Hektoen International

A Journal of Medical Humanities

The seeds of resilience

Bryanne Standifer
Redford, Michigan, United States

Downtown Detroit, MI 
“When I think about the city of Detroit, I don’t see a city filled with unskilled and uneducated laborers, I see a platform of opportunity.”

One Friday morning in high school, I counted fourteen murders in one week in the city that I call home.  I was born and raised in Detroit, Michigan. Not the cool, trendy Detroit we know now, but the Detroit that made us lock our doors at night and look both ways before we left our homes.  The same Detroit that built three-billion-dollar-generating casinos in a city with the highest unemployment rate in the state.  This was my home, but my soul craved more.

My mother always told my sister and me to work hard and go to college. She did not know what that meant exactly, but she knew it had to be better than working two jobs making $19,000 per year to support her family of four. I saw her struggle and heeded what she told us. I knew it was not going to be an easy journey but I was determined.  Many of the “hurdles” in my life have been woven into the tensile cloth that makes up my being.  Most people with time and effort can learn physiology, anatomy, and pharmacology; however the ability to self-reflect, work as team, maintain mental toughness, and assess when someone else needs help goes beyond textbook learning.

After graduating from eighth grade, I gained entry via examination into the Math, Science and Applied Technology (MSAT) program at Martin Luther King High School.  Due to the lack of funding, poorer school districts tend to lack proper educational resources, have overcrowded classrooms, and generally poorer school upkeep.  Although acceptance to this school was the greatest news one could hope for, it also presented a great challenge. Transportation to my new high school required two hours and seventeen minutes, five textbooks, one tenor saxophone, one roll of quarters, and two city buses for a one-way trip.  These buses, just like my high school classrooms, did not follow their published schedules, were overcrowded, and not always the safest place to be.  With time I learned to be extremely resourceful and creative. Being on the city streets during the busiest times of day, I learned the importance of observing my surroundings.  I learned how to hide my wallet, spot a scam artist, and developed a foolproof technique of folding my hands to keep warm when the temperature was below zero.  This resourcefulness became my ticket out of Detroit and to Michigan State University for my undergraduate studies.

My first class, general chemistry, was a both an academic and cultural shock. It would take more skills than spotting a thief to keep up.  I realized my professor’s assumption of my foundation in science was not quite my reality.  My high school chemistry class, unlike those in the cities that neighbored Detroit, was either led by substitute teachers or empty.   The school’s reputation and its low standardized testing scores  pushed teachers to suburban high schools that offered better wages, resources, and safety. Initially overwhelmed, I took myself back to the girl on the city bus that learned how to keep warm.  I became the student in the front row, attended every professor’s office hours, went to tutoring sessions, and participated in study groups.  I also became best friends with the library and  janitorial staff, and the midnight crew at the coffee shop. To that end, I became the first to hold a college degree in my entire family.

After graduating Michigan State University, I explored the working world for a few years prior to applying to medical school.  I worked as a hemodialysis technician at Henry Ford Hospital in Detroit, Michigan.  My facility was the third largest  in the city; it held forty-eight chairs and ran a total of four shifts of dialysis per day.  The role of technician taught me the value and importance of each member on the care team.  Aside from building relationships with patients, my feedback often assisted in physicians’ treatment plans for patients.  I also began to notice the high turnover rate, which triggered the question: why?  I learned that many patients did not know what kidney disease was, had many barriers to health care, and a mountain of social problems that kept them from managing their illness properly.  With this notion in mind, I worked with the dieticians and social workers to create flyers, mini-lectures, and nutritional plans for all the patients.  With time we began to see better compliance, evidenced by more consistent treatment attendance and improvement in laboratory results in many patients.

After witnessing the value of identifying a problem and working with the interdisciplinary team to create a plan for change, I became aware of the difference I could make as a physician. I grew interested in learning how to manage patients’ illnesses while learning about their lives outside of medicine.  During my internal medicine clerkship, where I was involved in diagnosing complex patient cases, my passion for medicine became evident.  I learned the value of a taking a good history and conducting a physical exam. I thoroughly enjoyed working in the hospital setting, being involved with the coordination between teams to address the patients’ needs,  watching abnormal labs improve and patients grow stronger, and witnessing the trust that develops between patients and internists.  Most importantly, I  enjoyed the intricate thinking; connecting dots using medical knowledge, patient presentation, and integration to make a differential diagnosis.

Perhaps it was the two class periods worth of a bus ride to high school, or masterminding the use of the  neighbor’s water hose running through our kitchen to provide water during a financial drought.  Or maybe it was the sighs of relief heard via automobile Bluetooth of a hospital employee who mistook me for a robber as we both walked to our cars at night.  I am pretty sure the lack of desks in my speech class, textbooks in English class, and teacher in algebra class created the tenacity that flows through my veins.  Maybe the combination of these things, with the expectation of more, have cultivated me into the existence I am today. In the words of  Lean In author Sheryl Sandberg: “The seeds of resilience are planted in the way we process the negative events in our lives.”

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