10/10/07

Thoughts \ Developed Thoughts \ Rants \ Raves \ Writing

02/26/2005 00:16 -0500 GMT

Job Application

From early on I wanted be a doctor. I wanted to help people in the expert way that only a physician can, but I needed a concrete, personal reason to make the commitment that being a physician requires.  It was not until my adult life that a reason became apparent to me. This personal statement describes my evolution as a humanistic individual, and how I found my driving force. My journey has crossed this planet, and has made me feel as much at home in sub-Saharan Africa as in Alabama. It is with complete certainty that I state this: my purpose for being a physician lies in helping the people that need it most. I see that purpose realized in serving those affected by HIV.

I grew up as an adopted child in southern California, in a household of six. Despite the intact nuclear family, I did not quite feel like I fit in, a fact that I attributed to being adopted. I proceeded through life as most with privilege do, obtaining a university education, but there was a subconscious, listless quality to my planning for the future. As a young adult, I went through a period when I was wondering where I came from, rather than thinking about where I would go.

Within this framework, I worked for three years in California as a hospital-based Emergency Medical Technician (EMT) where I learned clinical and organizational skills. In retrospect, perhaps the most important lesson was how to integrate into a team of caregivers, particularly within life-threatening situations. I also learned that medical practice was limited by policy. Health policy sparked my interest, and led me to the University of Alabama at Birmingham (UAB) to study health care policy and business administration, but an extraordinary event happened first.

Towards the end of my years as an EMT, I became reunited with my biological parents. This reunion answered many questions for me - personal questions that I did not realize I had - about who I was and where I came from. Finding them freed me from a burden that I did not realize I was carrying. Suddenly I no longer wondered who I was. Rather, I planned who I would become.

I moved to Birmingham and completed Master's degrees in Public Health and Business Administration. I undertook this graduate education to better understand the systems that guide our health care practice.  However, it was after graduation that I found my calling. Through a post-graduate internship in Africa that changed my life, I discovered AIDS.

From 1997 to 1999 I was the administrator for an HIV research clinic in Lusaka, the capital city of Zambia. When I began this work, I could not have cared less about HIV. The problem of AIDS was not on my radar. Rather, I was occupied by accounting for a million dollar annual budget, managing one hundred staff, overseeing four properties, interacting with governmental agencies, and complying with U.S. and Zambian regulations.  I hoped to gain on-the-job management experience…and I did learn innumerable practical lessons. However, in the process, I learned of a much more important need - the critical need for attention to AIDS - and it is this need that drives me every day, to become the best physician I can be.

I could write many examples of events that occurred in Lusaka that opened my eyes to the devastation of the AIDS epidemic. Each story would be the same in two ways. First, it would be tragic, with loss of a young life compounded by sick family members, the burden of orphans, and underscored by the deep despair of poverty. Second, and more importantly, I learned this: that if enough will, belief, and determination are applied, these tragic stories of AIDS would not have to unfold.

I came to see that individualized, caring medicine is the way to solving the problems of AIDS. I also realized that population-based, policy-savvy medicine is the way toward solving AIDS. I returned from Zambia with a will to do what I could to change things, the belief that these changes were the right thing to do, and the determination to translate these beliefs into action.

I returned to UAB where I worked as the administrator in the Center for AIDS Research. I augmented this employment with local and national community involvement in HIV-related activist groups as well as night classes to reacquaint myself with the sciences that I had a newfound craving to understand. Over this period I maintained ties to Zambia, traveling there once every year or two.

I began medical school in 2004 with continued inspiration to help those affected by HIV. Medical school has reinforced my resolve. Each clerkship has provided new opportunities to learn and to serve. Whether caring for a Spanish-speaking child on the oncology service, or an older man with cryptococcal meningitis, or a crack-addicted, pregnant mother of three in the emergency department, my passion has been to ease their burden. Of all the clerkships, Internal Medicine best fits my personal vision of being a physician.  I am interested in my patients, in their histories, in the way that their medical problems affect their lives, and I am motivated to do whatever I can to resolve those problems. I look forward to every patient encounter for two reasons: it is an opportunity for me to help, and it is an opportunity for me to learn. In my view, these are the greatest privileges of medicine.

During medical school I have continued to maintain close ties to Zambia, spending the summer after first year working on a perinatal HIV transmission reduction project at the Centre for Infectious Disease Research in Lusaka. In addition, I will complete medical school with three months of elective rotations in Zambia, at the University Teaching Hospital, at satellite clinics in Lusaka, and at the Chilonga Mission Hospital in the rural Northern Province. I come away from these experiences with a newfound understanding of the unique difficulties faced by women with HIV. I also have begun to understand the co-morbidity associated with TB and malaria in the context of high HIV prevalence. These experiences renew my sense of purpose in a way that no other experiences could.

Here I am now, nearly a physician, with a passionate purpose. I am no longer the adoptee that did not fit in. I am a man who has found his niche in the practice of medicine. I believe that my personal and professional experiences enhance my ability to take care of those who entrust me with their care. And I wish to apply these gifts where I believe they will do the most good.