Stargazing with You

9. Medical School

Chapter 9

Medical School

Second Year

D uring the weeks leading up to my Step 1 exam, the eight-hour long licensing exam that I had to pass to continue medical school, I felt like I was trapped in a small room with the walls steadily closing in on me. Each day added another layer of pressure, another whisper of doubt worming its way into my mind about my ability to go the distance. My panic attacks—once rare events that had only plagued me a few times before (the night before the MCAT, most notably)— seemed to occur with frightening regularity. Each time they happened, I felt like an animal was clawing at my chest, squeezing the air from my lungs, leaving me gasping on the floor of my apartment. I started to seriously wonder if I was cut out for this path.

The second year of medical school had ended a month prior. We were given extra, dedicated time to focus only on studying for the exam, the score of which would determine our entire future. A good score could open every door to every possible specialty. You could have your pick of programs in the specialty of your choosing if you succeeded. If you had a low score, or, God forbid failed the exam, you would be lucky to get a residency position at all . All those years, all that money, completely wasted.

Every time I sat to do practice questions or read my review materials, I could practically hear my father whispering in my ear that I would be expected to continue the family legacy . What if my score completely precluded me from any surgical specialty, much less cardiothoracic surgery? I remembered distinctly how horrible it had felt to have my MCAT score cripple me in my medical school applications, and I feared and dreaded the prospect of going through that again. To be ignored and ostracized from medical specialties, all because of one eight-hour period of my life.

The initial panic attack of the month came after my first practice exam, which I failed in spectacular fashion. I closed my laptop as my vision caved in, my breaths coming in short erratic gasps. Michael came over—we had made plans for dinner that evening–only to find me a gasping, sobbing mess in my bed. He seemed absolutely horrified by my state. I was certain only his sense of basic decency prevented him from leaving my apartment the second he realized what was happening to me. He stayed by my side, patting my back in a feeble attempt at comforting me as I spiraled into and eventually emerged out of the attack. But he didn’t stay long once I had returned somewhat to a state of normalcy.

Since that day, I could tell that he was steadily distancing himself from me. If I was honest with myself, I would have to admit that we had been drifting apart for months, the strain of med school pulling at the seams of our relationship. We had become like two stars in orbit, seemingly close in proximity when you looked at them, but light-years apart in every way that really counted .

The moment he ended things with me, we were both stretched thin, our nerves frayed. It was a week before we were scheduled to sit for the exam. I wore clothes that I’d been wearing for three days straight. My hair was a mess, piled on top of my head in a disheveled bun. I hadn’t worn makeup in weeks. He had asked me out for coffee, and I knew that this was going to be when he broke up with me. Coffee was short. Breaking up over dinner meant you would have to sit through the menu, the food, and the bill before you could physically part ways. Coffee was a cleaner break.

I hadn’t even taken a sip of my cappuccino when he began.

“I can’t do this anymore, Diana,” he began.

I nodded in understanding, looking only at my coffee cup as he continued. I let him get it all out without interruption.

“This is a really hard time, I know. It has been hard for all of us. The stress has been getting to me too. But you know that I need a good score on this if I want to stand a chance at matching into Ortho. And I can’t focus on my studies if I’m always worrying about you.”

He said it as if he had rehearsed the words a hundred times. He barreled on, seemingly not caring that he was wrecking the last bits of my coping skills with each word.

I admired how clean a break he made it. I had noticed he had been subtly preparing to leave me for weeks. He had quietly taken everything out of my apartment he had ever left there – a spare toothbrush, a few pieces of clothing, some office supplies he preferred for study sessions. He hadn’t packed them all at once, in an ostentatious way, but one at a time, over multiple visits. I had noticed, but never commented.

But even though I had felt it coming all this time, it surprised me just how raw and broken it left me feeling. I really didn’t think the loss of this relationship, mostly one of convenience, would affect me as much as it did. But the preparation for the exam had coiled me so tightly into such a fragile ball of anxiety, that the blow of the breakup simply broke me.

Not only am I failing at becoming a doctor, but I'm also going to be alone for the rest of my life.

After Michael had said his peace and left the coffee shop, I wandered back to my apartment in a daze. I crawled into my bed, pulling the blankets over my head as the heaving sobs began to ravage my insides. I wasn’t sure how long the panic attack lasted this time, but it left me in a stupor for days to follow. I stayed in my bed, only leaving it to use the restroom. Even then this was rare, as I was not making any kind of point to feed or hydrate myself. I felt like I was withering away into nothing, and I was content to let it happen.

On the third day after the breakup, the third day in a row where I had not touched a book even though my exam was only four days away, I heard Blake knocking at my door.

“Diana? Honey, are you there?” she asked through the door. “I’ve been trying to call. I’m really worried about you.”

My phone lay dead on my nightstand, untouched.

“Michael told me,” Blake explained.

I winced.

“Please let me in, Diana. I’m here for you. Please just let me in.”

She stayed outside my door for over half an hour; an admirable length of time, but it was like my brain and spine were no longer connected to the muscles of my legs. There was no communication telling my legs to move me to the door to let her in. I stared at the door in silent tears, finally turning away from it when there was nothing but silence waiting on the other side.

The next day, another knock came, this one firmer than Blake’s had been. Blake had sounded so worried, her knocks so hesitant. This knock was loud, almost angry.

“Diana, let me in!” the voice resonated through my apartment, and my heart—which felt like it had sputtered out in my chest days ago –lurched painfully, as if the knock had been a defibrillator restarting it. My eyes shot open. The neural pathways from my spine down to my limbs felt like they were regrowing slowly at the sound of that voice.

I pivoted until my legs hit the floor and tested my weight on them, as if I was truly learning how to walk again. I pulled my blanket around me and stumbled to my door. I undid the lock and opened the door to find Javi standing there, his suitcase beside him like his eternal sidekick. He must have taken the red eye from California. His usual stubble was more of an early beard, his usual suits exchanged for a cream-colored fitted henley and brown joggers.

“Javi,” I said, but the sound was less of a name and more of a strangled sob. I broke out into renewed sobs as he pulled me against his chest and held me there in my doorway for what felt like hours.

“Oh, Doc,” he whispered sadly as I cried into his shirt, his hands rubbing up and down my back as it shook with my emotions.

It took me ages to stop crying enough to look at his face.

“What are you doing here?” I asked, blubbering and wiping at my face.

He brought me into my apartment, pulling his suitcase and a few reusable grocery bags I hadn’t noticed before into the room before he shut the door. He guided me to the couch and settled my blanket around me, before sitting next to me.

“I would think the reason I am here would be obvious,” he finally said.

“But how did you know?” I asked.

“Blake called me yesterday,” he explained. “I came as soon as I heard.”

I nodded, thinking that Blake was too good a friend to me for how I had treated her yesterday. I didn’t deserve her. Didn't deserve either of them.

“Not to mention,” he said, in a gentle but stern way that let me know that I was in trouble. “That you haven’t answered anyone’s texts or calls in days. Not Blake’s, not mine, not your mother’s. Everyone has been worried sick about you. Your mom’s out of state visiting her sister, or she would have come. I had to talk her out of calling the police. But I thought you’d prefer me.”

“I do,” I said, sniffling.

“Good,” he said, and he squared himself up like he was about to do important business. “Look, we’ve got a lot of work to do here, but let’s tackle the most important tasks first. Give me your log-in for the Step 1 website.”

“What?” I asked, feeling slow and dumb, completely unable to follow his line of thought.

“Give me your log-in,” he insisted again. “Blake talked me through how to delay your exam. You cannot sit for this exam in three days in your current state. But you have to take it by the end of the month, or you delay the start of your third year, right?”

“Right,” I confirmed.

“We’re going to push your exam back a week,” he said. He grabbed my laptop off my desk and brought it to me.

“But it costs $100 to change the exam date this—” I argued, but he shot me a glare that shut me up halfway through my protest.

“Do I look like I care about the money? Log-in to the site, Diana,” he commanded. I logged into the exam website without further argument.

After a few minutes, he shoved my laptop aside and turned back to me. “Okay, it’s done. Your test is now ten days away. That gives us ten days to get you ready.”

I shook my head, and if I had any fluids left in my body, I would have started to shed more tears. But everything about me felt dried up with dehydration. “There’s no way, Javi. I can’t do it.”

“One thing at a time,” he said to me, holding my shoulders in both hands. “We’re not going to think about studying or taking the test right now. We’re just going to control what we can control. And the first thing we can control is how you smell.”

I sputtered out a sad little laugh. “I know I stink. I haven’t showered in days.”

“Now is the perfect time to change that,” he said. He pulled me off the couch. He turned the shower on to let the water get hot. He went into my drawers and found a clean pair of soft pajamas and comfortable underwear. He handed me both, turned me around, and pushed me toward the bathroom.

“You shower,” he instructed. “I will be out here when you’re done. Take as long as you need.”

I shuffled into the bathroom, placing my stack of clothes on the tiny counter. I shed my clothes and stepped into the shower, the warm water soaking into my skin and muscles, sore from lack of use after days spent in bed. I washed my hair and my body twice, convinced once wasn’t enough to clear the grime.

When I finished, I toweled off and put on the fresh clothes Javi had picked out for me. I wiped the oval mirror free of fog with my hand, and nearly jumped at the sight of my face. My eyes looked sunken, dark circles shadowed beneath them. My skin was paler than I remembered, even in the depth of summer. My freckles faded nearly to nothing. I looked like a ghost.

I emerged from the bathroom after I had brushed my hair and my teeth and looked, while not good, at least less like a zombie. In the time I had been gone, Javi had cleaned. The linens I had been stewing in for days were piled in the hamper, along with other clothes I had previously discarded on the floor. He had made my bed with fresh linens. He was straightening my desk, closing textbooks and organizing long abandoned study materials. He organized the space with such familiarity, you would have thought he saw it every day. A fresh pot of coffee was brewing in the kitchenette.

He looked up at me. “How do you feel?

“Better,” I said. I didn’t add that there had really been nowhere to go but up when he knocked on my door.

“Good,” he said. He grabbed the blanket from my couch and wrapped it around me. He sat me at my kitchen table and brought me a cup of coffee. “Next item on the agenda is food. I apologize in advance for my cooking. Dad never taught me his ways.”

I watched him silently as he moved about the tiny kitchen, taking items out of grocery bags and putting them away before making us cheese omelets and toast. He sat down across from me at my kitchen table. He didn’t grab his fork until he watched me take the first bite, like he wasn’t sure I was going to comply. I took a piece to get him to stop staring. He had warned me about his cooking, but it was actually pretty good. It was probably hard to gauge your skill when your parents were such excellent chefs. It might have been the whole not eating much for days thing too, but the omelet felt like the best thing I had tasted in a while.

After I was done eating, I told him, “Thank you, Javi. I can’t believe you’re here.”

“There is no place else in the world I’d rather be,” he said. It was saying something, considering it felt like he had been to just about every place in the world in the last two years.

“How long can you stay?” I asked, unable to keep the sad and desperate tone from my voice.

“I’ll be here at least for these ten days,” he said carefully, only indirectly alluding to my exam, careful to skirt around the subject. “Longer if I need to.”

The answer surprised me. Javi had never stayed longer than a week before, always having some important meeting or destination to make.

“Are you really? You don’t have anywhere you need to be?” I asked.

He shook his head resolutely. “No. Nowhere to be. Nothing that can’t be rescheduled or handled by someone else on my team.”

It was clear from his wording that he did, in fact, have other obligations. But I didn’t argue with him. I was just so grateful he was here. I looked over and saw one of the grocery totes he had left on the ground. I leaned over and grabbed a box from the bag.

“ Ticket to Ride ?” I asked, inspecting the game.

“Yes. There are several games in there. You can choose which one and when you want to play, but rest assured, I will be kicking your ass at some board games this week.”

I smiled, for what felt like the first time in a month. Leave it to Javi to always know exactly what to do to make me smile. I started unpacking the box and assembling the game between us. We settled into comfortable silence except for banter relevant to our match, and I was relieved when Javi didn’t bring up the test or the breakup.

For a while, we were immersed in the strategy of the game, with Javi making exaggerated gestures of triumph whenever he claimed a crucial route on the board. The playful competition was a balm to the recent turmoil in my life, reminding me of simpler times. His presence had a way of grounding me, pulling me back from the edge of despair that had seemed so seductive only hours before.

The game ended—Javi winning, as predicted—but it hadn’t been over for thirty seconds when he brought out Monopoly. I started setting up the new game while he went to the kitchen and made snacks. For the rest of the day, whenever we were between games or taking a necessary pause, it felt like Javi was shoving food at me.

I put a handful of popcorn into my mouth and said to him, “Why do I feel like you’re trying to fatten me up like a lost child in a forest? Are you going to trick me into falling into the oven at the end of the evening?”

“You have foiled my evil plot.” He cackled like a witch, making me grin. “But seriously, Di, you look like you’ve lost weight. I want to make sure you’re taking care of yourself.”

I was suddenly reminded that he was Alba and Juan Valenzuela’s son, and the need to keep people happy and fed was deeply ingrained in his genes. The reminder of them made my heart ache with longing, wanting to see them again.

“I miss your family,” I said wistfully.

He smiled. “They miss you. They ask about you every time I talk to them.”

“Are they doing well?” I asked .

“They’re okay,” he said, and the sad edge to his tone set off alarm bells in my mind.

“Just okay?” I asked with concern.

He frowned. “My nephew Theo was diagnosed with epilepsy. Started having seizures a few months ago.”

I gasped quietly. How was he just now sharing this information with me? Had I been so caught up in my own world, in studying for this infernal test, that he hadn’t been able to share this pivotal news from his life? The thought made me feel sick.

“Oh my God,” I breathed. “Is Gaby doing okay?”

He shrugged, nodding. “She’s taking the news okay. She is worried, of course. But Theo had a custom-fitted, green Artemis sent straight from my lab before he could even get home from the neurologist’s office. So that has brought her some comfort, I think. Theo, meanwhile, is doing experiments that I never even thought to run—namely, how many stickers can you fit on one device before it ceases to function all together.”

I laughed at the idea, picturing the sweet, little boy in my mind.

Javi added, “In happier news, Manuela is pregnant again. Another little girl.”

“Wow,” I said in wonder. “Grandbaby number seven. Your mom must be thrilled.”

“She is,” he replied. “Really takes the pressure off me to provide grandkids when you have sisters as fertile as mine.”

I laughed, and the sensation of laughing again felt good. His words brought the image to my mind of what Javi would be like as a father. I pictured him running after a toddler and picking her up in his arms, making her giggle as he tickled her sides. I pictured him teaching a child to ride a bike or helping a preteen through her math homework. He would be an amazing dad, I imagined. A part of my brain registered that in all my daydreaming, I had failed to include a woman who would be the mother to those children. My heart clenched painfully at the thought.

“Why are you looking at me like that?” he asked, making me realize I was staring rather intensely at him. “Do I have something on my face?”

“No,” I replied, shaking my head. “I was just thinking that you’d be a great dad.”

He blushed furiously. He wouldn’t meet my eyes after the unprovoked compliment.

“Thanks, Di.” After a long minute, he added, “For the record, I think you’d be a great mom, too. I mean, if that’s something you wanted. I don’t think I’ve ever heard you mention wanting kids. But I’ve seen you with my nieces and nephews. They love you.”

I pondered the idea. “Clearly, now, I feel like I can barely take care of myself, much less another human being. But I think I’d probably want kids someday, yeah.”

The thought hadn’t truly crossed my mind until this moment, but they became true as I said them. We sat in thought for another minute, neither of us making a move to continue our game of Scrabble .

“Hey, there’s still a little sunlight left in the day. What do you say we take a walk, get some fresh air? Maybe stop for some dinner on the way back?” he suggested.

“Well, considering you’ve been force feeding me snacks all day, I don’t know how hungry I’ll be for dinner. But I’m willing to give it a try,” I said. I moved to get some real clothes out of my drawers to change into.

We walked the half mile to the Columbia undergraduate campus and wandered through it aimlessly, Javi pointing out places that had been important to one or both of us along the way. When we had walked long enough for me to find an appetite again, we grabbed burgers and fries at the nearby Shake Shack, shameless comfort food.

When we made it back to my apartment at the end of the night, I set to cleaning up our board games, and Javi started making a bed for himself on my couch.

“You’re not staying at a hotel?” I asked him.

“No,” he said. “I came here to be with you. I’m staying as close as you’ll let me.”

“Oh,” I said, not knowing what else to say. We took turns in my tiny bathroom readying ourselves for sleep. When I had turned out the lights and climbed into bed, I stared up at the ceiling, knowing without asking that Javi was still awake.

“Javi?” I asked, my tone searching. He didn’t respond or wait for me to ask this time. I heard him approaching in the dark.

“Scootch over, Doc,” he said, and the familiarity of the circumstance was comforting. I scootched until my back was against the wall to give him space, but he held my hand between us as I fell asleep.

The next three days became a comforting routine of playing games and watching movies with Javi, who either made or picked up every meal and many snacks in between. He refilled my water bottle without asking me. He insisted we take walks at least once, sometimes twice a day around the neighborhood, insisting on fresh air and sunlight as part of my ‘healing regimen.’

When the day came that I was originally scheduled to take the exam, I felt like a new person. Like the last month hardly existed anymore.

Over breakfast that day, as Javi handed me a plate of French toast, I said to him, “I think I’m ready to prepare for my exam again.”

He looked pleased. “Great. How can I help? ”

We found our new rhythm. Instead of finding ways to distract my brain from the situation, to keep me from spiraling into feelings of dread and self-doubt, we found ways to focus it. I sat down at my desk to open my review book, happy to find that the feelings of panic and terror did not flood my senses like it had so often this past month. We spent the week in a pattern of studying and taking breaks. Javi would sometimes read aloud to me from my textbooks, his warm, deep voice making the dry material seem interesting again. During our afternoon walks, he would quiz me from flash cards and celebrate me when I got most of them right.

The night before the exam, we walked in the direction of Tom’s Diner without even discussing it. We got our milkshakes—cookies and cream and pistachio—and made our way to the sundial.

When we were settled in our old familiar spot, I said to him, “You didn’t have to do all this, Javi. I don’t know what I did in a past life to deserve you, but I will be eternally grateful for what you did for me this week.”

“I know I didn’t have to do it,” he said earnestly. “But I wanted to. I wanted you to be able to focus on healing and studying, not on your next meal or running out of coffee or whatever happened last week.”

“I’m still scared for tomorrow,” I admitted after a while.

“I know it’s scary,” he told me. “But you’re not alone in this. You’ve got me. Blake. Your parents. We are all cheering you on. Promise me you’ll walk into this exam tomorrow knowing you’re not only doing this for you but for all of us who believe in you.”

I leaned my head against his shoulder, looking up at the twinkling lights of Butler Library with him. “I promise.”

The morning of the exam arrived rainy and gray. Javi rode with me on the subway to the testing center. He had packed me a lunch and snacks for the testing day, which he handed to me like a kid going off for their first day of school. He hugged me.

“Just do your best, Doc,” he said in my ear. “That’s all anyone can ask.”

When I walked out of the exam eight hours later, my mind a blur of questions and answers I was already beginning to second-guess, he was there. The doubts and fears about the exam fled my mind the second he smiled at me.

On our walk from the subway back to the apartment, Chinese takeout in our hands for dinner, my phone rang in my pocket. The caller ID was a picture of Blake and me in ratty scrubs from our last day of Anatomy lab. I answered.

“Hi, Blake,” I said, gearing myself for Blake to be angry with me.

“Diana!” She said, sounding relieved on the other line. “I’m so glad you answered. How was the exam?”

The lack of anger in her voice surprised me. “Uh, fine, I guess? Didn’t feel particularly good, but how else can an eight-hour-long exam feel but terrible?”

“I feel the same way,” she said. “Took mine on Monday. Felt awful, but it’s done!”

“It’s done,” I agreed.

“Hey, is Javi still with you?” she asked. “Or did he try to make it to Zurich for the end of the Biotech conference?”

I peered over at Javi, with Blake still on the phone. “No, he’s still here. Didn’t say anything at all about Zurich, in fact. I’ll talk to you later, okay?”

“Oh, okay, Di. Talk to you later.”

When I hung up with Blake, I peered at Javi.

“Zurich?” I accused. “You missed a conference in Zurich for me? ”

He shrugged. “It’s fine. Someone from my team went in my place.”

“It’s not fine,” I insisted. “That sounds like a big deal. You missed it for me.”

“And I would do it again,” he retorted. “Look, all these meetings and conferences to promote The Artemis are important to me. But they mean nothing to me without having people I love to share it with. You’re as important to me as my family, Di. Would you expect me not to run back to Texas if they needed me?”

I said nothing. I knew beyond a shadow of a doubt that Javi would do the same thing for any member of his family. But even so, I couldn’t help but feel that I had become a burden to him, as I had become a burden to Michael. To the point that he couldn’t stand being around me anymore. Javi had handled it considerably better than Michael had, but it didn’t change the fact that it was unfair of me to expect Javi to pick me up off the floor every time things got stressful in my life. I had signed up for a career that promised a considerable amount of stress. And I had to find ways to cope with that stress without it affecting and hurting the people I loved.

Two days later, when Javi hugged me goodbye and hopped in a taxi to the airport, I looked up the number for student mental health services at my school and called to make an appointment.