Pain and Prejudice

In the summer of 1904, a Grenadian embarked on a journey to Chicago to attend dental school. The student, Walter Clement Noel, upon arriving to the United States was plagued with health complications requiring his internist to perform a blood smear, a relatively new technique not frequently used in diagnosis. This gave rise to the first documented finding of sickle cell-shaped blood cells which was presented to the world in a case study in 1910.

Almost 100 years later, a Chicagoan receives admission to a graduate program in Grenada, only to complete a thesis on sickle cell and chronic pain in the country that gave birth to a man whose blood gave name to a chronic disease.

Herrick

Dr. James B. Herrick, credited with the first description of sickle cell disease, taught and practiced in Chicago, Illinois.

In science and research, life and circumstances often influence and shape your focus. A son who lost his mother to breast cancer is propelled to devote his energies discovering oncogenes. An impressionable college freshman is captivated by her professor and his research resonates in her own through the years. Inspiration can often be quite predictable. With me, however, someone with no prior exposure or bearings on any blood disorders, I have to believe that sometimes the research chooses you, a phantom deliberately lighting paths and dimming others, making you falsely believe your decisions are truly your own.

A little more than a century separate the opposite journeys that Walter and I took. And yet in that chasm of time, I’ve learned that just because we’ve given a disorder a name does not translate to a cure or even a standard global practice in managing the pain. My thesis helped me more than becoming a published primary author this past summer; it opened my eyes into seeing firsthand how medicine is much more than just biology, but also one part sociology, one part politics and policy, one part psychology, and even some parts geography. Continue reading

Two Steps Forward, One Step Back

Forty-five days lie between me and my Step One Board Exam. The Step One. But is it really my first step? Is it only a step? It’s beginning to feel more like a hop, skip, and a jump. Of course, I’ve taken many steps, some towards open doorways, some towards closed ones, and some towards paths where I had to fashion my own door out of a neatly framed window. With all the endless locating and relocating I’ve done in the past couple years, I feel like life is just one giant terminal, and we’re all just perpetually loitering until our next lift. While we wait, we’re inclined look into the future, and somehow that makes our present tense a little more homely and agreeable. But if you’re not wary, the past can sneak up on you, like a closet crammed with all the things you no longer have room for in your day-to-day life, springing open and saturating you with memories and mementos.
My Alma Mater

My Alma Mater

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An Ode to Grenada

In what could be one of the greatest satirical pieces of work, Catch-22, Joseph Heller once wrote:

What is a country? A country is a piece of land surrounded on all sides by boundaries, usually unnatural. Englishmen are dying for England, Americans are dying for America, Germans are dying for Germany, Russians are dying for Russia. There are now fifty or sixty countries fighting in this war. Surely so many countries can’t all be worth dying for.”

Heller was right. Surely, all countries cannot be worth dying for. Only those countries you choose to regard as your own. I wasn’t born in Grenada, but a part of me is certainly alive because of this island. Some might even argue it’s the most important part: the piece that nourishes your what-ifs and gives substance to your wishful thinking. On the night of my own departure, as I try to test out my own wings from the land that’s served as my nesting grounds on-and-off for the past several years, will I ever deem Grenada as my own

Some of my favorite shots of campus:

Only time can tell what Grenada will become to me as I continue my life elsewhere: a pit stop, a detour, or a makeshift home? Even more, what will I become to Grenada? An honorary citizen, or merely a temporary dweller, holding as much fondness for each other as a midnight traveler to a dingy motel room. Was Grenada merely a means to an end, or did it define a bigger purpose? All I know is that when I moved to a different country four years ago, nothing was harder than saying hello for the first time. As those years started turning into hours, it got even harder to say goodbye for the final time.  Continue reading

The Beat of A Different Drum

As a student known to sleep through a larger portion of my immunology lectures, the material, for me personally, lacked a little oomph. IgM. APC. CD28. C4b2a3b. A litany of cells, cytokines, and receptor molecules with unimaginative names and, often, even less enticing tasks that sounded more like a roll call for Star Wars characters. Little did I know, however, that the lessons imprinted on me in immunology translated to a much broader message.

Our biological well-being relies on the body’s meticulous ability to distinguish between the innate and the foreign. Thus, recognizing our own self is a lesson imbued to us by our own immune system. If the crux of good health relies on our body’s ability to recognize the “self” from “non-self” then being a good doctor, in my opinion, is about recognizing one’s own motives, perceptions, and attitudes against the backdrop of competing interests.

While conducting a research study on undertreated pain in sickle cell patients in a small middle-income nation, I interviewed around 40 sickle cell patients. After several long weeks of talking to patients, they all seemed to blend together as one in my head. However, one particular patient would always stick out in my mind. William, as I’ll call him, was rather gaunt and scraggly when he walked into the clinic where I was conducting interviews. His uncharacteristically hollow and worn face spoke volumes about his disposition and how mismanaged his pain was as a result of his disease.

Nevertheless, it wasn’t his face or his stature that made him more noticeable in my mind, but rather something about his eyes. There was a glaring yellowish tone within them, signs of full-blown jaundice, a common symptom of the disease, but even that was far from what made them distinctive. It was, instead, the dejected look he carried about him, a man who lost that sustaining spark to carry on. More so than his body, it was his spirit that was crippled. Continue reading

Listen and Learn

Medical school is life-changing. Tell me something I don’t know. But the change that we all speak about occurs more in an evolutionary manner than a creationist-infused, divine poof! However, there are still a handful of  singular moments that I attribute to modifying how I view not only myself but this entire process of shaping future physicians. My own transformative moment last term culminated with a simple command: Auscultate the anterior chest.

Our 3-credit Clinical and Physical Diagnosis (CPD) course is a glorified title for what we actually do: playing doctor. As you can guess, this is far from using your Playskool doctor kit and treating yet another case of life-threatening cooties. This was a different kind of play-time: we really had to be as proficient as, if not better, than the actors we see playing doctors on television, without the excess dramatics, of course. Every now and then we had graded practice sessions which encompassed each member in a group selecting a different prompt from an envelope and performing the task correctly on a fake patient. Mine involved listening correctly to my patient’s chest. Continue reading