching people hustle to get everything ready for the birth.
I try to be careful not to dramatize medicine because this is people’s real life not entertainment – but I have to say this moment was pretty much like a medical drama. A few moments later, the resident called out that she was ready to cut, the incision was made, the table was dropped, the baby was delivered – all in minutes. Mom and baby were both ok and healthy.
I stood there in the corner of the OR thinking “I want to be THAT doctor.”
My time on L&D was incredible, I helped with many more deliveries and C-sections. The residents were such great teachers and were so excited that I was interested in OBGYN – to be honest I thought they were such bad-asses I had a “professional crush” and them – oh and the attendings?? More than a crush I was full on in love! This is how I knew I really loved this specialty but I’ll save my gushing over OBGYN and my other patient experiences for my residency application.
Truly though – this was an exciting time in clerkship year where I could visualize myself as an OBGYN. Having that vision of your future self is so important to stay motivated to keep going. I wanted to improve my skills, to suture better, to have steady hands, to be confident in my presentations, and to connect and advocate for my patients. I was fully re-inspired and assured in my decision to become a doctor.
April 2024 – Radiology
Sometimes it is the moments that are more relaxed that you realize how tired you are.
This rang true to me as I started my radiology rotation – known in the HMS curriculum as a “radi-holiday” because the rotation is way less demanding and less time in the hospital. But instead of a holiday I felt more stressed than ever. After being on the go – especially the 6 weeks of the grind that was OBGYN, my body and mind let me know how tired I was.
To make it worse, I pressured myself to take on more and more – as I typically do. I had just watched my friends match into their amazing specialties and was so inspired from AMEC – I had that voice of doubt in my head “you’re not enough, you’re not making the most of your opportunity at Harvard.”
I really struggled throughout the year with these thoughts because there was so much I wanted to do but simply didn’t have the time – or the energy – due to how demanding the year was. And in reality – I was doing a lot. In the same week I was having these thoughts, I was headed to University of Maryland where I was invited to a panelist for Black Alumni week discussing being Black in science. My expenses were paid for, and I was the youngest panelist member. It was truly an honor and I surprised myself and how much I had to say and offer.
I was surprised again when some audience members had come to the event just because they saw my name on the flyer. I was talking with one person to the next after the event, so much so that one of the event coordinators had to help me and interrupt so I could have a moment to eat a bite. I am so grateful for opportunities like this and for the moments I could speak life into pre-med students whose shoes I was in just a few years ago.
Despite my achievements, I experience self-doubt and I put a lot of pressure on myself. So when I found myself in the chill radiology rotation, it gave my mind the space for these emotions to bubble up to the top. I ended up breaking down crying to my clerkship director – a story that will be in a blog post about my mom’s breast cancer journey. But instead of getting into that story, I thought I’d use this chapter to speak more in depth about the self care practices I leaned on throughout the year to deal with the pressure.
It all starts for me with my morning routine. The one hour I give myself in the morning sets the tone for me day and is dedicated time to pour into myself. I start with my skincare, brew a cup of coffee of my Nespresso, and listen to a daily devotional on my Bible app. I then take out my outfit of the day – even if it was hospital scrubs 90% of the time – I still was sure to enjoy the process of getting dressed. I then sit with my coffee and do my hair and makeup, often listening to a podcast such as Balanced Black Girl or Self Care IRL – which always gave me some gems to take with me for the day ahead. I grab my pink Telfar and make sure it’s packed for the day, apply some lip gloss, and put my pink Beats on my ears and start playing some soca music as I head out the door and to the hospital.
I cared for myself this year by moving my body. I honestly worked out this year more than ever before. The best way I found to do this was to always have gym clothes packed and go to the gym after the hospital each day. Now were there some days that I got to the gym and only had enough energy to stretch and head back home? – yup! But at least by going it became a habit for me. I went to weekly pilates classes – shout out my girl Kendall! And by the summer I had even started running – an activity I never thought I’d do!
I never miss a reset Sunday (unless I am traveling). On Sunday’s I take a break from studying and pour into myself. I start the day at church then make my way to the gym. From there it’s a brisk walk to Trader Joe’s to do my grocery shopping for the week and meal prep – and I started a habit of always buying myself a bouquet of flowers from TJs. It is a small but powerful act of self-love I maintained throughout this year.
I go to therapy. And I am a firm believer that everyone is deserving of therapy. In my therapy appointments I have a space that is fully designed for me, my growth, and processing my feelings and experiences. I worked through many experiences. In therapy I didn’t have to be strong. In therapy I didn’t have to be ok. I could just be honest with myself.
I could not have gotten through this year without my self-care practices. My advice for anyone starting medical school is to develop your own toolkit of self-care and self-love habits to utilize throughout your journey.
May 2024 – Psychiatry
My radiology rotation was over and it was time to emerge from the dark reading rooms to start my next rotation: psychiatry! For the next four weeks I spent my days at McLean Hospital and my nights learning the various psychiatric conditions and medications. If I had to sum up my psychiatry rotation in one word it would unfortunately have to be “traumatic”.
McLean is the #1 hospital in the US for psychiatry and it was such a privilege to learn at this institution. I was in the inpatient psychiatric unit that specialized in depression and other mood disorders. Since I was at McLean, many of our patients were complex, had treatment resistant illnesses, or other reasons that a primary hospital would transfer them to be treated at McLean.
All specialties of medicine are hard – it is emotionally demanding to treat sick patients. I found that treating some diseases and areas of medicine felt harder and draining to me than others – hence why we find the specialty that is the right fit for each of us. Psychiatry I quickly realized was too close to home and too triggering for me. To be frank – I believe there could have been more to prepare us medical students for some of the clinical positions we are placed into. In my psychiatry rotation, I listened to details of self-harm, suicidal ideations and attempts, rape, and other traumas. As part of their care team, I had to remain professional and keep my own emotions at bay as patients often broke down crying during interviews or while I interviewed a patient in an acute psychotic episode, and I had to balance listening and redirecting tangents or delusions while also forming a therapeutic relationship. It was the hardest work I had done yet.
When I left the hospital for the day, I was drained in a way I couldn’t explain. I would get home, hop in the shower, and cry. Every. Day.
They say that when a person is depressed you can feel it when you are in the same room as them and I found this so be very true – being in the depression unit for a month truly affected my mental health. To add to the challenge, I was very triggered by the work I was doing. Unfortunately, my father has struggled with mental health challenges. Many times throughout the rotation, I had memories and flashbacks to moments in my childhood and the fear and sadness of the little girl who experienced it would come back rushing over me. I was processing all that was being triggered for me, studying for the psychiatry exam in four weeks, supporting my mom as she underwent her final chemo therapy (it was impacting her body more and more as the chemo accumulated), and continuing to show up each day to the hospital.
It was really hard because I was trying my best to learn, to care for my patients, and I wished every day that I was not as emotionally affected as I was. But as I said, we all have our strengths and our purpose, my place may not be in psychiatry, but I am so thankful for the skills I learned in this rotation to help me treat my future patients.
In addition, the rotation actually became another healing opportunity for me because as I learned more about psychiatric illnesses it helped me to better understand, sympathize with, and ultimately forgive my dad. One day of my rotation, I spent it with social workers as we did home visits out in the community to clients with schizophrenia. After our visits were complete for the day, the social worker and I were chatting as she dropped me home and asking me about my journey. I talked about my move from Saint Martin, about mental health stigma in the Caribbean, and eventually about my dad – speaking with someone who had worked with clients with schizophrenia and other psychiatric illnesses for decades about my life and experiences was so helpful to me. She also was able to give me advice on how to do this work while also protecting ourselves.
By the time we pulled up to my apartment I was thanking God because I knew it was no accident that I was paired with this person for the day and that our conversation had spanned the topics that it did. She told me she had goosebumps as she heard my story and was confident I would make an amazing doctor – I shared how impactful her work is and how much our conversation had helped me.
When this rotation came to an end, I reminded myself again “I can do hard things.” I also told myself “it is ok not to be ok” because life is hard. In psychiatry, I talked with patients about their traumas, childhood, struggles, insecurities, and struggles with mental health and believe me when I say that every person has a story and their challenges. You have no idea what someone has been through. Treating each other with kindness, humility, and respect is the least we can do for our fellow human beings. I want to take this moment to remind us to check in each other. Tell people you love them and ask them if they are ok.
If you are struggling with your mental health in any way, know that there is help and that you do not have to suffer alone.
June 2024 – Neurology
“Hi, I’m Kyeisha. I’m the medical student on service.”
It was June now and I certainly have gotten used to saying this sentence. It was time to be a neurologist for the next four weeks. To be frank, at this time I described myself as “crispy.” Because your girl was burning out. Other than the one week of spring break – half of which I had spent at the SNMA annual medical education conference – I had been going non-stop since January. Whenever there was a long weekend I was on a flight to Maryland to be with my mom, and after the emotional demand of psychiatry I was in need of a break. But there was one more rotation before a one week summer break: Neurology.
I sat in the conference room for our orientation and we began reviewing the neuro exam and cranial nerves – I found myself digging into the depths of my own brain to pull out the neurology I had learned in my preclinical course. “Damn Kye, gonna have to start studying immediately.” I thought to myself.
I began rotating through inpatient neurology. On this service, we had many patients who had suffered from a stroke. I came in one morning, took a sip of my coffee, and looked over our patient list. Reading over the one-liners I felt gutted as I read “51 year old with hemorrhagic stroke.” I checked the patient demographics in the chart: African American woman.
Within my first few days on the neurology service, the racial disparities were glaring. I quickly saw a pattern that the sickest patients and youngest patients were Black.
We’ll call this patient Ms. S – I read over her admission note and I was simply angry. Why was she not seen by a primary care provider? Where were the interventions? What could have been done for this patient before she experienced a stroke? Hypertension was truly a silent killer – especially in the Black community. But it doesn’t have to be this way.
We were on rounds and Ms. S was up next. “I’m presenting her this morning.” I saw my attending looked a little surprised that I would choose this patient to present because her care plan was complete and we were preparing to discharge. I went through my typical presentation on the patient’s vitals, medications, physical and exam and got to the plan for the day.
“I was thinking that as we prepare her discharge today if it was possible to help her have a PCP? I was reading over her chart and it seems she has been hypertensive for years now but doesn’t have a primary care provider – this could be a step to prevent her from having previous strokes or other health issues.” My attending nodded, “great point Kyeisha and thank you for addressing this on rounds with us.” We were able to have the patient enrolled in the Internal Medicine resident clinic and I asked Ms. S if she would like to be one of my longitudinal patients which allowed me to call and check in with patients throughout my clinical year. My time in neurology fueled in me the critical need for primary and preventative care.
I also have a lot to say about the hardships of being a Black medical trainee and seeing the patients that look like you be the sickest, youngest, and with worse outcomes because of systemic and intuitional racism. I have a lot to say about the pressure of being one of the few said Black medical trainees now part of the system and balancing advocating and changing the system from within with getting through the system so you can successfully graduate and be the doctor that these patients need you to be. I have a lot to say on how the micro and macroaggressions of being a Black medical trainee can easily wear you down when you are already in a high-pressure and difficult training environment. I’ll save more on this experience in a separate essay because it is a topic of its own, but I found it summed up well by this quote from physician and writer Dr. Omolara Thomas.
June was also the month of my mom’s breast surgery. I remember when her team was scheduling her surgery day a couple weeks prior. “Do you know what day you would be able to make it Kye?”.
“They don’t tell me my schedule that far in advance Mommy, but just go with whichever date I’ll figure it out. And I’ll be there.” I had made the promise and prayer at the start of the year that I would be there for my mom and I would make it through clerkship year.
I was on consult services the week that she was scheduled for surgery. I let my team and clerkship know that I would be taking one day off and that Tuesday night I headed to Maryland. Wednesday morning I drove my mom to her surgery and I was so grateful to be there for her. My mom has always been very proud and is the type to let any stranger know that her daughter was in Harvard medical school – but today it was not only pride but the representation I now possessed being physically there to advocate for my mom not only has her daughter but as a medical student as well.
The tears in my eyes came as they rolled my mom back to the OR and I made my way to the waiting room. All I could think of is how grateful I was to the surgeon and all of her providers for taking care of her.
Surgery was done and everything went great! Thank you God! I updated the family WhatsApp and drove her home, then went to the grocery store and cooked for her and my brothers and cleaned the house. Before I knew it, it was time to go back to the airport.
The next morning, I was back in the neurology consult room, I was thankful for my mom’s successful surgery but I also felt…numb. Truthfully, I wanted to still be with her.
My mom’s doctors sacrificed much on their journey’s I’m sure – and I am so thankful they did so they were able to take care of my mom. I’ll sacrifice more on this journey as I keep going – but if at the end it means I care for someone’s mom it will be worth it.
July – September 2024: Surgery
The OR lights turn on. The drapes are applied. The time out starts and everyone introduces themselves and their role in the patient care and we state what procedure we are doing for the patient today. "Scalpel please." - The incision is made and the surgery begins.
My surgery rotation was a highlight of my PCE year!
A quick aside - I know the last few chapters have felt quite heavy. This blog is sounding like it needs to be retitled something like “my tell all” or “my terrible clerkship year" - that's not the case, I just wanted to highlight the raw truth of my clerkship year experience.
It's just I have found that in medicine people don't talk about the hard stuff. Maybe it's out of fear that a residency program director would read a blog like this and be like "oh no she admitted to struggling sometimes or that this work affected her - remove her candidacy. But I truly do feel that the culture of medicine is progressing. As far as my thoughts, I always share everything with the assumption in mind that a peer, patient, attending, or program director may be reading it - actually with hopes that they would read it. This blog is a look into my journey, it's true to me, it provides advice for students like myself who are first in their family to enter medicine, it inhertantly subjuctive and personal. It's a personal brand separate from my professional brand. Anyways, I always used my platform to share in a way that is genuine, empowering, and shines light on my truth.
I spent three months on surgery throughout my summer and it was one of the best summers I have had. I think this was for several reasons, the first is realizing I want to be a surgeon. My previous surgery experience was in OBGYN at the start of this year but it was a shorter rotation and with less OR time. Now in my surgery rotation, I spent majority of my time in the OR and really began to visualize myself as a surgeon.
I believe that this being my last rotation was also a huge boost for me! I could focus on learning and being part of the team with less of my brain being used to just get used to the hospital and how to be a medical student. It felt great to actually know some things! I now had knowledge from internal medicine, pediatrics, OBGYN, neurology, radiology and psychiatry! In this final rotation, I showed up more confident and I started seeing my knowledge and skills grow exponentially. It was an incredibly rewarding experience after the hard work I had been putting in all year.
I knew I loved surgery because I felt more excited and energetic for my 24 hour trauma shifts than I had felt in the previous months. I was glowing in this rotation and motivated to push myself and improve my skills. I found that my detail oriented mind appreciated the delicateness and precise nature of surgery. And I loved the impact we could have on patient's lives.
One of my most impactful moments in this rotation was re-meeting a patient I had cared for during my very first rotation. She was one of the very first patients I had cared for and her story impacted me so much that I had journaled about it and thought about her often. So when I saw her name on our patient list I knew I had to go say hi - to my surprise she remembered me and the connected we had months ago was back. I sat with her and talked about how she had been since her previous hospitalization.
She was so thankful to have a familiar face while she was going through a scary infection that we needed to operate on. She openned up to me and I promised her I would be there for her surgery, that she would see my face before we put her to sleep and I would be there when she woke up. Being able to be there for her in those moments was so meaningful to me.
The patients are why I do this, why I pushed through, why I stay up at night studying, and they are what push me to become better. I have so many patient stories from my one year of clerkships that have formed how I will care for patients as a future doctor - I can only imagine how many more patients will mold me as I continue my training.
Just like that - it was my final day of clerkship year. I turned in my pager. Cleaned out my locker and walked through the hallways of the hospital where I had experienced so much in the past twelve months. As I walked out, I thought about all the attending, residents, nurses, techs, patients, and staff who had taught me, mentored me, and trusted me.
I walked out a look at the Brigham and Women’s Hospital sign and I felt...complete. It felt like when a really good movie ends and the ending just makes sense and you leave the theater in awe of what you had just witnessed. I had given this year my all and in return I am forever changed for the better.
Thank You
If you made it to the end, thank you for reading what I am sure is the longest blog I have written to date. I had a lot to reflect on and experiences that were hard to put words to - so I hope it made sense. Nothing will fully capture my experience of clerkship year but I think this blog came pretty close at highlighting some key parts of my experience.
I mentioned at the start of this post that I wrote this while on a bus from Spain to France – a few days after my last day of PCE I headed to Europe for a vacation to visit my cousins and it has been everything I could dream of. As I write this, my mom has also completed her last radiation treatment and is cancer free - we thank God!
I am so excited for my third year of medical school. Upon returning from Europe I will start my dedicated study period for my Step 1 exam – my first MD licensing exam. I have many passion projects in the works and I'm just excited for what this year will bring.
I am thankful to be on this journey. It is such privilege to be a medical student and I am dedicated to keep growing into the doctor God has envisioned for me.
Thank you for supporting me! I am forever grateful!
xoxo,
Kye
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