On Rotation(15)

But then, one day, something changed. I had been shadowing in the Emergency Department, as was the premed tradition. It was a slow day, and I was bored stiff; most of my shadowing shifts consisted of trailing after whichever resident* had gotten saddled with me and pretending to understand medical lingo. The Emergency Department techs wheeled a patient—a man, early thirties, Black—into one of the many empty rooms. He asked for pain medications, but when pressed for details about where he had pain kept giving us different answers. “My shoulder,” he’d said the first time. “My back. My stomach.” Every part of his body that we touched evoked a reaction, but further questioning was met with either silence or beratement—“Why are you asking me all these questions when I’m in pain?”

“This is what we call a ‘seeker,’” the resident said when we returned to the computer. “Look at his heart rate and blood pressure. Rock solid. He’s looking for a fix.”

“A seeker?” I asked.

“You know,” he clarified, giving me a pitying look. “For IV pain meds. Gets them high.”

I wasn’t so sure. The man’s behavior reminded me of my father’s. When he had appendicitis, Daddy had lain around the house, stone-faced aside from the occasional grimace, and vacillated between refusing and demanding our attention until Momma got tired of his mood swings and dragged him to the hospital. Four hours later, he was in the operating room.

There were no other patients for me to see, so I returned to the man’s room. Upon my entrance, he scoffed.

“The student,” he said. “Y’all really are just playing with me at this point.” When I raised my hand, he jerked away and fixed me with a scowl. “Don’t you push on me again.”

“I won’t,” I promised. “Look—I want to help. Can you please tell me what happened?”

Thirty minutes later, I got a story. He was a forklift operator in a nearby warehouse, and two days before his arrival in the Emergency Department, had been rammed in the gut by one of his coworkers. The pain had been terrible, but initially manageable, thanks to a friend’s leftover Percocet. When I relayed the history to my resident, his eyes nearly bugged out of his head. One STAT CT scan later and the man had been swarmed by a frantic surgical team and injected with enough IV narcotics to send him to nirvana.

Up until that day, pursuing a career in medicine had seemed like another box on my life’s to-do list. But without my interference, that man could have sat in the Emergency Department for hours. Maybe he would have gotten sicker. Maybe he would have died. And for what? Because the team had mistaken his distrust for criminality? Because he was young, Black, and not kissing their asses? I imagined a lifetime of patients like him. I imagined feeling a sense of satisfaction that went beyond grades and trophies and the approval and envy of Naperville’s coalition of Ghanaian parents. I felt . . . necessary.

“I know I want to go into a field where I have a long-standing relationship with patients,” I answered truthfully. “And that I probably don’t want to do surgery. But that’s as far as I’ve gotten.”

Dr. Wallace nodded, leaning back in her office chair.

“Okay, so that makes things a little easier,” she said. “We would have been in trouble if you wanted to go into a specialty like orthopedics or plastics.* No interest in dermatology, right?” When I shook my head, she turned back to her computer, clicking through her folders. “With that score, a nonsurgical specialty is more realistic. You can still match into internal medicine, pediatrics, psychiatry, et cetera, if you play your cards right. What ended up happening with that project you were doing first year? Did you get an abstract* out of it?”

“Yes,” I said. “And a poster presentation.”

Dr. Wallace beamed.

“Good.” Then she turned her monitor toward me. “Here. This is a list of clinical research projects that are actively seeking help. Go through them and see if anything interests you and let me know. I’ll introduce you to the PI.* Since your score is lacking, you’re going to need to bulk up the scholarly work section of your application.”

There was a humming sound; Dr. Wallace had printed the list for me. Ducking underneath her desk, she retrieved a small stack of papers from her printer, then riffled through her drawers. Having found her stapler, she pressed them together and, with a flourish, handed the documents to me.

“Look,” she said. “I want to be honest with you. You are a Black woman with a low Step score. They are going to use that to confirm their bias that Black students underperform.” When I lowered my head in shame, she rapped her knuckles against her desk to bring me back to attention. “So you need to do two things to prove them wrong: do well during your clerkships* and stack up on publications.”

“What about community service?” I asked, hopeful. I’d spent much of my first and second year coordinating free clinics, an experience that had continually reminded me why I was torturing myself into this field.

Dr. Wallace smiled. It was the same smile you gave a child who told you that they wanted to be an astronaut when they grew up.

“You know, your heart is in the right place, Angela,” she said. “And you have done a lot of good work already. But think of your service as sprinkles on an ice cream cone. It might help you stand out, but it won’t get you through the door.” She let her words linger, then tapped the list she’d given me. “Make sure you pick a project you can get done in your third year,” she said. “A literature review, or maybe a meta-analysis. Something where the data is sitting in a database, and you just have to comb it out.”