Aisa Osayuki Estelle

As a doctor, I will be saving lives. Individual lives. But what if I want to affect an entire population? What if saving a single life isn’t enough? I’ve taken a break from the hospital this year to pursue a Masters in Public Health. As a self-proclaimed social justice warrior (I know that label might have a negative connotation but I wear it proudly) and a lover of all things medicine, the decision to get a Masters in Public Health was a no-brainer. It’s frustrating how undervalued the field of Public Health is. Curative medicine is more attractive to the public than preventative medicine is. And in our individualistic (“it’s their problem, not mine”) society, people don’t realize (or choose to not realize) how much the health of their society affects them. But those in public health still find ways to change the world. It’s a thankless, but meaningful, field of medicine. I love everything I'm learning so far. My classes are addressing the problems I always talk about. But now I'm learning how to actually do something about them. So many things about our healthcare system need to be improved and I'm learning how to make a real impact. Even our first required project will transform a community (I'll write more about that later). I'm excited for what this year will bring.

After this year, I will return to the hospital with the rest of my med school classmates and graduate as a doctor with a Masters.

I have another reason for getting this second degree. All around me, I’ve seen classmates either burn out or get close to burning out. You know something they don’t tell you before you start med school? We have the highest number of suicides than any other grad school program. That includes law schools, pharmacy schools, nursing schools, and others. But it isn’t because of the coursework. We have an unspoken culture in medicine that makes us believe that asking for help is a weakness. We lose sleep, stop eating, and simply forget how to relax when we pour our hearts and souls into this field we love so much. And when we start to feel overwhelmed, instead of getting help, we look around and realize everyone else seems to have everything together.

If they can do it, I can do it.

I don't need a support team.

I don't want to be that one person who's struggling.

So we, like the rest of our classmates, pretend we have it all together as well, unknowingly contributing to the problem. Instead of finding help, we continue to push ourselves even more. There is so much we have to do outside of school work. Honestly, almost every extracurricular thing is very fun and interesting to me and most other students. It's the balance we don't understand. Because everything is so interesting we give our all to every activity. Some of us forget to step back and breath. Not only is burn out a problem for students and doctors, it’s a problem for the patients. When doctors are out of it, people can die. It is dangerous to let doctors spiral into insanity. You don't want to put your life in the hands of an unstable physician. This is a culture my school, and many other schools, are trying to change.

I want to be an emergency room doctor

Did you know that emergency physicians have the highest rate of burnout than any other specialty? It doesn't have to be this way. I love the emergency department. I love the adrenaline, the blood and guts, the life or death situations. It excites me. I can't imagine doing anything else with my life. This means that I'll hold more lives in my hands than my peers in other specialties. So I need to make sure that I'm mentally fit to do that. This year I'll get to refresh my mind and learn how to impact the community. Through my MD program, I'll learn how to impact individuals. I'll be able to influence change through all layers of society. 

Thus begins my MPH year.

Some of you may already know this story, but I want to share it again. A few months ago, as I held a bloody heart in my hand, I lost my first patient. She was a Jane Doe, a jumper barely alive when she was brought in. She lost her pulse seconds after she was transferred to the hospital bed. I was surprised by how quick the whole team responded. As some doctors yelled for blood and another pushed epi, a couple of them immediately made a large cut to open almost the entire left side of her chest. They used a tool to push her flesh and ribs apart and took the heart right out of the cavity. One doctor handed me the woman's heart and told me to start pumping. I literally had her naked heart between my hands as I rhythmically squeezed. I blocked out the commotion and focused on my job. I only took my hands off when the doctors shocked her with something that looked like a salad tong, then I got right back to it. I could hear them in the background yelling for blood and working on keeping her alive. A few minutes later, as my hands still held her heart and pumped, they called her time of death. They were frustrated but used this experience to teach the residents. They asked, "What could we have done better?" At the very end, they showed me how to sew her up and I closed her. And naturally, I couldn't help but wonder if I killed her. "Do no harm." That's what we're taught. What if I had broken the fundamental rule doctors are supposed to follow? I had to convince myself that her death wasn't my fault. Unfortunately as a doctor, I'll have to experience these things. But the lives saved more than make up for it. Like the patient I had a while later, a man who came in with a head laceration that he got while trying to protect a stranger. Someone shaved and numbed his very bloody head and I helped staple his scalp back together. I got him warm blankets and stayed to talk to him. He told me I did a great job and right before I left that night, he prayed for me. I would have never guessed it, but he had a greater impact on my outlook of life than the first patient did.