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2022 LMS Essay Contest 2nd Place, Medical Student Category: Joshua Musalia

It was the first week of my third year of medical school. I was equal parts excited and scared to start the new year, especially given that I was hot off the heels of taking step 1 after an extremely difficult year and dedicated study season. On more than one occasion, I had shared with my wife my doubts about whether the medicine was still worth it. I was tired of the constant need to stay perfect, the hoops that I had to jump through to show my worth, the always present shadow of self-doubt, and the overwhelming sense of being an imposter in a system that was not built for me. I remember dreaming of leaving medicine, a career that I had aspired to since I was a small child growing up in my homeland of Nairobi, Kenya, and waking up with a smile on my face only to quickly realize that my reality had not changed. It was safe to say that if I continued to feel this way, I might have pulled the rug and found a different profession to call my own.

However, during the first day of my neurology clerkship, everything changed. When we arrived, we were assigned two patients to follow. Neurology wasn’t my strong suit, but I wanted to learn as much as I could, so I picked one of the more difficult cases to follow through the week. This was a black gentleman who had had acute onset of generalized weakness of unknown etiology. On my way to preround on the patient, every nurse that I encountered that had worked with the patient complained of both his and his wife’s attitudes and talked down to both, labeling him a “problem patient”. When I walked into the room, I didn’t encounter a “problem” but what I saw was a man struggling to understand what his body was doing to him and a wife who was scared to lose her husband. Were there moments where interacting with him on our first day was difficult? Absolutely. However, it was not an innate feature of his being but one that comes about with a sudden change that drastically alters a person’s life.

Throughout the week, I got to know my patient at a personal level. I had a short break every afternoon and after lunch, I would visit him and just spend time getting to know him. I learned that he had 5 kids and worked as a mechanic. I learned of how much love he has for his children and how much he desires to see them succeed. I learned that he had been married twice and was hoping to have a long life with his wife. We talked about him growing up as a black man in small-town Kentucky and how facing hate from his community affected him. I learned of his fears of the future and how his current state was a point of so much stress as he didn’t know how he would be a loving and caring husband and father if he cannot care for his children. On most days all I could do was listen as I never had the answers. However, I believe that is what he needed as he seemed refreshed after each of our conversations.

As I was preparing to transition services by the end of the week, I went into his room one last time. At this point, we had an answer to what the cause of his weakness was and had started discussing future treatment options. None of the options were necessarily promising, especially given that he would require a long course of physical therapy to get back to full strength. Since his livelihood depended on his physical capability, the prospect of not working and providing for his family for a long time was a scary proposition. When he saw me, his face lit up. After running through the normal follow-up questions, he opened up to me about his fears about the future and what was going to happen. He started crying and before I knew it, we were holding each other in a deep embrace. We prayed for each other and in the end even though his predicament hadn’t changed his spirits had been lifted. He wished me well and we parted ways.

I vividly remember having the desire to be a physician because of the work that I saw my uncle do. He was and remains the biggest helper I have ever met. Everything he did was to the service of others. Before this week, my joy for medicine had faded. However, having the opportunity to be part of this patient’s care, to be a loving face that was constant in his care, to have the opportunity to share my time with him was the greatest honor of my life. I might not have had that much say regarding his medical care, but I know there is value in having a constant caring presence during his stay. Thanks to this experience, my love for medicine was reignited and I can say this has been the best year I’ve had serving my community.