Tag Archives: About Me

Sights Set on 2024

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Stopping by Woods on a Snowy Evening

By Robert Frost

Whose woods these are I think I know.  

His house is in the village though;  

He will not see me stopping here  

To watch his woods fill up with snow.  

My little horse must think it queer  

To stop without a farmhouse near  

Between the woods and frozen lake  

The darkest evening of the year.  

He gives his harness bells a shake  

To ask if there is some mistake.  

The only other sound’s the sweep  

Of easy wind and downy flake.  

The woods are lovely, dark and deep,  

But I have promises to keep,  

And miles to go before I sleep,  

And miles to go before I sleep.

2023 was a year of change. My themes of focus were quietness, absorption, and forward movement. I wrapped up medical school, moved halfway down the East Coast, and started residency. Despite all the professional development, I enjoyed a 7-week adventure in Puerto Rico, visited Paraguay, hiked the 33 highest peaks in the Catskill Mountains of New York, and undertook other small hiking/traveling/outdoor excursions as the opportunity arose.

Residency leaves me tired and overworked, but my progress toward becoming the doctor I wish to be is rapid. On one hand, Frost’s line “miles to go before I sleep” is a literal interpretation of what I expect 2024 to bring professionally. I have many professional goals which will march along as the days pass. On the other hand, the “stopping by woods on a snowy evening” part of Frost’s poem (pausing in an unusual place), resonates with me as I think about my personal goals and themes for 2024. As I set my sights on 2024, three themes are on my mind: quietness, pause, and connectivity. It’ll be a year where I focus on personal health.

Quietness

This was also my first theme in 2023. I’m carrying it forward both because I think it is of utmost importance and because I still have growth to achieve in this area. Being a doctor and learning to become a better doctor involves constant stimulation and 1000s of decisions daily. Adult life is full of challenges including finances (bills and earnings), home management, and unexpected disruptions like illness. With so much happening, I find that it’s easy to get lost in the hullabaloo and lose track of my inner calmness. As the unexpected challenges of 2024 unfold, I will continue to cultivate my inner quietness because I believe it is at the core of resilience and central to success.

Pause

Related to quietness, my second theme is pause. As the hustle of life unfolds, I easily forget to stop to appreciate small and large successes and delights. In 2024, I will take time to pause so I can absorb the joys of life. Focusing on joy will train my mind to see the positive and diminish the negative.  

Connectivity

The aspect of connectivity I plan to focus on in 2024 is the mind-body connection. My medical training has been extremely demanding in multiple ways. I have watched my health decline as the doctorhood quest unfolds because of my schedule, external pressures of doctorhood and the healthcare system, and the stress of my work. While my medical training will remain vigorous throughout 2024 and beyond, in 2024, I plan to focus my free time and energy on re-cultivating my physical wellbeing. This focus on physical health combined with my focus on quietness and pause will strengthen my mind-body connection. I think cultivating my own mind-body connection will ground me as I seek to connect with my patients, colleagues, family, and friends.

10 Years Blogging

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September 2023 marks 10 years of my blog Connecting the Dots. I started the blog in 2013 to document my experience in the Peace Corps in Paraguay. When I finished my Peace Corps service in April 2016, I had already formed the habit of writing and decided to keep going to share my experience of becoming a physician. Some months and years I’ve written more than others as my life unfolded this past decade. My blog has documented my time in post-bacc and as an EMT as I strived to build a resume strong enough to get into medical school. The blog was a constant as I trudged my way through 4 years of medical school. And now, after 10 years blogging, I’m 2 months into residency.

I’ve periodically wondered if I should stop blogging. Life reflection/journal blogs like mine aren’t designed to become highly successful or business ventures like other types of more broadly relevant blogs. But I keep blogging both out of a love for the writing process and because my journey has been a unique one. I suppose a key lesson that the Peace Corps and then medicine have taught me is that every human has a one-of-a-kind story that if given the opportunity to be documented as a movie or book could be the next blockbuster/best seller. Most folks, however, will lead their amazing lives and die without much of a trace. My posts about people I’ve met and lessons I’ve learned are my way of remembering all the lives I’ve intersected with as I trundle along my life journey.

The warm welcome I received in Paraguay as a Peace Corps volunteer gave me an opportunity to learn about a culture different from my own and to make life-long friends with individuals who I could not have imagined if I never did the Peace Corps. Similarly, the experience of being a doctor gives me a window into countless lives that are nothing like my own. Medicine, above all, has taught me that there is nothing as fantastic, comical, tragic, beautiful, and surprising as real people’s stories. I’m often reminded that as outlandish as any fiction story might be, reality is more extra and harder to believe.

Just like when I started my blog 10 years ago, I don’t know where I’ll be in 10 years. Reading some of my first posts, it is amazing to me how far I’ve come. I’m sure the next decade will be equally full of surprises. I can’t wait to reflect on the inevitable unforeseen events to come and then write about the highlights.

To those who have read my blog for a while, thank you for your unwavering support. To new readers, thanks for stopping by to sample and for considering future readership.  

Here are some of my favorite posts over the years (I’ve left many out for brevity):

Getting Ready for Departure – DC Chapter, 12/8/2013, on leaving DC, the city I went to undergrad and built my first career, for the Peace Corps

Getting Ready for Departure – DC Chapter

Ideal Boyfriend, Ideal Girlfriend, 11/10/2014, quotes from the 7th – 12th graders I taught in Paraguay describing their ideal life partners

Ideal Boyfriend, Ideal Girlfriend

White, 12/12/2014, on being the only white person in my Paraguayan community

White

Crosses in the Sand, 8/6/2015, on a uniquely Paraguayan form of ant control

Crosses in the Sand

Overheard In Paraguay: Friendship, 10/19/2015, on friendship that last forever

Overheard In Paraguay: Friendship

Guardian Angel, 1/23/2016, on feeling cared for

Guardian Angel

See You Soon Dearest Paraguay, 4/11/2016, on finishing my Peace Corps service in Paraguay

See You Soon Dearest Paraguay

Determination: 2 Girls, 1 Hill, 1 Tree, and 1 Ladder, 11/12/2017, on childhood and the nature of determination

Determination: 2 Girls, 1 Hill, 1 Tree, and 1 Ladder

Christof, 6/25/2018, on kindness and thinking of others

Christof

Below the Surface, 12/28/2018, on returning to Paraguay and learning an unexpected lesson

Below the Surface

Q-tips and Time, 5/16/2019, on how our perception of time changes as we age

Q-tips and Time

True Love, 7/27/2019, on true love as witnessed in the ED

True Love

Memory, 5/24/2020, on thinking about how memory works

Memory

Goodbye For Now Vermont, 3/21/2021, on moving out of Vermont (again) and reflecting on my time there

Goodbye For Now Vermont

A Cup of Coffee, 10/24/2021, on acts of kindness witnessed in the hospital

A Cup of Coffee

Together,  1/7/2022, on working as part of a diverse medical team

Together

Echoes from the Third of Medical School, 4/12/2022, on finishing my third year of medical school

Echoes from the Third of Medical School

Windows to the Soul, 9/6/2022, on caring for critically ill patients

Windows to the Soul

Nothing to Do but Be Happy, 2/14/2023, on waiting for medical school to end while spending a few months in Puerto Rico

Nothing to Do but Be Happy

Goodbye Danbury, 4/15/2023, on my time in Connecticut

Goodbye Danbury, CT

What do you want to be when you grow up?, 5/25/2023, on becoming a physician

What do you want to be when you grow up?

Night Float

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The hospital is 24-7 all year long so there are always staff who care for patients overnight. I was the doctor on a night medicine crew for a few weeks recently. That stretch, I worked in a veterans hospital which meant all my patients had two things in common: they were in the hospital and had served in the military.

Here are some snippets from my nights:

  • “Let us know if anything changes,” I said as I left the room having been called there because the patient’s heart rate had dipped for a few minutes. They were in the hospital because their heart was beating too slowly. Therefore, any time their heart went even slower it was concerning and I went to evaluate them. On this visit to their room, the patient’s symptoms were unchanged from earlier that night and the night before. They were stable, though lightheaded. How to best manage their heart was being explored by the day team. The patient had insomnia even when not in the hospital. I was holding the sleeping medication they’d used for months because it could make their heart slower. It was our second night together, the patient and I, and we were doing our best to get through it. They watched TV because they couldn’t sleep and I answered pages (yep, in healthcare we still use pagers and faxes), saw patients, and ordered medications as the need arose.
  • I stopped by a patient’s room early in the night because they were a “watcher” (someone who was on my “watch carefully list” because they were more likely than others to take a turn for the worse). They had recently turned 80 and were chatty. They glanced up at the news on the TV in the room, “Politics in this country is in a terrible state,” they said. I expressed my agreement. “We got shot at for this,” the patient said, shaking their head and nodding at the TV. Six million responses flashed through my mind; none expressed what I wanted to say. None made the gravity of their statement less.
  • I was called to a patient’s room multiple times over several nights. Every time they were writhing in abdominal pain. Every time they had their blanket over their head. What kind of trauma had this grown-up person survived to feel it necessary to hide under their blanket in the hospital? Our workup, so far, was negative. No explanation for their pain. We tried treating constipation and urinary retention. We tried nausea medicine. None of that helped. Tylenol wasn’t working. What else should I try? Should I give this patient another small dose of opioid medication like they got during the day? Were they seeking out opioid medication because they were addicted to opioids or were they just in pain? Did it matter if they were drug seeking because of addiction if their pain was real? Was their pain real? If their pain was real, was an opiate the best tool I had to help lessen it?
  • I walked briskly. A patient who was admitted for a small stroke had an evolving headache. Maybe it was just a headache, but I wasn’t going to just give Tylenol and not examine the patient. It would be terrible to miss a second stroke we might be able to do something about. Head and neck pain. Their neuro exam was normal – no weakness or sensation changes. I examined their neck. My heart jumped with joy. There under my fingertips was a good old regular muscle knot. We have great medications for muscle pain. Besides, hospital beds are uncomfortable. When this patient got home (especially if they stretched) their knot would surely go away. Finally, a fixable problem!

There’s something surreal about starting your shift when the sun is setting and driving home to sleep after the sun rises – driving in work traffic going the opposite direction as everyone else on the work-home axis. Some nights in the hospital seemed to move backward and other nights zoomed by. I don’t recommend the night shift and I never will – this wasn’t my first rodeo as we used to say in the ED where I first worked night shift. Yet, this was my first time on nights as a doctor. Night float afforded me more independence than I’d had previously. I grew as the nights trudged on. As I drove home on the morning of my last night shift, I felt a little bit more like a physician than I ever had before. And though tired and excited to transition back to days, the feeling of growth was rewarding.

In the Quiet Presence of Plants

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“Some people look for a beautiful place, others make a place beautiful.”

~Hazrat Inayat Khan

I’m a keeper of plants. Some might call me a gardener but, having grown up in the rural US, I reserve the term “garden” for plants that root in the ground. And so, I’m a keeper of plants because all my plants are rooted in pots.

I have over 75 plants in my smallish apartment. Some of them have followed me through 6 moves. Some joined just this month. The only common feature among them is that they prefer Virginia to any place we’ve lived before. I attribute this to the sparkly sun here which was a key feature that drew me to the state in the first place.

My plants are as diverse as Richmond. There’s the Norfolk pine I’m growing as my Christmas tree. There are begonias adding their clashing leaf patterns to the balcony-dwelling jade plant, banana plant, snake plant, umbrella tree, and palm. On my desk is a battalion of orchids, most of whom bloom in spring. There are calatheas, peperomias, and bromeliads mixed in with the succulents and cacti. The coffee plants, passion fruit vines, and lemon trees are some of the newest additions. A dear friend got me a money tree for luck, around the time I got a lucky bamboo – it was a period of much change, so luck was needed. These lucky plants keep on growing. My crown of thorns hasn’t stopped blooming since I got it 5+ years ago. The fig, rubber, and dragon trees all were recently decapitated to encourage side branches (so far these experiments have been fruitful).

The plants sit along the windows and in layers such that those that need the least light live in the middle of my apartment and those that need the most are on the balcony for the summer or reside on the wide windowsill between my bedroom window and the blackout curtains necessary for daytime sleeping when I’m on nightshift. I know each plant’s light and watering preferences. I have a strategy for keeping each one alive when I leave for vacation.

Sometimes I wonder if it’s silly to have so many plants because I work such long hours outside of my home. However, when I come home to find a new flower bud or a fresh leaf unfurling, I’m reminded that it’s not silly but genius to have so many plants. The plants add a different beauty to the apartment than art (I have that too) and their quiet company is something I enjoy. With my plants even the most frustrating day can be softened when, upon sitting on my couch, I notice just how much the peace lily likes its new spot or how much the Chinese evergreen has flourished since we arrived in Richmond only months ago. And when I see the plants that I’ve potted up at least 3 times threatening to outgrow their current pots, I remember how we all change and grow with time. Sometimes our process of growth is too slow to see from day-to-day and only can be realized when we compare month-to-month or year-to-year. Yet, just as surely as my plants are renewing their roots and leaves, I’m also growing as the days of residency pass.

Hey Doctor!

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I got in the hospital elevator. One person was already in it – a maintenance guy by his uniform and the fact that he had a ladder in hand. Before I’d decided if I was going to say “hello,” he declared joyfully “Hey doctor!”

I glanced down at my badged (“doctor” was written on it in capitalized black letters on a yellow background larger than anything else on the badge). I looked around the elevator…yep just me and him…he was definitely talking to me. I said, “Hi!”

“Did you have to look at your badge?” he asked in a voice cracked in the way voices are when a laugh is bubbling up. We both burst into laughter.

I’ve been a practicing doctor for 5 weeks. While I feel ready and excited to be a doctor, the title is still new and I’m learning the role. Some patients and non-doctors take the title seriously and some don’t; however, when you ARE a medical doctor, the title comes with some weight as you know exactly what responsibility is behind it.

As part of my residency training, I work in a primary care clinic where I have a group of patients for whom I’m their sole primary care doctor for the duration of my residency. This means I’ll see them when they have a new issue and I’ll also manage their health maintenance. Primary care is about tackling health challenges before they become health issues and preventing people from experiencing life-threatening events and worsening health if possible. It’s arguably the most important part of the healthcare system even though it gets the least recognition, compensation, and emphasis in our corporate/profit-focused US healthcare system.

My first week as a primary care doctor I ordered a cholesterol panel (a blood test) for one of my patients. They had obesity and chronic pain. They hadn’t had their cholesterol checked before and at their age and BMI (body mass index) I wanted to see if we needed to start a cholesterol-lowering medication to reduce their risk of heart disease. During our appointment, the patient and I had a lovely conversation about their life and the changes they’d made to improve their health. I was inspired by them because it was clear that they were motivated and dedicated to their health – they had made diet changes and were finding ways to fit exercise into their routine despite having housing insecurity and struggling to make ends meet. 

The cholesterol panel came back several hours after the patient’s appointment had ended. I looked at the numbers and panicked. How do I interpret these numbers? I asked myself. This patient was relying on me to evaluate their lab results and provide recommendations on lifestyle and medication use. It was a big burden. I read some medical resources then, based on what I read, decided that their cholesterol was okay given their other heart risk factors. They didn’t need to start a new medication. I sent them a letter with the normal result.

Even after I sent the patient a letter about their cholesterol, panic lingered in my toes. Had I interpreted the results correctly? Would I need to call them back and tell them I was wrong, and we needed to do something different? Had a missed an opportunity to help them protect their heart?

Over the next week I researched more about cholesterol panels and then talked to my supervising doctor about the topic. In the end, I confirmed that I had made the right decision for this patient. I also learned there is a calculator I should use to determine patients’ risk of heart disease and the benefit of starting a cholesterol-lowering medication.

Soon interpreting cholesterol panels will be easy and fast. But the first time I did it for a real patient (a real person) was exciting and nerve-wracking. Just like being called “doctor” in the elevator this week required a little extra processing to realize that I was the doctor being referenced. I know I won’t have to check my badge for much longer to confirm my profession. I’m excited to grow into the person who can respond without pause to “hey doctor!”

First Impression of Richmond, VA

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The James River winds through Richmond, VA and serves as the city’s playground. On a sunny day you’ll find folks lounging on river rocks; testing the rapids in rafts and kayaks; and biking, walking, and running on the riverbank trails. From the numerous walking bridges across the river, you can watch osprey dive, great blue herons fish, and geese and ducks eat bottoms up.

When you turn away from the river you find yourself wandering along streets lined with old brick buildings including row houses and factories-converted-to-apartments. Murals are scattered throughout the city. Parks and green spaces are more numerous than tall buildings.

Downtown Richmond is quiet. There isn’t much traffic – even at the peak of rush hour the traffic is manageable. There’s a boarded-up window or “for lease” sign every couple of storefronts on the primary street at the heart of the city. Neighborhoods with different vibes sit like cars on a Ferris wheel around Richmond’s often sleepy downtown.

Richmond could be called the city of highway sampling. Numerous highway bridges crisscross through the city. Under these bridges are blocks filled with restaurants and parks. When you use Google maps to navigate almost anywhere in or around Richmond, you’ll find yourself driving on several highways for less than 1 minute each.

Richmond is easy living. It’s urban enough that there are big name shows yet it is quiet enough that you can often hear birds singing. Without many tall buildings, Richmond feels more like a large town than a big city. I suppose “big city” is relative. I like having a 6th floor apartment that feels like a penthouse because a 6-story building is tall in my neighborhood.

From my mini balcony I have a lovely view of the sunset. From my apartment windows, I can watch the numerous lightning storms that come from the south-west to dazzle the city. I guess living in a hot and humid place leaves ample opportunity for any cold front to make the air zippy-zappy. I’ve never seen so many lightning storms in such a short period as I have living here.

After about 3 months in Richmond, I’ve found my favorite ice cream place and some go-to walking routes. There’s still a lot left to explore and learn about the city, but it already feels like home. It doesn’t usually take me long to settle in a place, but Richmond was an especially easy transition.

This Is How I Started Residency

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Starting residency was like a flash flood. Beginning from the first day, I was overtaken with more work than I knew what to do with. As a new doctor in a new healthcare system, I found myself equally challenged by creating care plans for my patients (like deciding which medications to prescribe them) and implementing the plans my supervising doctors and I devised (like ordering medications in the computer system). I completed tasks more slowly than I imagined possible. My patients were well cared for because I was part of a team, but my work hours lengthened in a way that the saying “burn the candle on both ends” was created to describe.

All of us headed to residency (regardless of specialty) are warned that it will be challenging. Each person experiences different challenges and different low points. Residency is hard for everyone because the hours are long and there’s a lot to learn. So, when my work hours exploded like water through a broken dam, I wasn’t surprised. I was surprised by how my program responded.

As my hours lengthened to a point where I was exhausted and just barely surviving, my chief residents stepped in to help me develop ways to become more efficient. Senior residents observed me throughout a shift and offered advice on how I could streamline my workflow. People on my team and other teams helped take some tasks off my plate so I could focus on learning the computer system better and on writing patient care notes quicker. I was given a little extra time off to catch up on sleep because I was on track to work far more hours than permitted by the national governing body that oversees US residency programs.

At first the extra help and attention made me feel like a failure. I tried to keep my spirits up because I’ve struggled to overcome big obstacles before; I always learned more from those experiences than I did from experiences where I didn’t struggle. Similarly, past experiences have shown me that it’s okay to accept help. Still, I wondered if I was going to learn enough or as quickly as I should if people helped me more than some of my peers. I wondered if I’d get better at being a doctor.

On my extra time off I reviewed my senior residents’ feedback. I reorganized my view of the electronic health record system to make it easier to access all the information I knew was important. I took time to recharge. When I returned to work, I was still a new doctor. I hadn’t changed much from the days prior. Yet, I found myself checking things off my to-do list without the help I’d required before my recharge day. With a little more sleep behind me, I was able to see how much I’d learned in my previous days of working – something I hadn’t noticed when I was exhausted.

As I reflect on my first two weeks of residency, I don’t look at them fondly. I do think that I’m a tiny bit better at being a doctor now than I was two weeks ago. I appreciate my past self for prioritizing a work culture of support and collaboration when applying to residency. I know that there are many hard days to come before residency is over. However, my experience during these first weeks made me confident that I will be able to overcome future hard patches when they come – not completely alone, instead, with a program supporting me as I find my path forward. Feeling like my residency program genuinely wants to help me become the best physician I can be gives me confidence in the residency training process and makes me excited for who I’ll become by the end of it.

This is how I started residency. The future will tell how I end residency.

Yes, I Can

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I listened to a song about a job interview that went poorly on repeat while I struggled to complete a new workout that I’d written for myself that day. Perhaps the song about the interview resonated with me because I was in my own transition or, perhaps, I just liked the beat. The workout would have been easy for certain versions of my past self. However, recently I’d led a life that didn’t involve intense workouts like this one and, so, the workout was challenging me. “Back to the beginning,” I thought.

I couldn’t ignore the metaphor of my physical fitness and learning medicine because the parallel captured the sentiment I’d been hoping to write about as a reflection of what, exactly, medical school had been like in a broad sense. I’ve had a few months between finishing my medical school classes and starting residency. It’s been a time of celebration and doing things I didn’t have time for during school and won’t have time for during residency. I’ve also taken time to reflect on my medical school experience. “What exactly was the utility of medical school?” I’ve asked myself often during these months of the happy stillness between.

You can guess what medical school was like on a superficial level – it was school. I spent hours studying and hours listening to people instruct me on all kinds of things. I spent more hours practicing skills as varied as suturing cuts shut in the operating room to writing patient medical notes. I attended lectures, engaged in simulated patient interactions, and I worked with real patients and physicians in real hospitals and clinics. I took written exams of various lengths that were proctored by various organizations. Through these actions I learned how the body works and breaks and how we try to make bodies function better with medications and interventions like surgery.

Yet, while learning about the body and how to improve health was the backbone of my medical school learning, it wasn’t the heart of it. The heart of medical school was the exercise of continually starting at the bottom, a place of not knowing much, and climbing to some place of better understanding. Medical school is a lot like the process of doing a hard workout after not working out for a long time and being unable to finish it, then engaging in a few weeks of intent and thoughtful exercise, and finally being able to do the original workout and more.

Medical school taught me that I can learn anything with time and effort. The hardest concepts can be cracked. The first year, I struggled to understand how the body worked. The second year, I expanded my knowledge from how the body worked to how it can go wrong and what we can do about it. Then, years three and four, I learned more about how different specialties in medicine address different diseases and injuries. Each year built on the year prior and then expanded beyond what I knew to things I didn’t yet know. Each time the curriculum expanded I felt like I was starting over. Much like starting in the beginner exercise class and working my way to the advanced class…repeatedly.

I bet you’ve had the experience of riding the rollercoaster of being excellent then falling to subpar and then, through sheer will, climbing to a place of excellence again. And if you have experience doing that in any area of life, then you can imagine what medical school is like. Because it’s just like that. Every month or so you start at the bottom of one area of medicine and climb to the top just to fall again and start the process all over in a different area of medicine.

Medical school is an exercise in being mediocre with a drive to be extraordinary. Each lesson helps move your personal dial from mediocre to better, but there’s a catch. Medicine is founded in science and research and, as such, it’s forever expanding and changing as we (humans) learn more. And so, there is no possible way to ever know everything. To be a physician is to be forever learning while also mastering the knowledge that you explored before. There is no end to medicine, no time when you can’t get better.

Medical school taught me that I can learn anything while I can’t know everything. It taught me not to be intimidated by an obviously hard road, but to take it one step at a time just like I take my plank exercises after a long time not engaging my core. Medical school taught me that experts are built with time and effort. It also taught me that experts remain humble and equally aware of the things they know and the things they don’t know. Medical school taught me that I can do whatever it is I choose to do if I’m willing to put in the effort. The heart of medical school for me was learning that when faced with a challenge to think “yes, I can” instead of “maybe it’ll work out.”

They Said It Would Change Me Forever: Now Almost 10 Years Later

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I recently returned to Paraguay after 5 years away – COVID delayed my return. It’s the third time I’ve been back since finishing my Peace Corps service there. I also realized during the trip that 2024 will mark my 10-year anniversary of first arriving in Paraguay as a just-starting, excited, and (yet) terrified volunteer. What I remember most about the pre-departure materials and pre-departure orientation speakers for the Peace Corps is how often they said that my service would change me forever.  At that time, I thought their message was a bit sentimental and dramatic.

It would take 27 months for me to understand how right they were – aka it took exactly the duration of my Peace Corps service. I remember returning to the US after more than 2 years away and realizing that the person who lived in the US before (pre-Peace Corps me) didn’t exist anymore.

When I returned from Paraguay after my service, US life hit me like an overloaded moving truck. There were glorious aspects such as being able to throw toilet paper in the toilet rather than into a trash can next to it, no days without running water or power, and not having to run around to unplug everything at the start of a rainstorm in case the power surged. Yet, there were also terrible things about returning. Perhaps the worst was that I lost the community that I’d built over the years, which had become central to my life. I transitioned to a cold region of the US where few people spoke Spanish – two things that made me sad because I find joy in the sun (and its warmth) and the interesting way that Spanish captures our thoughts.

Now having had a decade to think about my Paraguayan self and my US self, I’ve come to understand how the Peace Corps in Paraguay changed me. Thinking about it, I’m not remorseful if I sound a bit sentimental and dramatic because, perhaps, I’m appropriately both of those things.

Having just graduated medical school I can say with a certain amount of pride that my Peace Corps service remains the hardest experience of my life as well as the period where I learned the most (more reflection on my medical school experience to come in future blog posts). This may be because my Peace Corps service came first so I applied what I learned from it to my medical school experience, but I suspect that the challenge the Peace Corps poses is unique and may still have outcompeted medical school even if it came second.

I should clarify that hard doesn’t mean miserable. By “hard” I mean an experience that pushed me to problem solve frequently and on the fly, find new ways to tackle obstacles because every known way didn’t work when I applied it, challenged me to revise and revisit ideas, placed me face-to-face with my own preconceived notions so that I could consider how they may not be absolute truths, forced me to define my values, and required me to look inward both to reflect and to find strength.

When I say “learned the most” I don’t mean I sat and studied all day (I did do that sometimes in medical school though). What I mean is that finding a way to navigate two second languages (Spanish and Guaraní) and to operate in a culture that wasn’t my own required unlearning, relearning, and new learning behavior, vocabulary, customs, traditions, and systems that may have been similar or completely different form my native equivalent and may (or may not) have been in line with my belief system.  

The Peace Corps in Paraguay stretched me to look at things differently. It forced me to decide what parts of myself I was willing to give up to assimilate into Paraguayan culture and what parts I would keep even if they accentuated my otherness. Living in Paraguay was a give and take between, on one hand, being open to new ideas and experiences that required flexibility because often situations were unpredictable or not completely understood and, on the other hand, defense of individual needs and goals that did not fit nicely into Paraguayan life.

The experience of navigating conflicting parts of daily life in Paraguay and shifting self are what changed me so much during my Peace Corps service. It showed me that I have multiple identities that come together to form me and how the pecking order of those identities shifts depending on the situation and the activity I’m doing. Also, the amount of self-reflection I engaged in during the Peace Corps (both as a factor of my strange schedule there and as a byproduct of living in a different culture) is what made me who I am today. No time before or after the Peace Corps (so far anyway) has given me so much time to look inward and examine who I am and how that relates to who I hope to be.

When I returned to Paraguay after 5 years away, I was struck by how much I’ve grown since I finished the Peace Corps (and last visited Paraguay). I was surprised and content that who I am today (a doctor about to start residency) is still grounded in the self I created in Paraguay starting now almost a decade ago. When they said my Peace Corps service would change me forever, they undersold exactly how much. Even now, having done and achieved many things since returning to the US, I find my mind drifting back to those days in the land of the Guaraní as a volunteer and falling back on the strategies of perseverance I developed then to help me through rough patches now. These days, I remain skeptical when someone tells me that something will change me, but I also remain humble and open to the possibility because Paraguay taught me that one experience has the capacity to change everything. 

What do you want to be when you grow up?

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“What do you want to be when you grow up?” one of my Paraguayan friends, who used to be my student, asked during my last visit to Paraguay.

I paused a moment before answering. I was surprised by the question because he and I don’t often talk about abstract things and because I’ve been feeling awfully grown up recently. “A doctor,” I said.

“That’s it? You don’t want to be a diplomat or someone rich or famous?” my friend asked.

“Nope,” I said.

“Oh, that’s cool,” my friend said. The conversation continued as I asked him about what he wanted to be when he grew up and we discussed more details of what I hope to do as a doctor.

I graduated from medical school on May 21, 2023. I received my resident medical license yesterday. I’m officially an MD! All that remains between me and practicing independently as a physician is residency (and fellowship if I further specialize).

People like to say “it’s hard to believe” when they achieve a particularly hard goal like graduating from medical school. But, let me tell you the truth, I don’t find it hard to believe that I graduated medical school. Why? Because I was there every minute that I studied at my desk and learned how to care for patients in the clinic and hospital. I read every test question and picked an answer. I showed up on time, managed my email inbox, pestered school administrators to get answers, and did voluntary projects to expand my learning beyond the medical school curriculum.

Becoming a MD is a lot of work; I did the work to earn my degree. Becoming an MD is also an amazing quest. I was excited when my patients were cured, I was humbled that so many people allowed me to take part in their journey to death or to better health, and I loved uncovering the mysteries of how the body works and what medicine can do. I’m grateful for every person who helped me along the way – from my family who cheered me on to the patients who let me care for them, from my classmates who struggled and soared beside me to the numerous physicians who taught me. I did the work, but becoming an MD takes a village. There were many people in my village who were my heroes and who guided and supported me as I journeyed through medical school.

The last months of medical school left me feeling awfully grown up. Grown up in the tiring kind of way. My friend’s question helped remind me how much growing is left. And how, somehow, I’m lucky enough to be growing while building my dream. Next stop on the Doctorhood Quest, residency!