When my mother emphatically woke me up at 1 a.m. and claimed that I might die from a pulmonary embolism, I didn’t know how to react. Moreover, I didn’t know what I could do. I was laying on my bed with my right leg elevated over almost every pillow we owned to combat the swelling that came with a torn ACL. At first, I rolled my eyes at what seemed to be the classic WebMD diagnosis. However, there was a confidence and fear in her voice that indicated to me that she didn’t have a doubt in her mind. As this sunk in, the thought of not waking up made it near impossible to go to sleep. At age 20, death wasn’t something I had thought about a lot.
*****
I tore my ACL on Aug. 1, 2019. The reason why I remember this date is because it was conveniently three weeks before I had signed up to take the MCAT. It took seeing three different specialists over the span of a week before I could get an MRI which confirmed the tear. With a certain diagnosis comes a strange sense of relief. While I had received the news that I had a serious knee injury, I suddenly could see a way forward. I scheduled an appointment with my surgeon for a consultation and then with that I’d begin my road to recovery. Over this period of time I continued to study for MCAT. For a whole summer I labored over a standardized test that is as long as a flight to Europe while a lot of my friends actually took flights to Europe to study abroad. I didn’t want my efforts to go to waste and was stubbornly hell-bent to take this exam. Strangely enough something that had given me a great deal of stress earlier that summer now acted as a way to displace the stress that came with my health.
For a while, I truly believed that I’d be able to get away with this. I felt like Michael Jordan playing through the flu in the 1997 NBA finals. I found time to study interspersed between the multiple doctors appointments that I went to. With a pair of crutches, MCAT study materials, ibuprofen and a ridiculous amount of pillows, I felt invincible. Until a week later. My injured leg had gone completely numb halfway through a practice exam I was taking. I felt pins and needles start from my calf and make its way up my leg. At first I thought that my foot had fallen asleep or I was just nervous about the practice test. However, by the time I had finished I was sweating and breathing as if I had run a marathon.
*****
A pulmonary embolism is when a blood clot that forms on the inside of your vein dislodges and ultimately makes its way to the arteries of the lungs through the pulmonary circulation. If the embolus is big enough then cardiac arrest is almost immediate. Even if you get lucky and don’t die immediately, you will die eventually if the blood clot remains undetected.
*****
It was based on the symptoms from my practice exam that my mom announced my impending doom. Usually in the case of life or death emergencies, one would call 911. However, we somehow decided that a panicked email to my doctor and a call to UHS for reassurance would suffice. The combination of being left on hold for 30 minutes, the UHS nurse’s reassurance that I didn’t have a blood clot and general fatigue was enough for me to go back to sleep — I was willing to accept any good news at that point.
This interaction all seemed like a dream but I was reminded of its reality when I woke up to a phone call from my doctor who ordered me to come to the hospital immediately to get an ultrasound of my leg. In no time, I found myself on a hospital bed with a nurse taking an ultrasound image of my injured leg. There was an incredibly tense moment of silence with the nurse staring at the imaging screen, my mother staring at me and me staring at the nurse trying to read the reflection of the ultrasound monitor off his glasses. Ultimately, he swung the monitor around and showed me the image of the blood clot that totally occluded my right gastrocnemius vein — a Deep Vein Thrombosis. This complication meant that I had to be put on blood thinners for three months in order for the clot to dissolve before I could get surgery on my knee to repair my torn ACL.
*****
There have been very few moments in my life where I felt like I had no control over what was happening to me: this was one of them. I remember trying to desperately negotiate with my doctor if there was any possibility I could do a shorter course of blood thinners. It wasn’t possible and at this I felt hopeless. Usually in response to adversity, I’d try to make a plan and could usually see the light at the end of the tunnel. However, as a college student, I could barely make a plan for the next two weeks. How was I supposed to just wait for three months? Also given the seemingly unpredictability of my recent health, how did I know something else wouldn’t happen that would further delay my surgery? This is the anxiety and paranoia that lived in my mind rent free. I started my summer by preparing for an exam that would help me become a doctor and save lives, but I ended the summer as a patient on crutches.
I also started to resent the whole pre-medical process. For an entire summer, I crammed a whole college education’s worth of material, I stressed out over not doing well on practice tests and then became a compulsive MCAT reddit checker, which didn’t do any favors to my anxiety. This vicious cycle consumed my mind over the summer. As days went by and my practice test scores didn’t improve, I found myself fighting an uphill battle with doubt. I started to doubt my ability as a student and also if I had what it took to pursue the rather daunting task of becoming a doctor. I was not just in pain physically but I was also mentally exhausted. The fact that I wouldn’t even get the chance to at least try to take the exam that I had put so much time and energy into broke my spirit. Though a lot of friends and family tried to reach out to me and offered their consolation, I truly felt alone.
*****
With a deep vein thrombosis diagnosis, I was referred to a hematologist who is essentially a blood specialist that would be managing my treatment. This was the fourth doctor I had seen in the span of 2-3 weeks. It was quite rare for people to get blood clots at my age. I was also told that a torn ACL puts me at risk of getting osteoporosis earlier. These continual reminders made me feel like I wasn’t a 20 year old. I had never been to the department of hematology, but as we arrived at the waiting room and noticed that it was in the cancer center, a familiar yet sorrowful feeling took over me as my mother turned a bit pale.
My mother moved to the United States in 1995, and when she tried to start a family with my father in 1998, she received two pieces of information from her doctor. The first was that she was pregnant with me, and the second was that she had been diagnosed with a rare form of blood cancer called chronic myelogenous leukemia. She had the option of getting an abortion and starting her treatment as soon as possible, however she chose to go ahead with the pregnancy and wait to get treated. Cancer treatments in the 90s weren’t the most refined at the time, so as soon as she had given birth to me she underwent a pretty rigorous chemotherapy treatment. Luckily, my younger aunt turned out to be a perfect donor for a bone marrow transplant, and she’s been cancer free for 20 years. Though I don’t have any conscious memories of my mother going through chemotherapy, I have always had this indirect relationship with cancer as I would always accompany my mother to her post-treatment checkups when I was younger.
*****
As soon as I got to the office, I was reminded of where we were. I was seated in a waiting room of cancer patients. Many of them used walkers to combat the fatigue that comes with the treatment of cancer. Many bald heads had swollen faces, which are common side effects of chemotherapy. My mother had told me that as a little kid, I was a source of joy whenever she’d bring me to the waiting room of her appointments. In what seemed like a parallel of years prior, I watched a little kid walk around the room and introduce himself to everyone. It was both heartbreaking and admirable to watch my mother put on a brave face. I don’t think she could have ever imagined that after risking her own life to give me mine, we would be back in the same waiting room, but this time I was the patient. There was a moment where I met the gaze of a row of cancer patients, and fear surged into me. I stared at them and couldn’t help but frown. They stared at me and my hair and then also frowned. In that moment, we had come to an unspoken common understanding that something was wrong and that I didn’t belong there.
Shortly afterwards, a frail elder woman wearing a red head scarf made her way from across the room and started talking to me. After patiently probing and trying to get me to open up, the woman asked me what was wrong and that’s when I told her this whole story. I told her about my ambition and dream to become a doctor. I told her about the cancer research that I’m involved in and that I was studying biomedical engineering. But I also told her that I was scared, that I had started my summer with all of these plans for my future, but now I was living at the mercy of fate and navigating its unpredictability without a compass.
By the time I had finished my story, an attendant had called the lady into the office but before she went in, she pointed at me from across the room and proudly claimed “You’re going to be the one who cures cancer.” I scoffed and without a beat asked “How do you know?” She replied, “I don’t, but it’s kids like you who give people like us hope” and walked into the doctor’s office. I held my tears in until she was out of my line of sight. This simple and honest interaction seemed to ease the majority of my doubts and reaffirmed my passion for medicine. It was a moment of clarity that I hadn’t had all summer.
Ironically, while preparing for the MCAT, I had lost sight of what drew me to the field in the first place. I had gotten too caught up with the anxiety and the competition of the process. My over-ambition had narrowed my perspective of the profession and prevented me from thinking about the long term. Becoming a doctor seemed to be reduced to the pre-med checklist that was given to me as a freshman. I was focused on getting good grades, a good MCAT score and doing everything I possibly could to pass off as the “holistic” applicant. In the hopes of helping others, I found myself becoming incredibly self centered.
However, I was missing the main point of it all. The cancer patient that approached me reminded me that the root of medicine is our service to others. It’s about how we treat each other. It is the ability to empathize with complete strangers who are in their most vulnerable state and to reassure that they would be alright. The patient/doctor relationship is based on a unique trust and faith that everything is being done to look after the patient. Having the perfect medical school application does not correlate to my ability of being a relatable and comforting human being.
*****
It was that simple sentence that brought me out of my loneliness. As I inevitably canceled my MCAT date and started my next college semester, I began to value my relationships with people more than I had done before. I had friends who checked in on me when I was stressed out during the semester and especially around my surgery date. I had friends who insisted on hanging out with me even though it was inconvenient because I was commuting from home. I had friends that would carry my bag and walk with me to classes while I was on crutches. Some shared stories of their own injuries. I had professors that supported me and worked with me one on one to ensure I was staying on track. My family supported me unconditionally throughout the process as well. By the time I took the MCAT exam this summer, I realized I was not just a sum of my own hard work but also that of everyone around me. Thankfully, I was able to walk into the exam room on my own two feet.