How a Birthday Celebration Changed the Course of My Life

I remember the moment I decided. It was at the Rochester Psychiatric Center, the state psychiatric hospital where I volunteered in high school during patients’ monthly birthday events. At the event being held on this particular day was a patient in her 50s or 60s, with a head full of gray hair, a cautious smile when it peeked out of her facial tardive movements, and a story to tell about the deep gashes on her neck, now long healed and covered over as though out of politeness by thick folds of skin. She had been sexually abused as a child and later diagnosed with schizophrenia and made multiple suicide attempts. Admitted to this hospital years ago, she was still here, taking it day by day. But today her birthday would be celebrated, the party atmosphere on the patio was nice, so things were OK.

I sat next to her as she told her story, absently handing out juice boxes while entranced by both her sorrow and her resilience. But what got me was this: after she was done, she turned to me and said, simply, “Thank you for listening,” with tears in her eyes.

I remember driving home that afternoon, as quickly as I safely could, and calling my best friend in a rush of inspiration. “I want to go to medical school,” I declared. “I want to be a psychiatrist.”

To be sure, a confluence of factors had led me to that decision. My parents loved the idea of my being a doctor and hinted at that with regularity. My own interests were psychology oriented, and I’d been a curious observer of human behavior from as far back as I could remember. But what I’d never felt before at that magnitude, what really swayed me that day to make that decision, was something it’s taken me years of psychiatric training to truly understand and describe: the grace of holding the suffering of another, and thereby making it known to her that she is not alone.

Four years later, I enrolled in medical school. Though I had more than an inkling that psychiatry would be my passion, I followed the advice of my mentors and reserved my judgment until at least halfway through my third-year rotations. In the eager manner of any type A med student, I immersed myself in the particulars of each subspecialty as I passed through it, alleging to my attendings (and evaluators) that this was the specialty for me. Two strange feelings struck me, though, during and after the psychiatry rotation. The first was that I felt naturally engaged with and focused on my work, instead of striving to be so. And the second was that, even after the rotation had been over for months, psychiatric topics continued to draw my interest. I became the de facto mental health consultant on some of my subsequent rotations, largely because my fascination with the field was clear to see.

When the time came to apply for a residency, my choice was easy. Telling my friends and family about it, however, was a different story: many were supportive, but some doubted the wisdom of entering psychiatry. The latter group expressed well-meaning concerns and questions that ranged from factual to mythical: Was psychiatry a safe line of work? Would it make you more prone to mental illness yourself? Why not a more “prestigious” specialty? Why not a higher-paying specialty? Explaining my decision only strengthened my drive to be a psychiatrist, since I became more aware of the stigma surrounding practitioners—not to mention patients—of the profession, made my peace with it, and resolved to change what I could about it.

I completed residency at the Massachusetts General Hospital/McLean Hospital program in Boston, where I honed my ability to listen to, prescribe for, and, most of all, be present with my patients in their times of need. In my search for even more ways to positively impact the lives of individuals with mental illness, I branched out into grassroots advocacy, teaching, and research, and I’m continuing to develop skills in these areas during my fellowship with the National Clinician Scholars Program. As I’ve found out, there are many ways to touch patients’ lives—from the individual to the population level. But my heart remains the heart of a clinician: my patients imbue my work with meaning and purpose. I have never forgotten that first patient who let me into a sliver of her world—and who, in doing so, changed the course of mine. ■