How a homeless teen became a physician [PODCAST]

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“During my medical school clerkships, an attending recognized a truth within me that I’d hidden for many years. Just a few hours into my pediatrics rotation, the attending asked me, ‘You had a rough childhood, didn’t you?’

I was astonished. How had he known? I asked him, needing to know what gave away my most deeply kept secret. And he said something that surprised me. ‘You don’t react. When patients tell you about risky behaviors, you treat them like regular people and just keep talking to them. You don’t look shocked by anything they say.’

I accepted his insight and started to notice how different my interactions with patients were. That secret part of me led to a deep, intuitive understanding of patients who were often unseen and unheard. Because for much of my early life, I was not seen or heard by people who I desperately needed to have protect me. I spent several years as a homeless teen in Hollywood before my life finally stabilized, but the scars remained.”

Sheryl Recinos is a hospitalist and author of Hindsight: Coming of age on the streets of Hollywood.

She shares her story and discusses her KevinMD article, “The story of how a homeless teen became a physician.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Sheryl Recinos. She is a family physician and hospitalist, and she wrote the book Hindsight: Coming of Age on the Streets of Hollywood. There’s an excerpt from that book on KevinMD titled “The story of how a homeless teen became a physician.” Sheryl, welcome to the show.

Sheryl Recinos: Thank you for having me.

Kevin Pho: So we’ll get into your book and excerpt in a little bit, but first off, can you share your story and journey to where you are today?

Sheryl Recinos: Of course. I had sort of an atypical journey into medicine. I didn’t start medical school until I was 31, and I went to medical school with three kids. And so it was quite a difficult and different journey. Before I went into medicine, I was a high school biology teacher for 8 years, and the dream of going into medicine just kept weighing on me heavily. Finally I pursued it, and we ended up moving to the Caribbean for school at Ross. My kids still speak fondly of the island, and I still remember all the sleepless nights studying.

Kevin Pho: So tell me some of the challenges, obviously, of studying for medicine while raising a family. Can you paint a little bit of a picture, or tell us a little bit of a story about some of the difficulties that you faced doing that?

Sheryl Recinos: There were so many times where my experience was very different from my peers’. I remember sitting down and studying, and oftentimes my kids would walk into the classroom and interrupt me, because they lived on the island with me, and so they were always on campus. They would show up to the classroom when I was studying with bleeding feet or other ailments that needed to be dealt with, and that was just part of the experience. I was taking care of them as my first little pseudo patients.

Kevin Pho: Tell me about your experience with medical education in the Caribbean. I know that there are a lot of perceptions regarding that. I think there was an article in the New York Times recently talking about Caribbean medical education, but tell me about your experience.

Sheryl Recinos: I felt like it was very hard, and I feel like that’s the way medical school typically needs to be, because we need to make sure we understand all of the material they’re teaching us so that we’re ready to save lives. I don’t feel like it was very different from U.S.-based medical schools, in the sense that we have the same boards and we have the same clinical rotations, but we were often taught that we needed to work harder and be there earlier and leave later than our peers. And that lesson stuck with me when I was in my clinical rotations. I was always present.

Kevin Pho: And for those students who are considering medical education in the Caribbean, any tips and advice that you want to share with them from your own experience?

Sheryl Recinos: Obviously, if you can get into a United States medical school, that’s going to make your journey so much easier. But if the dream is still there and, for whatever reason, there are barriers in place, go ahead and push and see what you can do. But remember that if you’re going to a Caribbean school, that means that they’re taking a chance on you, and so you need to work extra hard. Don’t take it as an opportunity to party like an undergrad. That doesn’t work. Those are the students that don’t make it. You need to be there and be focused and realize that it is equally as hard, if not harder, to go to a Caribbean medical school.

Kevin Pho: And if you were to do this journey all over again, would you do it?

Sheryl Recinos: I would, but I would have set aside probably a year’s salary in the bank first so that we wouldn’t have struggled so much financially during the journey.

Kevin Pho: All right. So let’s transition into your book and excerpt on KevinMD. The book is titled Hindsight: Coming of Age on the Streets of Hollywood. The excerpt is titled “The story of how a homeless teen became a physician.” Now, for those who didn’t get a chance to read your book or excerpt, can you just walk my audience through it and share the story of why you decided to share it?

Sheryl Recinos: When I was going through medical school and when I was going through residency, it became very apparent to me that the experiences that I had with patients were very different from the experiences that my peers were having, because I was able to understand them on a different level. Oftentimes, patients who have been through profound traumas know who to trust. And even though I didn’t initially understand what was happening, a lot of patients were sharing extra details with me that they weren’t sharing with my colleagues or with my attendings. Over time, that grew into a curiosity about what made me different.

I started to really reflect on my journey and what was different about me, because throughout my life, I had kind of tucked away that story of what had happened to me as a teen as something that had just happened to me. But it was a huge, profound part of becoming who I am. Once I embraced it and started sharing that story, I really felt like I was starting to change lives, because people have come to me and shared their own stories. I know it’s a great story of hope, but it’s also a story of a reason for all of us to give a chance to every single human being that we meet, because I was one of those kids that many people don’t expect to see make it in the world. And here I am as a physician.

Kevin Pho: So tell us a little bit about your background and your journey, perhaps from the book.

Sheryl Recinos: I’m the youngest child in a family of five, and we were a very dysfunctional family. On the outside, most people couldn’t see it. A lot of what was happening in the home was kept very private. My mother suffered from mental illness, and my dad was very controlling. It was just an unsafe and unhealthy environment for me as a child. I started leaving when I was 11 and ended up running away to California when I was 13, which was a cross-country trip, just to get away and try to find something new. I really didn’t understand why I was running away or what I was doing to try to protect myself from what was happening back at home. It took me a long time to understand that I was running from the trauma and the different problems that were happening within my household.

Looking back, there weren’t a lot of adults that stepped in and asked me why I was making the choices I was making, or tried to offer me a solution that would have made sense to me and would have given me agency in making my own choices. And so I continued running, and I continued getting in trouble. Unfortunately, one of the times that I had run away, I took money from my dad, and he pressed charges, which led to me ending up in juvenile hall at 13 for 10 months. That marked me. It made me feel like I was less than for very many years.

When I got out of juvenile hall and they placed me back with my dad, it didn’t get better, and things continued to escalate until it got to a point where he told me not to come home, and so I didn’t. That was when I was 16, and I ended up back in Los Angeles, where I stayed. That could have been the end of my story, but for some reason, I just had some stubborn willpower to survive. I didn’t know what survival meant or who I wanted to be, but I kept pushing forward, and I kept trying to survive the insurmountable odds that were thrown at me.

Staying on the streets as a homeless teen, especially as a female, is incredibly dangerous, and there are too many people looking to take advantage of or harm young people on the streets. And so it was a very scary time. Part of what I shared in my KevinMD article was one of those particular nights where somebody was pursuing me with bad intentions, and somehow I got away. But even at the end of that scene, there was no safety. I still couldn’t tell the police officer who intervened what was happening or what I needed, because I was still a minor, and again, I didn’t have the agency to really ask for what I needed. I was 17, and they would have sent me back, and that was the exact opposite of what I wanted.

It’s a story that ended well, because I ended up graduating high school and I got into college. But it wasn’t an easy story, and it was something that I held deep inside and blamed myself for, for many years, until I really started understanding adverse childhood experiences and resiliency and the role of parents in raising teenage children. When I started to have my own teenagers, life looked very different for me, because I realized that their experiences are so markedly different from the experiences that I had. They’ve never had to worry about where they’re going to stay at night or what they’re going to eat. Maybe they don’t get everything they want at the store, but they’re well cared for. When I compared those experiences, I realized just how different our lives have been.

Kevin Pho: So you mentioned that you went to college, and then you went on to become a high school biology teacher, and then medical school. So tell me about that transition from being a teacher. What were some of your motivations to go into medical school?

Sheryl Recinos: I was teaching biology kind of by default. When I graduated from college, I needed a job, and one of my professors told me that there was a program that was allowing pre-intern teachers to start teaching without having a teaching credential. And so it was kind of the right time to graduate without really a plan. I had wanted to go to medical school at that time, but I hadn’t taken the MCAT, and I was graduating a year ahead of time because I needed to pay my children’s daycare and pay for our lives, and it’s expensive to live here in Los Angeles.

What we ended up doing was I taught for the first six or seven years, and I kind of just kept moving forward and continuing teaching until I considered going forward in education and becoming a principal, and I had signed up to start an administrative program. One of my colleagues pulled me aside and told me, “Absolutely not.” She told me, “You know you want to go into medical school, and I don’t know why you’re doing this, because you should go after your dreams.” I kept telling her I didn’t believe in myself, and I didn’t feel like I deserved it, and someone like me didn’t have the right to be in medicine. And that beautiful, amazing friend told me, “Take a couple years, take the pre-med classes, and see what happens.” I took the pre-med classes, and I volunteered at a couple of hospitals, and what happened was I got into medical school, and I got to chase my dreams even though I thought that I was unworthy.

Kevin Pho: Now, tell me how your background influenced you as a physician. You did tell the story about how you connected with patients, but how else did your background influence not only your medical training, but you as a physician as well?

Sheryl Recinos: I feel like it gives me a lot more empathy. I know a lot of the time we’re all very tired and we’re burned out, and it’s been a very hard year, especially with the pandemic. But it gives me an added layer of insight where I can really hear what the patients are saying, and I can really look for solutions to some of the problems that they’re experiencing. It’s really hard to see the same patient come into the hospital over and over again. And I know for a lot of physicians, myself included, sometimes it gets frustrating to see that the patient isn’t really following the plan we’ve set out with them.

But what it’s given me, having this extra background and extra experiences, is a tool, a way of talking to people and communicating with them about what barriers to care exist, so that we can go beyond calling someone non-compliant and start talking about what barriers really are taking place that are causing them to continue getting sick. And so it gives me not just that extra layer of asking questions, but it also allows me to really just meet them at their level and ask questions in a way that’s non-threatening. Even in my lifetime, I never had a class on talking to people with trauma-informed care, but I know what worked for me when I was a kid. And I know which questions made me walk away and not go back to a doctor. But I also know how to talk to someone in a way that makes them feel safe, and I feel like that’s very helpful a lot of the time with the patients that I see.

Kevin Pho: Now, for those clinicians who don’t have your lived experience, what kind of advice can you give to them on how they can better connect with and empathize with patients?

Sheryl Recinos: For physicians that want to learn how to better communicate with patients that have gone through traumas, or are just struggling in general with life, because life has been so difficult over the past year or so, listening without judging is really important. But sometimes also asking why, and really letting a patient give their answers. I have patients, for example, who will come in in DKA, and it’s very easy to say, “OK, fine. You didn’t take your medicine. You’re sick again.” But if we really look at it and we see, for example, it’s a homeless patient and they’re on insulin, the bigger question is: Where are they storing their insulin? Is it being stored in a refrigerator, and how is that navigated as a homeless patient?

And so things like that are so important to figuring out how to prevent this from happening again, and perhaps contacting community agencies and different people who can provide resources can prevent the next hospital stay. I feel like just thinking outside of the box is important. So think about what a normal routine looks like, and then ask patients to describe their routine. That way, you can figure out if they’re not taking the meds or if there’s something that they’re doing that is causing them to get sick.

Kevin Pho: We’re talking to Sheryl Recinos. She is a family physician and hospitalist, and she wrote the KevinMD article “The story of how a homeless teen became a physician,” and that’s an excerpt from her book, Hindsight: Coming of Age on the Streets of Hollywood. Sheryl, for all those students who come from a non-traditional background and want to go into medical school and perhaps become a physician, what’s some advice that you could give these students?

Sheryl Recinos: The most important advice that I have is find a mentor. For me, I sought out mentors, and I latched on to them for a very long time until I found my next mentor, throughout pre-med and medical school and residency and even beyond. Find somebody who believes in you and will fill you with guidance as well as positive words whenever you’re struggling. And then take that to the next level. Once you’ve gotten through the process, once you’ve gotten in and you’ve gone to medical school and you’ve gone to residency, become that mentor and just continue that cycle.

Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Sheryl Recinos: I want each of us to look at each individual person that we see and see that there’s a potential even they might not know, they might not have imagined. And help them find their potential just through kind words and listening, and really just giving hope in places where hope might not exist. I really feel like that’s so important, because a lot of us who got into medicine got here because somebody encouraged us. Take it from me: Everybody can find their place. We just need to give them hope and give them that opportunity.

Kevin Pho: Well, thank you so much for sharing your time and insight. And thanks again for being on the show.

Sheryl Recinos: Thank you.

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