My Brother’ s Keeper, Essay By Vincent Long, MD( continued)
land of my forefathers, a place where“ Black Excellence” was the rule, and not the exception. At Howard, I realized that I was just a man. No longer a Black man in a world in a foreign world because the“ Black” was simply implied. I felt as if I could finally breathe. The weight of the“ minority stress” was lifted from my shoulders and I found a confidence within myself that I had never known.
When seeking where I would pursue my graduate medical training, and upon hearing of the new Internal Medicine program that was just starting up, I knew in my heart that CDU was the place to be. Upon my arrival to LA, we immediately spent six weeks immersed in community and behavioral medicine, learning about the history of CDU and being inspired to know that the future, and suddenly the very present, face of medicine would look like me.
The first year was rough. Intern year is always tough, but starting a brand-new program made it exceptionally harder. We started off behind the eight-ball. A non-traditional course meant there was a lot of catching up to do. That, coupled with profound culture shock, made it difficult to adapt. But those of us in the program had each other for. support. During the day we would be dispersed throughout the hospital on different medical services, integrated into predominantly UCI-led teams. But at 12 Noon, we would come together. Noon conference was all we had. We would log into lecture and start to listen, but nevertheless there was more than medicine on our minds. We would vent, we would cry. We encouraged each other and reminded ourselves of who we were.
We shared horror stories surrounding our interactions with our attendings, who were in just as much shock as we were. They didn’ t know what to do with us. They didn’ t know how to help. But we had each other, and we had our Program Director, and his paternal energy made us feel safe in the midst of the storm. Back then, the name of the game was to just keep showing up.
When you have high expectations for yourself, it hurts to know that you are underperforming. I remember thinking,“ There is something that I’ m missing. There is something that I am not getting I don’ t know how to get it and I need one of these doctors here to give it to me.” I needed to learn how to think like a doctor, and more specifically, like an internist. But I just kept showing up. A quarter of the way into my second year I remember feeling like,“ Umm.... I think I got it!” I finally understood the rules of the game.
Fast forward to my third year of training. I have the breadth of the medical knowledge, and now I am going deeper. We welcomed the new class of interns and one of the Black men in the class was just like me. I found myself getting impatient with him as he presented his patient cases. I was getting a taste of my own medicine. I quickly put myself in check. One morning on rounds I took a deep breath in and blew it out. It was a sigh of relief that I had come so far. But it was also to fill my lungs with the air I needed to take the plunge. I knew what he did not know, but I also knew how to help make him know it.
One day after a long shift we ended up staying pretty late reviewing concepts. We identified the framework to think through the diagnostic process for the patient’ s presenting complaint. In true morning report fashion, we identified the key clinical factors that we gathered from the history and the physical( exam?). We developed a list of differential diagnoses and parsed out the illness scripts associated with each one. We identified what diagnostic studies we wanted to order, and predicted the results for each, and developed contingency plans in case we were wrong.
When we were done, he said“ Bro, that was one of the best talks that I have received.” I then responded,“ I didn’ t even know that I could do that!” I was then flooded with a warm sensation of fulfillment, and joy knowing that my own struggle was not in vain. Knowing that I could spare my coresident from having to work through this on his own made it all worthwhile.
Whether it is medical decision making, or navigating program politics, one thing I know is this; as Black men in medicine, we must stick together. I am my Brother’ s Keeper; and he is mine.
About the Author: Dr. Vincent Long is a third-year internal medicine resident and aspiring interventional cardiologist. He is hoping to serve as Chief Resident here at the CDU Internal Medicine Program for the next academic year before applying to clinical cardiology fellowship. This article was developed as part of a writing workshop conducted by Dr. Roberto Vargas and I.
For so long, I was going through the motions, completely clueless, until eventually, I figured it out. The synapses were synapsing. Medical decision making started to become fun. I started to figure out why my attendings were so bored with the unnecessary information in my presentations and why they would cringe as they tried their best to listen patiently.
CDU College of Medicine | PG. 38