Victoria and I shared fish sandwiches from McDonald’s in her hospital room the night before she was to begin chemotherapy. She was the traditional picture of a lung cancer diagnosis: presenting to the hospital with a subtle, persistent cough, with workup ultimately revealing malignancy. Beyond this, however, she was anything but traditional. Over the days, in staccatoed conversations in the mornings and evenings, I got to know Victoria. Her life had been hard: a transgender, HIV-positive woman, and now this. She had weathered storms and persevered in ways beyond my experience and comprehension, out of reach of my classical, simple, empathy toolbox. I could, however, appreciate the shock of how a simple symptom may ultimately come to reveal a much more complex and morbid condition. And how hospital food for the better part of a week is not ideal. In part, we bonded over our discussion of foods we enjoyed and that she missed while hospitalized. Removing this from her problem list, via a fried fish sandwich, was the least I could do. Extra mayonnaise for Victoria.
This was my first opportunity to care for an individual either transgender or with HIV. Admittedly, I felt ashamed with my initial discomfort when it came to examining her. As a believer in evidence-based medicine and science, I understood this discomfort was irrational from a biological perspective. I knew this, and yet I have also found that my emotions do not always respect the findings and conclusions established by scientific literature. With time and conversion, this discomfort slowly dissolved. I learned her pronouns. I learned her story. I watched her go home, with a new life course charted, medications and office visits in tow.
So, when the COVID-19 pandemic hit the Midwestern United States just about a month later, and us medical students were ushered out of hospitals and into our desks and onto Zoom, I simultaneously found myself reevaluating who I was as a person. Being a trainee in the medical world was my profession, but with time I began to recognize that my medical knowledge and training was not the only way I could find meaning and contribute to society. In this academic bubble, I had security, health, and the ability to do what I needed to manage this new era of life. “What would Ms. Victoria need?” was a question that slowly became louder. What would the financially and medically vulnerable citizens of my society need during this time? And how could I help address this need? It was a time that required me to step outside of my routine and comfort zone and learn to further hone my role as citizen of a community. A new role for me, but one equally as important to my clinical complement. Ultimately, I found myself volunteering at an organization of homeless shelters across the city, helping to prepare and serve food for their residents. However small and menial that task may have seemed, it gave me newfound senses of purpose and meaning. Much like my existence as a medical student rotating through different services, our roles may be in the periphery, scattered, and often simple, but they serve a purpose and with the goal of helping our team and patient.
This was not how I expected to be spending the end of my third year of medical school and beginning of fourth year. I had a very idealistic and linear plan, with clerkships, board exams, and sub-internships all plotted out. And while I mourn(ed) the loss of these experiences, COVID gave me an entirely new experience, perspective, and opportunity for introspection that I would never have had otherwise. It gave me the time to reflect on who I was, what satisfied me, and what will sustain and motivate me as a medical provider.
Through Victoria, the residents at the homeless shelter, and our common bond of food, I realized that people are the key ingredient in medicine that energize and satisfy me. I learned to push myself out of my comfort zone, step outside academia, my home for almost two decades now, and use my security, position, stability, and resources to help others in a way I never could as a simple medical student. Thanks to Victoria, a global pandemic, and the fact that food brings even the most unlikely of friends together, I have learned to look for teachers, inspiration, and lessons in all facets of my life, not just in the clinical setting, at my desk, or on Zoom.