What Is a Hero?

Quandary and Claim

Recently, the discussion as to whether the football players who took a knee during the national anthem were heroes has been zooming across my social media feeds. Often those who do not believe they were heroes show a side-by-side of a sportsman next to a soldier and proclaim that the soldier is the real hero. The first time I saw the comparison it irked me because it is an-apples-to-oranges argument. Further, I think the logic is founded on false pretenses because it says that what title you have determines your hero status. History has shown us many times that title and profession have little to do with heroism. Think of any recent disaster you’d like, you’ll find a story of some common human stepping up to be a hero. Further, being a hero is not exclusive, which is to say that just because one human is a hero does not mean another cannot also be a hero.

Being anything, even a soldier, does not automatically make you a hero. Many soldiers grow to become heroes, their line of work can be a selfless one, but not all. It is unwise to overlook the crimes specific, individual soldiers have committed—the pain they caused soundly rules them out as hero candidates. It would also be foolish to say that any highly-paid athlete is a hero—providing entertainment and winning games does not a hero make.

Some Incomplete Definitions

Google defines hero as, “a person who is admired or idealized for courage, outstanding achievements, or noble qualities.”

My Merriam-Webster dictionary ap defines hero as, “a person who is admired for great or brave acts or fine qualities.”

These definitions leave a bit to be desired because they do not define what exactly an “outstanding achievement” or “brave act” is nor do they define what “noble” or “fine” qualities are. So, let’s explore those concepts.

Outstanding Achievements and Brave Acts

I do not believe that just any outstanding achievement or brave act makes you a hero.

For example…

Getting into medical school is an outstanding achievement, but all medical students are not heroes. It is brave to ride a motorcycle down a curvy, highly-trafficked highway (if you worked in the emergency room you’d think that too), but not all folks who ride motorcycles in dangerous places are heroes.

Selfless acts make heroes.

The acts and achievements that bring “hero” into the dialogue are those where an individual does something that will help another person or group (family, peers, race, gender, nationality…etc.) even though the cost of that act for the individual outweighs any potential personal gain.

For example…

The firefighter who rescues a kid from a burning building. A bystander who helps an old lady cross the street even though he is then late for work. MLK who scarified his freedom and life to fight for equality. The soldier who threw himself on a grenade to protect his comrades. The teacher who stayed after school every day to help a struggling student grasp the material. Malala Yousafzai who spoke up for women’s rights even though it put her in harm’s way. The list goes on…and on…

Noble and Fine Qualities

Similarly, not all qualities that are noble and fine are heroic qualities. Being kind is a noble quality. But kindness alone doesn’t make you a hero, it just makes you a decent human.

Qualities that heroes often embody are selflessness and a fierce definition of right and wrong. I would argue, however, that a hero need not exhibit these qualities every moment of their life.

So, what is a hero?

A hero is someone who changed the course of another’s life (or many others) in such a way as to reduce their suffering, increase their happiness, or protect their individual freedom to reach their full potential (I’ll leave you to define “full potential”) without directly benefiting themselves. Heroes can be local, national, or global. The scale does not detract from the heroism, it simply describes how widely known the hero’s story is. I believe a child who stands up and stops other students from bullying a classmate on her playground is as much a hero as Nelson Mandela, even if the impact is smaller. It is not easy to act selflessly. It is true, however, that some professions and circumstances provide more opportunities to be a hero. I would also argue that “hero” is not inherently a permanent title. It is fleeting and describes a specific act during a specific time. However, some people are so often heroic that they earn the description again and again.

Conclusion

It is not productive to nitpick whether Colin Kaepernick is more of a hero than a soldier. It is worth acknowledging that Kaepernick did something that many football players have not. He brought race discussions to the forefront of entertainment. He forced us to examine if our country is living up to what we claim our guiding principles are in a time when public figures have attacked just about every minority and women. In making us question if our country is truly fighting to give ALL its citizens the right to life, liberty, and the pursuit of happiness Kaepernick made me wonder if we are giving our soldiers the chance to be national heroes or if we are putting them in impossible situations where they can only be heroes within their unit because their country is sending them into battles that cause more harm than good. I think it is important to remember that even if not every soldier is a hero their profession is asking them to put country before their own life. That is a big request; it would be worth reminding our leaders that such a request should weigh heavily on every decision they make.

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Leader vs Boss

The many teams I work on (of varying sizes) throughout my shift in the emergency department have provided ample opportunity to experience different team leads. And, in recent weeks, I’ve been reminded of a lesson I once taught my Paraguayan students (I taught life skills classes to grades 7-12 as a Peace Corps volunteer in Paraguay for 2 years). The lesson was during our leadership unit and it was on the difference between a leader and a boss.

Lesson

I started my class with the following image:

I defined the differing titles as follows:

Leader

A leader is someone who leads by example. They are skilled, trustworthy, and levelheaded. A leader is confidant with their abilities, but they are willing to change their tactic if any team member has a better idea. A leader gets their hands dirty. A leader reminds you of your strengths and approaches weaknesses as learning opportunities not permanent shortcomings. A leader is willing to have that hard conversation or make the decision no one else wants to make. A leader makes every team member feel like the project belongs to them, not just the leader.

Boss

A boss is someone who leads by giving orders. They think their way is the only way and expect others to follow them. A boss is an expert, but they are not someone you go to when you’re having a problem. A boss is the first to address a shortcoming or mistake and says little when a job is well done. A boss stands above the work, but tells you how you should complete each task. A boss makes all the decisions, but when something goes wrong blames it on the team. A boss expects you to pledge allegiance to their project.

Reflection

It’s not the breadth of knowledge or the level of skill that distinguishes a leader from a boss. They are differentiated by how they approach their colleagues. When I was a teacher, I asked my students to reflect on which type of team lead they’d rather follow and they always picked the leader. I asked them, then, how they were going to be leaders rather than bosses.

“Listen and be kind,” they said.

We could all remember my students’ advice. For some it comes easily while others have to remind themselves to listen and be kind. However, as long as the end is reached, it’s okay if being a leader doesn’t come naturally at first.

When work is slow, the opportunities to dish out compliments are obvious and abundant. Amid the chaos of a high census (lots of tasks all at once) or when faced with a critical patient, it can be harder. Leaders always find a way to lift us. That’s why we follow them. When the going gets tough, leaders bring us together while bosses push us apart.

Choose to be a leader. Your team needs you.

Work-Life Balance

Why do some people always seem to have time for vacation, camping trips, and concerts while others always seem to be working? How do some people function on what seems to be no sleep? What exactly is work-life balance? Is being a workaholic a problem or just one way of giving life meaning?

Some Case Studies

Hospitals

Health care is full of people who work almost around the clock—nights, weekends, and holidays are fair game. But, for example, the shift work of nursing can allow for many days off every 2 weeks. Plenty of nurses I know take advantage of 36-hour, full-time work weeks (broken into 3, 12-hour shifts). A sample biweekly work week is 3 days working, 1 day sleeping, 3 days working and 7 days off. Despite the exhaustingly long shifts, these nurses enjoy 4 more days off every 2 weeks than a person who works a job Monday through Friday.

My American Family

In my immediate family, there are many models of work. Several of my family members are self-employed. They may work every day but they might also take long stretches off. Some days are long; some days are short. My sister is a trainer and fitness queen. While she often works fewer than 40 hours per week, her hours are spread out across every day of the week and at different times of day such that taking even one day off requires scheduling magic. There’s my step-mom who has the stereotypical workaholic, business schedule which is based on an 8-hour slot Monday through Friday. Of course, a few hours are tacked onto each day and she works additional hours over the weekend. In the end, she works something like 80 hours a week even though she’s on paper for 40—and, stepping away for any stretch of time seems impossible.

Paraguay

In Paraguay, holidays are sacred, summers are lazy, and commutes are so long they seem unreal. Except for the man I knew in the Navy and some small business owners, no Paraguayan I met while living there worked during a national holiday. Perhaps that’s different in Asunción (the capital) and in major hospitals (of which there are few) but generally Paraguayans don’t work holidays. Additionally, few people work on Sundays. Almost nobody works past midnight. While many Paraguayans have long commutes to work and work long hours, the number of days off they have in a year dwarfs the number of days off many Americans choose to take.

Paraguay vs US

In Paraguay, family comes first for most people. Most people work to support their family and buy nice things. Most Paraguayans prioritize time off visiting, eating, celebrating, and watching soccer over working endless hours. Most Americans prioritize working. Many Americans bank hundreds of vacation hours that they cash out or lose entirely. Of course, these are stereotypes…but, during my experience living in both countries, the stereotypes of family-first for Paraguay and work-first for the US seemed justified. I’ve often asked myself, “Who has it right?”

The Perfect Balance

The balance between work and other activities isn’t static. The perfect balance, the one that yields the greatest happiness, is unique for each human. Neither the Paraguayan approach nor the American life approach is better, they are just different. Paraguay taught me the importance of downtime while the US emphasizes overtime and constant production. Regardless of who you are, there are times when work should come first and times when family, vacation, rest, or anything else must come first.

Winning the balance comes down to being willing to reflect on your life and to make changes. For example, when one of my friends frequently complains about working too much or is always exhausted, I often ask if it’s time to scale-back or change their work schedule, job, or approach to working. When another friend often talks about being bored at work or not making enough money, my thought is that it’s time for them to invest more effort in professional growth. Is it easy to change things up and move toward something different? No.

It’s hard to reflect on your life and make meaningful changes. What I do to face the challenge is break my life into chapters and then identify what made me happiest and saddest during each chapter. I use what I identified to inform my guesses about what I need to do today to tip the scale more towards happy going forward. I tend to be work-centered (mostly because I love learning and feeling productive). As a result, the life side of my balance always requires more attention and energy than the work side. Knowing this, I put extra effort into “life” to keep my scale level. My scale often dips one way or the other, but I try not to let the off-kilter stretches jar me. Rather, I make small adjustments until I waver around a mix of experience that feels right for the time.

Sirens

Life boils down to tidbits like sounds. These days as I walk the sidewalk—scuttling, rambling, or strutting from one place to another—I listen to the sirens. Since running (EMT talk for “working”) on an ambulance, I accidentally developed the ability to distinguish fire truck, police car, and ambulance sirens. Since studying the Doppler effect, I can tell if the sirens are approaching or withdrawing. And since learning to drive an ambulance, I know that a change in siren tune or the blast of an air-horn indicate that the vehicle is at an intersection.

I never cared much for automobiles. I still don’t. I’m not particularly proud or impressed by my siren radar. Nor am I gleeful about that fact that I always notice ambulances, no matter where I am. Before joining a rescue squad, I hardly ever processed sirens or saw ambulances because I lived in a city where there are so many of both they become part of the background. But, since moving to the countryside again and joining the world of emergency medicine, my consciousness has changed. I find myself almost subconsciously tracking the progression of sirens around my large Vermont town. A cop car went first—drugs or a car accident maybe? Just an ambulance—maybe the firetruck is out already and it’s just a medical call? Firetruck and ambulance—maybe cardiac arrest?

I started noticing that I listen to sirens because I was thrown into a different world of sounds: the soundtrack of the emergency department. The emergency department is noisy. There are the heart monitors that beep along with patients’ heart rates and alarm whenever the heart rate or oxygen levels deviate from a norm. There’s the clicking of blood pressure cuffs inflating. There’s the sound of wheels scraping as wheelchairs and beds and carts with supplies skid across the linoleum floor. There’s the clacking of those typing about what medications they gave and assessments they did. There is the thud of quick footsteps and the shuffle of walkers. Patients groan and puke and roll in their beds. And that is only the beginning.

I think all the noise is why, after a long week of work, I seek a few hours where people are scarce. It’s hard to think when there is so much to grab your attention. In the bustle of life, we can forget what the wind and the waves and the trees and the birds sound like. But more than anything else, we forget the sound of silence. I’m not talking about the strained, artificial silence of a library during finals week. When I say “silence,” I mean those moments when no one else is there to drop a pin. I’m talking about the silence that can’t be found in a city and is endangered by our social lives. If nothing else, I think true silence helps us ground ourselves and gauge when life’s racket is distracting us.

When I stroll about my town, I always hear the sirens. When I visit the woods where I grew up, I erase the ringing of so many sounds and soak in the quiet of the trees. I’m grateful that I can experience both.

Mansplaining Women’s Empowerment

I went to a training on managing aggressive patient behavior, mostly via verbal de-escalation. The class included a section on basic physical defense—such as getting out of a chokehold and escaping when someone grabs your arm. The skills were useful, but I found myself more frustrated than fulfilled by the class. What ruined the class was that one of the instructors preached for 20 minutes about how the young women in the class should feel empowered by the self-defense skills he just taught us. He told us some stories about women who were raped and killed because “they didn’t put up a fight.” He explained how we should be careful, avoid bad situations, and if attacked fight back.

Mansplaining: definition from the wiki article, “(of a man) to comment on or explain something to a woman in a condescending, overconfident, and often inaccurate or oversimplified manner.”

I was insulted by the lecture because as a woman I’ve been told countless times to be careful. When I told my family I was joining a night crew on an ambulance squad, almost before I was congratulated on finally starting as an EMT, I was asked if it would be safe for me to sleep at the station with my male crew members. Throughout my Peace Corps training, we had sessions on gender relations and how to avoid getting raped in our host country. In college, our advisers used to give us party-going strategies to avoid getting drugged. The list goes on.

It is NOT empowering to be told that you’re a victim and will always be a target. It is NOT empowering when people create boundaries (perceived or real) for you. It is empowering when others complement you on your success, offer intelligent advice as you work through challenges, and lend their support as you strive to reach lofty goals. Let me offer an example of what disempowering and empowering look like:

Disempowering: In a recent conversation with a male nurse, both the fact that I’m applying to medical school and my age (I’m almost 30) came up. The nurse didn’t comment on my age until I mentioned I’d applied to medical school. Upon hearing about my professional ambition, he “jokingly” asked why I wasn’t married and pregnant at my age. That is such a classic example of sexism it could be in a textbook. He never would have asked any man that question, even in jest, about applying to medical school.

Empowering: Upon telling one of my mentors about a test score I wished was higher, he said that he was sure I’d be just fine and turned to the other person with us to explain that “good” by my standards was quite different than “good” by most standards because I have high expectations.

Being an adventurous, single woman does clash with society’s view of women. How can I travel to foreign countries alone? It’s so dangerous. How can I go hiking or camping alone? It’s so dangerous. I’m not going to argue that those activities are safe. What I wish to suggest is that I have the intelligence to decide for myself what is safe and not safe, worth the risk and not worth it, and how to avoid unnecessary danger. I don’t need people to remind me how awful the world is. I need people to help me figure out how to overcome the challenges between me and reaching my goals.

What I wish that the instructor of the class about managing aggressive behavior knew is how many creepy men I’ve avoided in my life already, long before his class. I wish he understood that I don’t need him to tell me I should be careful and fight back. It is not empowering to be viewed as a potential victim of aggression, especially sexual aggression, even if you know how to fight back. It is empowering to be seen as a peer and fellow human with dreams, strengths, and weaknesses that transcend sex and gender. That is what women’s empowerment is all about; being viewed as an intelligent being and not an object or target or static lump.

On Not Becoming Jaded

One night a coworker in the emergency department, who also aspires to be a doctor, asked me if I was worried about becoming jaded as I worked in health care. I answered confidently that I wasn’t worried about becoming jaded, my hope for humanity waning, or burning out like so many medical professionals do. He was skeptical, but I am certain of only that one aspect of my future.

Defining Jaded

Especially late at night when most patients are tired and grumpy, the drunks roll in after exhausting the bars, and the patients held for mental health evaluations decide to spend the early morning hours holding yelling matches that involve nonsensical accusations against staff, it’s easy to see how one can grow tired of working in a hospital (and specifically the emergency department). In medicine, we take care of everyone, even if they’re jerks to us, because the fundamental principle of health care is that we serve all people.

Not so long ago I was greeting patients in the waiting room at the emergency department. We had around 20 folks waiting for rooms, the rooms weren’t changing over, and the wait times for many were over 2 hours. That’s a recipe for an unpleasant experience as a greeter, and the recipe was rich that night. I had a parent repeatedly insult the staff, including me, and ask why we hadn’t brought her child to a room yet. That was annoying, but manageable. What got to me was when she stormed up and demanded to know why we brought back “a drug addict” (her words, not mine) before her child. Her argument was that her child had a bright future while that person was a lost cause. Of course, I couldn’t tell the hysterical mother just how awful it is to watch a person go through withdrawal shakes and then seizure. That’s something you can only understand once you see it. I couldn’t tell her about the alcoholic who came to us one night shaking so badly he couldn’t drink water from a cup. I couldn’t tell her how he had looked me in the eye and told me he wasn’t human anymore. That mother was choosing to believe him, but I knew that that patient was human even if he didn’t feel like he was. That angry mother in the waiting room clearly had never seen a person beat an addiction—winning the daily fight to not give in to a drug or alcohol for years. I have.

It’s not the job of medical professionals to pass moral judgment. Sometimes we are weak and tired, and we do judge our patients’ life choices. But if we were to slip into a world where we used our personal morals to decide who should receive care, we would betray the heart of medicine. Medicine was never meant for only a select few.

In my view jaded is another way to describe losing empathy. There are many presentations—impatience, anger, and hating work to name a few. These feelings come when we are too tired and too worn out to see patients as humans. They come when we no longer find joy in the small things about the job that are awesome. And jaded becomes the norm when we give too much. It’s easy to work hours no one else would dream of working when you’re in health care. Each hour is rewarding because we help someone feel better, but the hours take a toll on the giver.

Considering all the above, how am I so certain I won’t become jaded?

  1. My empathy comes from selfish sources, so I don’t expect that it will fizzle. The first source is curiosity and the second is a love for stories and puzzles. Each human has a story. Each sick person is a puzzle. The curious mind can’t help but wonder about the story plot and the answer to the puzzle. These two factors are some of the main reasons I veered down the medical path in the first place.
  2. I know that I’m brave enough to step away and recharge as well as to shake things up when caring for patients under specific conditions becomes wearisome.

How do I know I am brave enough? Paraguay. While living in the land of Guarani, I cultivated an ability for self-reflection and the bravery to face fears because they were required to survive the Peace Corps. Paraguayans also showed me the value of letting yourself be still. In America, we are so determined to be productive we schedule every moment. I think running around all the times makes everyone miserable no matter what their profession. I also think those who become jaded forget to reflect and change. They fail to see that their job is draining them until it’s too late and, then, they lack the courage to change their work so it’s fresh again. It comes down to the best professional advice I was ever given. When I asked a presenter in one of my undergraduate classes how she knew when it was time to leave a job (she had an awe-inspiring, lengthy job history) she said, “You’ll know. You know when it’s time to leave.”

She was right. We do know when it’s time to mix things up. The hard part is taking the steps to act upon what we know. But, if we do take those steps, then jadedness can never catch us. The moment she gave me that advice, years ago now, I promised myself I’d be strong enough to change my course whenever I “knew” it was time. That strength sent me to Paraguay and brought me back to Vermont. So, no, I’m not worried about becoming jaded. I’m just excited to see where my adventures in medicine bring me.

Human Side of Medicine

Not so long ago I worked a code (cardiac arrest = patient’s heart stops and they neither have a pulse nor are breathing) in the field. The patient was middle-aged and had a complex medical history. The patient’s father, visiting from out-of-town, found him unresponsive, started compressions, and called 911. We did all we could—did compressions, ventilated, pushed epinephrine and other medications, and analyzed for a shockable rhythm. As we worked the father knelt at his son’s head. The patient’s fiancée sat outside the house. As it became clear that we were not getting our patient back, my crew chief reviewed, outload, all we had done. She asked us if we could think of any other interventions we hadn’t yet done and then she engaged the father, explaining why we were going to stop resuscitation. Once we had stopped she went outside to talk to the fiancée.

As heartbroken as the patient’s family was, they were calm when we stopped CPR. They had seen us sweat over their loved one, try everything we could, and ask for suggestions. We included them in our decision to stop our efforts. We lingered after our care was done to answer questions and offer condolences. This call showed me how it is within the pauses between action that we connect with our patients.

The human side of medicine comes through when we take time to ensure our patients understand what is happening and our plan for treatment. It comes when we include our patients and, when appropriate, their family in decisions about their care. And it’s completed by taking a moment to share their feelings, whether of relief after a successful procedure or sorrow after the loss of a loved one, before we scurry on to our next case.

Amid medical histories and assessments of signs and symptoms that lead to differential diagnoses it can be easy to let the presence of a disease or condition consume our attention. We can focus so intently on the disease that we forget humans bear the illness. But, below the clammy skin and wheezing is a person with a family and life experience just like you and me. And, what the patient will remember from their time during the flurry of a medical crisis is how someone treated them. It’s the offering of a kind word or an act of kindness on the worst day of someone’s life, not just the hope and likelihood that we have a cure, that defines good medicine. I try to remember to take advantage of the pauses by offering a blanket or bit of conversation to my patients. There aren’t always many pauses in my day, but when there are I don’t like letting them go to waste. It’s in the shared moments between points A and B that we build our humanity, but we must be attentive or we’ll miss the opportunity.

In Arlington Cemetery

This summer we held a memorial for my grandfather in Arlington Cemetery. His name will be on one of the niches in the columbarium. He was in the Navy and served in the Korean War. The service was short and concise. I think its precision and simplicity was well suited to my grandfather who was a high school and college math professor and liked things to be just right but not conspicuous. The chaplain was empathetic and caring and the soldiers who performed the flag ceremony were on point. As we said our formal goodbyes a trumpet’s song floated in the air above us.

My grandmother used to comment how they enjoyed when I visited because I’d sit all day and laugh as my grandfather told stories. He was a particularly gifted storyteller with the dry wit that ignites my science-loving and logic-focused brain. He told stories of the Navy (usually when he and his comrades were causing trouble), his struggles as a student (he went for a doctorate in math but didn’t finish his thesis because of a disagreement with faculty), or his adventures as a teacher (he had many years of teaching from which to draw).

In EMT lingo, my grandfather had an “extensive cardiac history.” When I called my grandmother after hearing of my grandfather’s passing she told me, “The EMTs who responded to my call were wonderful. You do good work.” She said that even though they couldn’t get him back. His heart had stopped and he had no cat-lives left. When my grandfather died, I’d been volunteering as an EMT for several months.

I’m still an EMT and I also work in an emergency department. An interesting thing about providing emergency medical care is that your mission is to lessen pain and ward off death, but you end up seeing a lot of both. You end up being there when medicine meets it limits and the time of death is pronounced. I sometimes wonder what the EMTs at my grandfather’s death thought. I wonder how they ran their emergency call. What did they do to make my grandmother feel like they’d done the right thing? I hope the families of my patients have the same impression when we determine it’s time to stop CPR.

I used to visit Arlington National Cemetery periodically when I lived in DC. I like cemeteries because I enjoy walking the tombs and imagining the histories of the people they memorialize. Now when I visit Arlington, I won’t have to invent my grandfather’s story because I know it. I’m a product of it. I think of him often, partly because I wish he’d send me some of his math-genius as I continue my medical studies. Mostly, I think of him because he is one of the few people I know who successfully and completely built a life he loved. His only unfinished business is the family he left, especially his wife, but we’ll join him again one day if afterlife exists. Until then, we’ll keep making stories worth telling just as he always encouraged us to do.

Photo Credit: Mary Lou (family friend)

Night Shift

A few months ago, I started working the night shift in an emergency department (ED). Those who have known me awhile were surprised that I decided to work owl hours. When no other forces are at play, I happily get up at 5 a.m., even 4:30. Until I took the ED job, I got up early to study or run before going to work. In college, I worked the opening shift at Starbucks. In high school, I got up to work out or study before my sibling hooligans stirred. I love the stillness of dawn before most people rise. Growing up, I saw deer, foxes, and herons in the gray hours of misty summer mornings. I like the dampness of dew on the grass before it’s evaporated by the sun. I enjoy watching the sun creep over the horizon as I listen to the bird songs crescendo.

I wasn’t particularly surprised I started working the night shift. I’d suspected it’d come to that a few years ago, when I was still in Paraguay. I remember thinking about my return to the US, and my terrible tendency to lay my paper planner out in front of me and plot how to fill the blank spaces. I remember thinking, “Going into healthcare is very dangerous for someone like you. It’s a 24-hour business. Make sure you block out time to sleep or you just might not get enough rest.”

The night shift was the most practical choice when I started my ED job. The wage is higher and it leaves the day for studying or errands. Flipping my sleeping schedule was no light matter, however, especially because I started going to bed an hour before I used to get up. It’s also been a challenge finding a new eating schedule that works for me–I now eat meals at completely different times than before I worked nights.

There’s a strange stillness in the ED when the early hours of the morning approach – 1 a.m., 2 a.m., 3 a.m.. Even when a very sick person arrives who requires many hands to care for them, the ED is strangely quiet in the morning. Many patients are sleeping or too sleepy to chat with their family members anymore. The patients staying with us until a bed opens in a facility that can help them heal their mental health challenges are usually sleeping or partaking in quiet activities. Sometimes a drunk patient arrives and disrupts the silence, but often they too fall quiet as the morning creeps onward.

Now instead of waking to stillness, I head to bed in its midst. As I drive home from the hospital, the birds are just starting to sing, but the sun’s rays aren’t yet seeping into the sky. The roads are empty save for a few souls coming home from a party or, perhaps, going to work. I arrive at a silent house, those there are sleeping. Not even the dog, when he’s visiting from my parent’s home, greets me when I open the door.

When I first started working nights, I was always tired. But, now that I’m used to it, I’m no more tired than I would be after any long day at work. There’s something about the night shift that keeps you coming back. Perhaps it’s because I like quiet, or perhaps it’s because I like the self-efficiency that’s required when you’re providing quality health care without all the resources of regular business hours that excites me. More likely, it’s that the people who work the dark hours are different than those who work when the majority of society is awake. Many of us won’t work nights forever, but we have some reason to do so now. It’s the fact that we have a reason to be nocturnal, I think, that creates a sense of comradery that’s different from any dayshift vibe I’ve known.

Prayers

Trying to get into medical school is a bit of a slog at times. I’ve been lucky to have people support me during each leap through the hoops of fire. Recently, I’ve had a few folks tell me they’re praying for me, and then qualify their statement by saying they know not everyone believes in God. I was surprised that they felt the need to acknowledge I may not believe in their God.

In Paraguay, my adopted mothers prayed for me almost every time I left their house for mine (so almost daily). I am and was always thankful because of the sentiment. I believe it’s tremendously generous and kind when a person cares enough to think of me, to support me, and then to ask for help on my behalf—whether they communicate with their God or simply wish me luck.

In America, I think we publicize the extremes. I see politics radically divided. Political opinions are often based on extreme visions of how things should be or a rebellion against others’ interpretations of right and wrong. These hardline stances don’t allow for more than one opinion to thrive. To me, holding an unweaving “I’m right and they’re wrong” stance is limiting because it creates rigid definitions of aspects of life that neither the State nor another individual can interpret for me or you.

I attended church often in Paraguay because the church was the center of everything in my Paraguay community. I did not and still do not believe in the God of that church. But, I could feel how strongly my Paraguayan friends and family believed in their God. To them, their God was not only the source of life and reason for living but also the definition of love. Going to church allowed me to better understand how they saw the world. The Paraguayans who welcomed me into their lives knew our views of God were different, and they still embraced me as a dear friend. They included me in their secular and religious activities, answered my millions of questions that began with “Why?”, and they accepted it when I sat out from certain rituals because they were “too much for me.” What these shared experiences taught me was that we do not need to have the same definition of life and love to build friendships. We just need to be comfortable knowing that even though we see eye-to-eye on some things and share some history, we also hold very different views of certain aspects of life.

My hope is that someday the US won’t just be tolerant, but that each of us will be comfortable standing side-by-side with folks who are different from us, be strong enough to ask questions to learn more about how those different people see the world, and be proud enough of our belief system to follow it without expecting others to pledge allegiance to our view.

When I think of those who prayed for me before I took the MCAT, I’m thankful. Perhaps their prayers didn’t mean to me what they meant to them, but I think we share the knowledge that what I was doing was hard and whatever assistance they gave would be part of my success.