19. Medical School
Chapter 19
Medical School
Fourth Year
T he tension and excitement in the air was palpable as I stood among my classmates, each of us clutching a sealed envelope that held our futures. The chatter around me felt distant as I gripped my own envelope, my name starkly printed across the front. The rapid drumbeat of my heart pounded in my chest from dread and anticipation. My parents and Javi sat at the table beside me.
As the dean began the countdown and the crowd joined in, my hands trembled uncontrollably.
"Three, two, one...” An eerie silence fell over the crowd as roughly 140 envelopes were frantically opened and their contents unfolded. There were screams of excitement rippling around me as my classmates realized where they would be spending the next three to seven years of residency, depending on the specialty to which they were matching on this day.
I was frozen, not able for several moments to open my own envelope and reveal my fate. I looked up and met Javi’s eyes. He nodded and smiled encouragingly. I took a deep breath and tore open my envelope, unfolding the letter inside.
My eyes skimmed the words frantically. When I finally found it, my heart lurched and then sank.
Baylor College of Medicine in Houston.
I fought to breathe. It was an excellent program. I connected with the residents and the program director during my interview. I probably would have ranked it even higher, based on fit alone. But it wasn’t in California. It wasn’t close to Javi.
My top programs had all been within a few hours of Palo Alto, yet here was a binding contract telling me I would spend another four years halfway across the country from him. The room began to spin as the disappointment settled over me, heavy and suffocating.
I felt a hand on my shoulder and looked up to see Javi’s concerned face.
“How’d it go?” he asked, giving my shoulder a reassuring squeeze.
Shaking my head, I felt the sting of hot tears in my eyes.
“Not the one I wanted,” I managed to say, my voice barely a whisper.
I couldn’t meet my parents’ eyes. I couldn’t look at my father and face his disappointment when I was already drowning under my own.
Without a word, Javi took my hand and led me outside, away from the noisy celebration and into the quiet of the university courtyard. The cool air hit my face, a small relief from the rush of emotions. My vision went in and out of focus. My chest ached, and it became more and more difficult to breathe with each passing second. My body felt distant and numb, as if it didn’t quite belong to me. I couldn’t feel my hands as they clutched the piece of paper that had sealed my fate.
I both recognized the feelings and didn’t. My panic attacks had evaded me for so long now that the experience felt almost foreign, but not quite distant enough to forget.
“Talk to me, Di,” Javi urged gently. He held my trembling shoulders in his hands.
I looked up at him, tears now freely streaming down my face. “Baylor. In Houston.”
He looked shocked for just a moment, before mustering some enthusiasm to say, “Hey! Baylor’s an amazing school. And you’ll be in Texas! You’ll be in the heart of Valenzuela country!”
I shook my head. “But I couldn’t do it. After everything I worked for, I couldn’t match in California. I couldn’t bring us together.”
I was quickly losing my composure, the sobs starting to wrack my body as I trembled. He looked conflicted; obviously concerned for me, but I wondered too if there was a trace of disappointment in his features, like he too worried about our chances of surviving another four years of separation. He pulled me into his arms, stroking my hair.
“Hey, hey,” he soothed. “It’s going to be okay. We can make this work?—”
I choked on another sob. “Why is it always like this for us? Why do we always have to make concessions to be happy? Why can’t things go our way for once?”
He squeezed me even tighter. He sighed against the top of my head. “I don’t know.”
He held me for several minutes as I cried. He finally pulled away, brushing the tears from my eyes. “I know this isn’t exactly what we planned. I know you’re disappointed with how things turned out, but I want you to know how proud I am of you. And how much I love you. ”
I hiccuped and tried to stop the shaking of my voice. “I love you too. And I’m so sorry, Javi. I tried.”
“Hey, none of that,” he scolded gently. “Don’t apologize. I want you to be proud of yourself. We will figure everything out.”
But there was nothing to figure out. Our fate was sealed. He would be in California, and I would be in Texas. And while I knew we would try to visit often, I saw the life we could have had together flash before my eyes—coming home to each other at the end of the day, someday getting married and having children. These were things I hadn’t realized I wanted until this moment but that seemed inconceivable if we couldn’t even manage to be in the same state .
But it was Javi, I told myself. I would take whatever I could get. A piece of him would have to be enough. I sniffled before taking a deep, steadying breath. “Shall we go back inside and join the party?”
He looked at me with concern. “Are you sure? We can stay out here as long as you need. Hell, let’s leave the party all together?—”
“No, no, it’s fine. We should really get back inside,” I insisted.
I wiped under my eyes to make sure my makeup wasn’t smeared. He didn’t look particularly enthusiastic about the idea, but he obediently led me back inside to the celebration. I found my parents and accepted their hugs when I was finally able to share my match results. My mom spoke animatedly about flying down to Houston to go apartment hunting and furniture shopping. My father spoke about the merits of the program and the contacts he knew there. I nodded and smiled along feebly, grateful for their enthusiasm, but unable to provide much of my own.
And I wanted to kick myself for not being more excited and prouder of myself. Baylor was a g reat program. I really thought I would be happy there after my interview. And I had always considered myself a person who wouldn’t upturn her entire life to be near a man, but here I was, grieving what could have been. And that grief seemed to swallow up all the good feelings, the entire sense of accomplishment and excitement in my achievements I might have had otherwise. It made me feel small and silly and childish.
I milled about the room with Javi and my parents, seeing my classmates excitedly write their match results on signs provided by the school. I matched: Pediatrics at Children’s Hospital of Philadelphia. I matched: Ob/Gyn at Brigham and Women’s Hospital. I matched: Dermatology at Johns Hopkins. I was in awe of the accomplishments of my peers. I found myself once again reminded that I was surrounded by some of the most brilliant minds in the country, maybe the world. I was in a room with people who would find cures for illnesses thought incurable, create new surgical techniques and make the world a better place. And I was right there with them, as I had been for the last four years. I had taken all the same classes, passed all the same exams. I had finished the same clinical rotations.
So why did I still feel like I somehow didn’t belong? Like my accomplishment was somehow lesser than, just because I didn’t match my top choice program?
I vaguely registered the figure of Michael feet ahead of me, taking a picture with his parents in front of a navy step-and-repeat decorated with Columbia-blue crowns. His sign read, I matched: Orthopedic Surgery at the University of Miami. Our eyes met for the briefest moment. He smiled, and I smiled feebly back. Javi wrapped on arm around my shoulders, and I watched Michael’s eyes turn decidedly away from us, back to his family and friends. If I had been in the laughing mood, the sight would have inspired a laugh.
I heard the steady approach of high-pitched squealing before I felt Blake’s arms wrap around me in a tight hug.
“Diana!” she exclaimed. “I’ve been looking everywhere for you!”
She pulled back, searching me for a sign or a paper, anything to tell her where I might have matched. I had left my sign on my seat, not yet filled in for the pictures I didn’t have the heart to take. She lifted her sign for me to inspect. I matched: Anesthesiology at USC!
“ Los Angeles!” I said, forcing every bit of excitement for my friend that I possibly could into my voice. My heart thudded a little at the thought. Blake is going to California. Not me. Both of them would be there, without me. I understood, of course, that California was massive, and USC and Palo Alto were not close, but it still hurt to know that Blake had made it to my desired destination when I couldn’t.
A hint of concern broke through Blake’s excitement. “Did you?—”
“Baylor,” I cut her off quickly, “in Houston.”
“Oh!” She said, and I saw her eyes flit from me to Javi and back, as if in question. As if she wasn’t sure what to say next, not knowing what the future had in store for us. I didn’t know either. “Baylor’s a great program!”
“It is!” I said, forcing some enthusiasm into the response.
Blake pulled me in for another hug, squeezing me tight. She whispered into my ear, so quiet not even Javi or my parents could hear, “I’m sorry, Di.”
I patted her back reassuringly. “Don’t be. We’ll be fine. ”
I pulled away from the hug and looked at both her and Javi. “Now I have two reasons to visit California!”
Neither of them seemed to believe my feigned enthusiasm. Javi hugged and congratulated Blake on her match. She gave me another squeeze for good measure before she turned to rejoin her family.
I tried to rally some excitement after seeing Blake, but mostly I felt exhausted. The huge buildup that had led to this day, combined with the five stages of grief I had cycled through in the last half-hour, had left me feeling drained.
But I knew in my heart that if I didn’t at least go through the motions of the celebration, I was going to regret it. This was a once-in-a-lifetime moment, no matter the result. So, I filled out my sign. I took the pictures with Javi and my parents and Blake. I found Dr. Karam, who was absolutely thrilled for me, and took a picture with her as well. And through the act of pretending, my feelings on the match started to change ever so slightly.
My parents had booked us a celebratory dinner that evening at one of the nicest restaurants in town. Even though I had grown up in their home, I felt out of place. I had been scraping by on loans for years, living like a college student. The idea of spending my entire month’s grocery budget on caviar made my stomach turn.
As I watched Javi make light conversation with my parents, it struck me once more how different it felt to be around Javi’s family compared to mine. The contrast between the stuffy, formal atmosphere with my parents compared to his family’s typical colorful, loud home was never as stark in my mind as it was now. Wearing my tight formal dress, pushing a tiny pretentious portion of food around my plate, I knew in my heart which of the two environments felt more like home to me now.
Maybe the match in Houston was the universe trying to tell me that? I smiled to myself at the idea, the first genuine smile that I had felt all day.
“You’re being very quiet, dear,” my mom said with concern.
“Sorry,” I replied. “I was thinking about the move to Houston. Starting to get excited about it, actually.”
Javi analyzed my expression with an approving smile.
“Where was Houston on your rank list again?” My father asked, sipping a whiskey old fashioned.
I looked down. “Number five.”
My father shrugged. “Probably for the best then that you didn’t decide to go with surgery. If you only matched your number five in neuro, might not have matched at all in surgery.”
“ Hunt, ” my mother exclaimed reproachfully.
I felt Javi stiffen beside me at the comment. His hand found mine beneath the table and squeezed it gently, a silent promise of solidarity.
“What?” my father said, his tone too-innocent. “I’m saying it’s a field that not just anyone can enter. It requires a certain caliber .”
I remained silent, even as his cruel words hung between us. It stung more than I expected, even though I had long come to terms with the fact that I had no interest in surgery. I had matched into a specialty that I loved. I had thought my father, after our discussion during my third year, understood that. And after everything I had been through that day, the disappointment and sadness, the insult was just too much. My vision blurred momentarily with my anger, focusing back just in time to catch the flicker of indignation in Javi’s eyes.
“I think what Diana accomplished is extraordinary,” Javi interjected, his voice calm but firm. No one who didn’t know him like I did would know that there was anger there, simmering just beneath the calm surface.
I stood suddenly, my chair skidding backward, making a rude noise that drew the eyes of several nearby tables.
“You know what, Dad?” I seethed, my tone dangerous and challenging. All reason and logic fled my body, leaving behind it only rage. “ Fuck you . I have been doing nothing but trying to win your approval since my earliest memories. I went to fucking medical school trying to make you happy. And there were multiple times that I questioned my choices, wondering if I should have considered doing literally anything else. But God damn it if I didn’t fall in love with medicine anyway. But at least I have this one thing to set me apart from you. I love neurology. I am proud of myself for what I have accomplished. I know it may not be good enough for you, but I’m just now realizing that nothing will ever be good enough for you.”
His eyes grew wider and wider at my speech, the rage bristling behind his mask of shock. My mother’s eyes darted between the two of us, looking completely distraught. I briefly felt sorry for upsetting her, but not enough to apologize. I wouldn’t apologize for finally standing up to my father, after all these years.
I extended my hand to Javi, saying resolutely, “Come on, Javi. Let’s get out of this place. It’s pretentious, and the food isn’t even that good.”
He took my hand with a wry grin, throwing his napkin down onto his plate and his untouched foie gras. He saluted my parents as we walked away. “Lovely as ever to see you, Dr. and Mrs. Richards.”
An hour later, we sat on the steps of Low Library, at the foot of Alma Mater , eating burgers and French fries from Shake Shack as we looked out at the campus where we had met .
Javi cleared his throat. “I know you might not want to talk about it?—”
“Not really,” I interrupted.
“But,” he added, amused, “let the record show that watching you stand up for yourself was hot as hell.”
I grinned at him. His suit jacket was long abandoned—he had put it on the stone step for me to sit on. He had loosened his tie and run his fingers through his hair, sending it into a sexy disarray. I reached for his tie, pulling him to me by it. I pressed my lips to his.
“Why don’t we go home so you can tell me more about it?” I whispered, and he grinned at the idea.
Even though there was a lot of uncertainty and doubt that still lingered in the back of my mind about the future, we had excellent ways of distracting ourselves from those feelings.