FROM HEAD TO TOE
M TO F, F TO M, WTF(Y)—MALE TO FEMALE,
FEMALE TO MALE, WHEN TITLES FOOL YOU
I
Tathyana Fensterer, MD, PhD
n sharing with you my history and philos-
ophy, I don’t intend to promote doctrine
or reveal magic formulas for success or
happiness. This is just an invitation for
reflection based on a different experience.
I learned at a young age that education
is a privilege based on the experience of
my parents. My family settled in the south of
Brazil after fleeing European dictatorship and poverty. My parents
couldn’t attend school, not even kindergarten; but they managed
to survive, learn two languages and pay medical school tuition for
me and my sister (which has similar high costs as an American
medical school). In Brazil, matriculation for medical school begins
immediately upon graduation from high school and lasts six years.
I was then a very immature 17-year-old girl who didn’t have the
slightest clue of the meat grinder that I was about to endure.
I was placed in the biggest emergency room in Latin America
during my first year, and for the subsequent six years of medical
school, this experience made me carry a heavy psychological load
which strained some of the structural conservative values with
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LOUISVILLE MEDICINE
which I was raised. I was a very spoiled child who thought poverty
was not wearing Nikes. I was educated in a conservative, religious
family. The moment that I started witnessing violence, abuse and
death juxtaposed with good faith, I started to rethink what was
important and I learned to keep my heart open, even in moments
when life was more evil than fair.
In a “free” governmental health care system (please don’t call it
socialized, the system is based on democracy and taxes, more than
30% that I still remember only too well; bourbon, for comparison,
is taxed 100%), the problem is not the lack of money but volume/
demand. At the beginning of the day, I would get the joy of a Coke
before opening the door for the 2,500 people who were reaching
out to us for help daily. It was challenging, and challenges make you
become creative and develop talent. I remember suturing without
tools and performing surgeries after first checking the list of avail-
able “sutures of the day.” When I started my surgical residency at
University of Louisville, which was my third time doing a surgical
residency, I was astonished on my first day at the number of stacked
gowns, gloves and sutures available. I didn’t know if I had entered the
storage room or the operating room. I was like a child in a sandbox