personal statement

It seems like so long ago that I started writing this for my med school primary app. Almost exactly a year ago. So much changes in a year. In the last year I have very much come to know God as the Father who loves to give good gifts to His children. And they really are gifts...unearned and good. Receiving from God, I've come to see, is most complete when we can offer back to Him what He gives us and allow Him to continue to shape it.

In the spring of my freshman year at Penn I asked a few friends if they wanted to join me for an organized street clean-up of West Philly. This is the kind of invitation that many feel guilty turning down, but rationalize by saying: "the trash will just reappear the next day," or " you can't do everything to try to fix the world." Both statements are true. Half a day of picking up trash has no lasting effect, and I struggled that week with the feeling that serving others is an overwhelming task- that there are too many people and places in the world that need help.

The next summer I worked at Esperanza, a Spanish-speaking medical clinic in North Philadelphia that serves the poverty-level families of the neighborhood. My days were filled with accompanying doctors in examining rooms to translate, writing and administering quality of well-being surveys to patients, and compiling these responses for the purpose of future grant proposals.

The patients at Esperanza frequently struggle with diabetes, hypertension, malnutrition, skin diseases, depression, and a wide range of STDs. I sat with physicians and observed the process of developing treatment plans for patients, often diagnosed with multiple conditions. I then accompanied the doctor during his time with the patient, translating prescriptions and medical documents into Spanish, explaining, and often re-explaining, the purpose of each drug or nutritional suggestion. Many of the patients could not read or write well enough to complete the needed paperwork without my assistance.

One afternoon I spoke with a woman who had recently emigrated to Philadelphia from Puerto Rico. She had diabetes, but could not find a successful treatment plan. When her lab results came in, I listened as the doctors problem-solved for a better combination and dosage of drugs. What intrigued me about this process was that it required a personal knowledge of the woman's medical history as well as a powerful and intricate scientific knowledge of the biochemistry unique to the drugs prescribed. Even slight changes to dosages affect the patients in individual ways. This problem-solving process required patience and a clear and systematic thought process, as the medications she had previously been prescribed should have been effective. I learned that persistence and patience were key in the medical field, and I called the woman once more to double-check the medication that had previously been prescribed to her. Through our dialogue I learned that she could not read the instructions on the pill bottles and thus had not been correctly administering the medication. I asked the woman to come in so that we could give her a more formal explanation of diabetes, the treatment plan, and the remainder of her lab work, which showed that she was also infected with an STD. When she returned to the clinic the following day, I reviewed each medication and dosage she would be receiving and helped the doctor relay vital information about diabetes to her. I saw that as a physician I would need to know the biochemical consequences of these medications, how they would affect other physical ailments or drugs, what nutritional and environmental factors could be helpful or harmful to treatment plans, and most of all, how to communicate these facts to patients in a way that is clear and compassionate. It took a lot of patience and determination to ask the right questions in order to get accurate medical and personal histories; but it often took even more patience to respond, knowing that I had to put aside complicated scientific explanations and instead deliver accurate information in ways that showed each person dignity and compassion.

After explaining diabetes and the procedure for measuring blood sugar, the doctors and I told her about her STD, Chlamydia. She was clearly upset, vexed by the issue of how she had contracted it. It was difficult and heart-breaking to then explain that if she had been faithful, it was likely that her husband had not been. It was in conversations like these that I marveled at how different genres of medicine fit together. My time spent in research at the Scripps Institute and in science classes at Penn made the process of prescribing medication and explaining the intricacies of the human body to patients in a clinic extremely meaningful.

Further experiences at Esperanza and in my current job with the UCSD clinic have shown me that many patients share similar, heart-rending circumstances. No matter how hard the doctors, nurses, and I work, we find the same stories walking through our doors every day. My time in city clinics has taught me to persist in choosing action, relationship, and communication through the moments I am tempted to settle with simply feeling overwhelmed by the condition of community healthcare. In these clinics I find myself re-living that morning when I cleaned the streets of Philadelphia, and I think back to that summer day at Esperanza when I chose to give 'esperanza,' or 'hope,' to one of my first patients. It was then that I learned that hope, emerging from persistent scientific research melded with sincere human compassion, is not only something worth giving, but what I most desire to bring to patients in tangible and lasting ways.