It’s the day of my last case presentation for my neurology rotation. Hearing the subway doors shut, I run up the stairs just in time to see them close. Breathless, I walk to the center of the platform. Noting the next train isn’t coming for another seven minutes, I groan in frustration and pull out my notes to spend the time to prepare.
I see a woman approaching me from the corner of my eye.
“Hi, do you speak Spanish?” she asks, in a thick Spanish accent.
“Sí, que necesita?” I respond.
She asks me how to get to East Harlem, and I tell her I’m heading in that same direction and that she should stick with me. When I first moved to NYC, I was 18, alone, and in my first year at Columbia University. I know the city’s overwhelmingness, even without the added language barrier.
At first, we sit quietly next to each other. After a few stops, she turns to me and thanks me again for helping her. Her name is Maria, she says, and she moved to this country three months ago from South America. I share with her my journey of immigrating from Venezuela to the United States when I was eight years old. Although I was young, I still vividly remember being frightened of everything around me – where nothing is familiar and everything is foreign. I tell her I mostly learned English from watching Spongebob, which makes her laugh.
She has two children who are living back home. They’re adults, the oldest being my age, and she tells me my eyes remind her of her daughter. We talk about the importance of family and coming from large families. She tells me she’s one of five, to which I say, “Beat you! I’m one of seven!” and we laugh.
We start talking about why we both immigrated, recognizing our similarities as we escaped political turmoil in our home countries. She also moved here for “the American dream,” to work and be successful in providing for her kids back in her home country.
Unfortunately, her recent experience is far from a dream. She tells me of her struggles with her current job. She works as a nanny and is being paid less than minimum wage to watch three children under five. Today is her first day off since moving to this country three months ago.
Despite her current circumstances, she still finds joy in the beautiful parts of New York City and recognizes how wonderful it is to be in a city where many people speak Spanish. It’s comforting, she says, to be surrounded by people who know your battles without having to tell them, especially in a new country. I understand exactly what she means by this, knowing the unspoken bond that exists between her and me. It’s difficult being the “foreigner.”
She then asks me what I do, and I tell her that I am a medical student. As I answer, it occurs to me to ask her – where are you getting your medical care?
“No se. No puedo ir a ningun hospital, no tengo seguro.” “I don’t know. I can’t go to any hospital; I don’t have insurance.”
Years ago, her thyroid was taken out due to a large goiter. She brought three months of thyroid medication with her but quickly ran out of pills. She has been spacing them out to make them last but is already starting to feel the effects – her hands are tingling, and her fingers are numb.
After talking with Maria for almost thirty minutes, I recognize how all the current stressors in her life have caused her to cast her health aside. Realizing she lives close to another medical school’s free clinic, which provides health services to the uninsured, I think about how I can quickly connect her to resources. Remembering I am a part of the Latino Medical Student Association’s (LMSA) group chat that has medical students all over the Northeast, I hastily send a message between subway stops, taking advantage of the fleeting internet connection. Immediately, a student answers with their number, and once we get off and are waiting to transfer to the next train, I call them. After a five-minute phone call, Maria has an appointment.
As we ride the train together, Maria thanks me, as this is one less thing she has to worry about. We exchange numbers, and I get off at my stop.
Later that day, in the middle of my presentation, she texts me in the style of a typical Hispanic mother saying: “Hola Fabiola que hermosa eres y tienes un corazon de oro cuidate mi niña que dios te protege siempre y pronto sea mi médica.” “Hello, Fabiola, you are so beautiful and have a heart of gold. Take care of yourself, my child. May God protect you always, and soon you will be my doctor.”
Reading her text, I again recall when I moved to this country. At eight years old, I didn’t recognize how I would be separated from my family and friends and have to start a new life altogether. I struggled to fit in once I entered school; it’s hard enough being the new kid, but it’s even harder when you have a strong accent. I was ashamed of my heritage because it constantly reminded me I was an “other.”
I would never have thought that I would feel such pride in that heritage sometime in the future. Without it, I wouldn’t be connected to this large organization of other Latines. I wouldn’t be able to help Maria find medical care. I wouldn’t have even met Maria.
As a medical student, it is easy to feel powerless. Whether standing during surgery rotation, being seen and not heard, or learning about the various health care disparities in our country, it is challenging to know the importance of your role. I often find myself with this mentality, thinking that medical school is simply a stepping stone for when I can make a real impact in the future. But this is far from the truth. We have the power to be the patient’s advocate, connecting them with the large number of resources that we have at our disposal. We can lead the change in the future of health care to ensure that immigrants like Maria will no longer have to worry about accessing care.
Fabiola Plaza is a medical student.