By Liz Fullwood

The mice never developed the words freedom, earnest, envy.

I am a scientist. I am supposed to create change. I hear my family, my mentors raving about my work and how I will bring a better tomorrow. “Make sure you solve Alzheimer's before I'm too old,’ my aunt jests. “I can't wait to see how you revolutionize medicine,” my grandmother coos. Yet, day in and day out, I go into the lab, observe the behavior of my mice, do an analysis, and then go home; Nothing changes. This cycle repeats over and over and over again, but it's not just the 9-5 job that cages me. Culture is claustrophobic; Nothing ever satiates this tasteless haze of desire. Our motives and minds are driven by the undying hunger for achievement and the fruitless life-long pursuit of happiness. Why do we frantically accomplish but listlessly live? We are asked what we want to be, and what goals we want to reach, never considering the alternative; I don't want either. I am an orca at SeaWorld, trained to perform, to please— but even if the hoop changes, it's still the same jump at the end of the day. How long am I expected to perform the act in which I was trained? I am grateful for my privileged experience, and I am still looking for a way out of the enclosure they call the modern lifestyle.

In a way, I am jealous of the enclosure the mice in my research facility dwell in.

The lab mice have food, clean water, housing, toys, trained professionals to look after their health, and a quick and painless death. They are never aware that they could be aware, and they never dream of anything outside their containment. Their suffering is brief, and they have a higher quality of life than most humans. The world is falling apart, and all we are doing is filming it. Both the forest and the tongues of the people are on fire. Children are dying, the rich keep getting richer, and water is not deemed a human right. Currently, my transfeminine, Jewish girlfriend is struggling to find housing due to the current political climate. I work over 50 hours a week to pay for a place to sleep and to put food on the table; It is never enough. I can’t help but wonder if there is more to life than this.

Lab mice may be poked, prodded, and undergo experimentation but they are never expected to be more than what they are.

All I want is to be human. Yet, I can only actively be another cog in the capitalist machine; that is how you survive. In today's society, you can’t have achievement without sacrifice, you can’t have love without grief, and you can’t have pleasure without addiction. So where does one go when chaos is all there is outside? One folds within. My bed is a foam pit and my spirit toddles on a tightrope of dysphemism. All I want is to curl up and dissolve in the innocuous embrace of my lover. I want to exist in each breath we breathe together and be free of my own head space. My psychiatrist deems it depression and writes me a note for happy pills, but that’s not it. I've been to the pits of despair and lived my middle and high school years in a constant state of apathy. This current hopelessness has too much yearning; is this grief? I lay on the navy-blue couch in my 3rd -floor apartment and watch as traffic passes by. The sirens that used to put me on edge are now just dull background noise. I turn on my phone and scroll through Instagram. Terror, death, destruction, cute pets, and the latest pop culture gossip all held on my tiny screen. Everyone has a cause they are fighting for, an opinion that you are not supposed to disagree with. I can't help but wonder if being humane is not the practice of quiet benevolence but rather perfecting the art of scratching a phantom itch. Scientists say creatures are born performing the skill that is essential to survival: giraffes are born walking, sharks are born swimming, and humans are born crying for help.

The mice live in isolation and are never able to form their own mischief.

I have a community. There are people in my life who listen to me, who actively care for me. In this I am blessed. This world may be exhausting, and life may be a sexually transmitted disease that ultimately ends in death, but unlike the mice, I am not alone. I have been able to find people who are now close to kin. They are my motivation each and every day to get out of bed, to work the 9 to 5. I feel like blunt scissors, desperately trying to make a difference but never able to fulfill the one thing I was made to do. Yet, I am held, someone decided to give me a chance and then kept me around. So, thank you, all of you, for showing me love and compassion. Each laugh and every cuddle bring me hope for a better tomorrow. The mice will never understand the bliss of their situation, but they know to be content with their enclosure. So, though it drains me, I will do my best to be content with mine.

Author Statement

I search for understanding how to operate in today's world I found that we have domesticated ourselves.

Photo Credit: Matt Bero

By Annabelle Hatsav

As my phone fell to the ground, my body went with it. Everything went blurry and I couldn’t even understand what was coming out of my mouth. A fire lit inside my chest.

“She’s gone, I’m so sorry Annabelle.” I don’t believe it. I keep asking why, why, why? We were just texting a couple of weeks before this. We had plans, this was not meant to happen. God please tell me this isn’t true. I kept touching the gravelly pavement beneath me to ground myself, to feel that this was all real. I faced dark green bushes trying not to fall forward or draw attention to myself. This is not real, this is not happening. She is not dead, she is not dead.

I heard footsteps approaching me as my tears poured down my face like a faucet. “Are you okay? Do you need some water or anything?” A staff member asked me. “No, I’m fine, thank you.” I lied. Usually, I’m so good at pretending I’m fine, but I don’t think I could have put on a more convincing act.

One of my best friends texted me a message I never saw coming. “I heard what happened to Ava*, I’m so sorry and I’m here for you if you need anything.” I didn’t want to assume the worst. Please don’t tell me she died. Please don’t tell me she killed herself. Please don’t tell me she’s not here anymore.

Don’t jump to conclusions. “Ruby please tell me it’s not true, what did that text mean?”

“I’m so sorry Annabelle, Ava killed herself two weeks ago.”

The worst was true. My body was on fire as I started hyperventilating and sobbing in the driveway of my camp. Feel the ground, feel that you are real. I couldn’t breathe. I couldn’t do anything but cry.

Questions were popping into my head as I sat there. How long was she feeling that way? Should I have reached out more? Should I have made more of an effort?

Somehow it felt like my fault. When people talk about suicide loss they often talk about survivor’s guilt. It’s not the feeling that it should have been you, it’s the feeling that you could have done more to help. That it’s your fault until proven that it's not. Every interaction I had with Ava was rushing through my head and I was feeling the survivor's guilt heavily. I told my mom about it and she didn’t know what to say. I told my brother Matan about it and he was speechless. I told my therapist, and she assured me, it was not my fault. How could I believe her? The feelings pounded through my body every time I thought about her, which was every day for weeks.

I didn’t know what to do with myself, but I knew that I couldn’t be alone. All my friends were in a meeting on the other side of the camp, which I was late for. There was no way in hell I would go to that meeting. But I headed there anyway.

I dragged my feet through the freshly cut grass passing by a gathering of staff members. Don’t look at me. I couldn’t stop the tears, I knew I would eventually get dehydrated then my body would really start shutting down. One of my campers walked past me and saw my red puffy face so she asked if I was okay. I gave the classic answer: “Yes I’m fine, don’t worry about me.” And continued on my track to find a friend, anyone really. My friend Adam was playing basketball when I saw him. I knew he would come running to support me. He wrapped his arms around me and said, “Where do you want to go?”

We headed into the woods to a dock overlooking a lake,  a beautiful place where a lot of counselors would come to think. On the way there he held me as I was shaking and couldn’t stop. We hobbled so much shit in our path. He tried to make me laugh, I did, but I couldn’t stop my mind from racing. I watched the water ripple as I talked in my shaky voice. My head started to hurt as the water left my eyes so willingly.

Ava, my friend from middle school and high school, was two years younger than me. In middle school, we did crew backstage for the plays together. I was the stage manager and she was a perfect crew member. I was her mentor, I answered all of her questions and helped her with everything. I remember feeling so valued by her. She made me realize how much I could give to others, and how much she could give. Ava called me freckle. She said it was because I had six freckles (she counted), and I loved it. When I left to go to Paris for my freshman year of high school, she was worried we wouldn’t keep in touch. She said she would miss me a lot, and I told her I would too. We kept in touch and when I came back, I was so excited to see her again, and I would always answer her questions.

When she entered high school, I wanted to still be a good influence and mentor, but also her cool older friend at the same time. I tried my best and always made time for her, then I graduated.

I felt that I didn’t keep in touch enough after I graduated. I felt guilty for not texting her as much. We texted once in a while, and I always kept up with her on social media. But it wasn’t the same. A month before I left for camp, she texted me saying she was going to Wheaton College in the fall and that we should hang out. I suggested we hang out in New York before the fall because I missed her. She said she missed me too. I will always miss her.

Those texts ran through my mind for the next few weeks. I thought about how I could have asked her how she was feeling, we could have called. I should have done more, I should have asked more questions…I should have connected with her more. All the what-ifs were circling my brain and making me spin into a guilty state of mind. I had to remember, this was not my fault. How could I have known she was depressed?

I didn’t bottle it up this time, but I did keep it from my friends for a week. Being at camp and receiving this news was so conflicting because of the high-stress environment where I had to be responsible with a positive face on all the time. I couldn’t afford to mourn.

It was like I was floating above my body and observing what was going on below. The camp counselor in me wanted to keep it together so badly, but I had my moments. Thank God my co-counselor was one of my best friends and understood that I needed time for myself. But I didn’t tell my other friends until they asked me what was going on.

It was the worst, yet the best place to be to mourn. I knew I had so much love and support around me, but I just couldn’t ask for it.

I wrote in my journal after Ava died. I wrote letters to her asking her why she did it, begging her to forgive me. For what? I’m not sure. I messaged her on Instagram telling her I missed her. I spoke to her ghost trying to find some peace. I found out the funeral was recorded on YouTube, I never watched it, I’m not sure that I ever will.

Why’d you do it? I asked her over and over again in my moments of being alone. Please tell me why. Send me a sign. Anything.

Thinking about Ava made me think about how happy she was with me. She left my high school after I graduated to go to a different school. I wonder if that’s when she started having suicidal thoughts. Or maybe it happened before that. It’s so incredibly hard thinking about all the things she’s going to miss out on. Fuck my school for not doing enough. I had to direct my anger somewhere, so I chose my high school instead of myself.

I found out about the American Foundation for Suicide Prevention in 10th grade and how they host walks to raise money for suicide prevention all over the country each year. I loved the idea of seeing people who had similar experiences and feeling a sense of community, rather than feeling alone. The first year I went on the walk it was beautiful, I cried the whole time around hundreds of people wearing t-shirts with family members that died on them and crying with their friend’s arm in arm. I have participated every year since, and I never plan to stop. Ava made me want to fight even more for the discussion on mental health, and how anyone can prevent suicide.

I will never be the same. I call into question my own actions to my friends. Am I being a good friend? Thinking about each time I hear the news it never gets easier. My body catches on fire each time and I gasp for air reaching for something that slipped away moments before. I remind myself each day how lucky I am to have the support I need, and how I wish Ava had the support she needed. I can’t turn back time. I can go back to the moment of me sitting on the pavement in disbelief that she was no longer on this Earth.

I will miss her every day. I will never stop fighting for suicide prevention because it’s a part of me, my story, and so many others too.

Rest In Peace, Ava.

*A pseudonym was used to protect the privacy of the family.

About the Author

Annabelle is a third-year student at Northeastern University studying English and Communication studies. She loves writing non-fiction and poetry, and in her free time she enjoys baking, reading, and spending time with her cat.

By Emily Cheng

The air in my parents’ restaurant is hot and greasy and always loud, but that is how they know it is good. I first stepped into the restaurant when I was ten and didn’t know anything. My parents were owners of a Chinese restaurant, and I didn’t even know what a wok was. They brought me in to “work” when they couldn’t find a grandparent or uncle to watch over me. I would sit by my mother and do the simplest tasks, packing white and brown rice into Chinese takeout containers. With every container I finished, she would tell me “not enough, more, more.” Then, she would take the container out of my hands, scoop triple the amount I had filled, and pack it with the rice bursting out of the paper box. She would always give more rice than I thought we could afford.

 When it was not so busy, I eyed the chefs who held large metal woks and tossed food with them like it was nothing. I would learn that these woks were the key to a real Chinese restaurant. They needed special care—constantly seasoned in oil and heat to produce wok hei, the breath of the wok. Over the shouting of my mother and chefs in the kitchen was the sound of oil sputtering and popping at the addition of washed green scallions. I had convinced myself that this was the wok breathing life into food. And in this same way, the woks’ air would season the whole kitchen—its staff, the walls of the restaurant, and the greasy floors—imbuing itself into everything. 

***

In mid-October, my father called to tell me that they have decided to sell the restaurant and have found a buyer. They’ve spoken about it a few times, but it was something so distant it didn’t seem real. “I just wanted to let you know.” So simple, unsentimental.

I didn’t have enough time to think of an answer for him, so I only began to process after he hung up. Did we have enough money to live? It was the most obvious question, and I hope they had thought this through. How much was the restaurant? But more accurately, how can you assign a price to this? Overnight, everyone had seemingly become hard and unemotional when all I could do was feel. Feel for all the stories unaccounted for.

***

My father remembers his childhood at the restaurant as the worst time in his life. It is a Chinese tradition that the oldest son is the one who will suffer the most. He was the one to care for his younger siblings and the only sibling expected to help in the restaurant, tasked to hold the family together while his parents worked in the kitchen downstairs. 

After high school, he would return to the restaurant and help my grandmother take orders at the front. My grandmother, overwhelmed with stress and responsibilities, would verbally lash out at him in front of customers and the entire kitchen staff. Good for nothing! Stupid! Worse than garbage! Words to that effect. Words my father could not believe a parent could say to their child. 

When my grandparents retired, they urged him to take it over; they saw it as the greatest gift they could pass down. And as the oldest son, my father could not refuse. Traumatized by his childhood, my father spent nearly the next 40 years working at the restaurant. He has worked through countless invoices and business statements until he physically could not handle seeing numbers anymore. He started taking medication to help him through this, but eventually it stopped helping. At his lowest point, he stood at the top of the third floor of the restaurant office and attempted.

I remember my father before this time. He would come home and play with us and smile. He was so happy to just be with us, in the moment, alive. He has never been like that since. He had survived, but some part of him had died in the restaurant many years ago.\

***

Now, he’s cleaning up the mess from the past 50 years. He has been moving out his sister’s old books and his parent’s picture frames. As much as the restaurant has hurt him, his texts to our family group chat read a bittersweet. “Today I realized Cleaning out 30 years worth of stuff is quite exhausting.” 

The second floor of the restaurant is an office that looks more like a dump. It is a collection of everything discarded, but not thrown away. My father sends us a picture he’s found of him and my grandfather in the clutter of that office. It’s him as a kid. My grandfather has on a yellow polo, one arm wrapped around my father, wearing a matching polo in white. I don’t recognize my grandfather in this picture, but they’re both smiling. And for some reason, I find myself zooming on the icee my father is holding because seeing him as a kid brings out something so sad in me that I don’t want to feel it. All I can see now are his tiny fingers gripping onto a paper cup.

***

My mother has no fears. While my father works in accounting, my mother works in the kitchen, in the fire. She comes home with cuts and blisters. I’ll ask if she’s ok, if it’s painful, if she can still go back to work. She won’t give it the slightest attention. “It’s not anything.” Her hands are not rough, but strong, necessary to push woks, withstand burns, and raise children.

She was like this even before I was born. When my mother was pregnant with my older brother, she continued to work in the restaurant. She called orders and cooked and sweated in the humid New York summer air. 

For one order, it required lobster which they had not prepared that day. My mother, big-bellied but still strong, walked downstairs to the restaurant’s inventory to start preparing the ingredients. On the way, a coworker bumped into her, and she fell one flight of stairs down to the bottom. My mother was rushed to the hospital by my father who had already started grieving. When she was told she and the baby were fine, she had taken that day off, then returned to the restaurant the day after.         

She kept working all the way to August, until the moment before her water broke.

***

My mother has spoken with the Chinese man buying our restaurant and his lawyer. She’s been managing stipulations, lawyers, contracts, and all the things that she does not understand. And she feels herself getting older and smaller, fading into a shadow of her past self.

“You are in such a good place. To have perfect American English.” I can type these words, understand the nuances of English words, and find beauty in the language. But when she tries to negotiate with the lawyer, she gets pulled aside and her English is called “childish”—like she is playing games by changing her mind, but it is only that she is unable to explain her thoughts in American words. She tells me this is what happens when you are bad at English. 

For so long, I’ve been trying to learn Mandarin, but even with Sunday Chinese school, textbooks, and living in a Mandarin-speaking family, my fluency is still that of an elementary school student. Sometimes, I think about all the stories my mom wants to tell me but can’t. All the words that she knows in her perfect Chinese, the three dialects—Mandarin, Cantonese, and Fuzhounese—she’s fluent in. 

I know she is not a shadow of who she was. She is only waiting in the shadows, holding onto the words she knows. She is biding her time, planning her moves, and learning her options in an American world. And when she’s ready, she’ll strike. 

***

I am angry at myself for wanting to hold onto the restaurant. For even feeling sentimental towards leaving it behind. It has been the source of my parents’ despair for decades. I should really be celebrating, cheering, and jumping at the idea of it never being in our lives again. Leave it somewhere far, far away. For too long it has been a mass, growing and growing, becoming unbearable and draining my parents. Cut out a pound of the flesh that feeds on the pain of good people. Cut out this tumor.

But as much as it has hurt, it has supported three generations of my family. It is my grandparents’ true first-born, and my parents’ entire lives. As I’m going back home to see the restaurant for the last time, I am going to indulge in the gluttony, filling myself with the pain, hurt, love, death, and ends of my moments being there. It’s like I’m gripping onto a broken wok, seeing all of its scratches and imperfections, and trying to learn to let it go. I know using it will break it—the shards recutting the wounds of my family. 

So once more. Before I go, I’ll oil it one last time, give it heat, give it breath, give back all it has given to us. In return, we’ll slowly learn to move on and learn to feel the way it has breathed into our family new life.

About the Author

Emily is a student, writer, and her own personal chef, honed from her experiences at her parents’ restaurant. In her free time, she is an avid puzzler and admirer of her dog, Truffle.

By Ashley Brown

Held down. I remember light and I remember terror. My heart races. Stabbing searing pain three times. Three permanent tattoos across my hips. “To make sure we line you up for radiation correctly every time.” I stare at the ceiling, following the circle of light that changes colors. Changes colors just like my skin, now thin, brown, and brittle. On the ceiling, there is a circle that is a rainbow. Real rainbows are circles anyways. They burn the cancer from my body, just my skin is in the way. Every Friday, I sit in the car on the drive and then they burn me. Until my skin breaks and until I move through the degrees, end on third-degree burns. I wake up in the night and scream. A resident sees the burns and they change colors too, now a pale white. “We need to burn all of the cancer. We must continue.” They give me drugs now to numb me so that they can burn me. I drift away on morphine. They burn me and I burn.

I wore my first sports bra when I was six: it held my catheter, the tube stemming from my chest, in place. “This will prevent it from getting tugged by anything.” I dream of my sisters playing with me again and suddenly they grab the tube and pull. They pull and I unravel. I unravel, a spool of yarn untethered with each tug as my organs are pulled outside of my body. I still dream it.

I am at a sleepover and we want to watch a movie. I am 9 but the movie is rated PG-13. I ask to call my mom to get her permission. My friend laughs at me, but I don’t understand. There are rules. Don’t scratch your burns. Don’t play with your catheter. Rules are important. Knowing rules and following them mean I get rewarded. “If someone gives you anything but Tylenol, what do you tell them?” “I can’t have that. It is an NSAID, those are too hard on my kidneys.” I am very smart, very responsible for following rules. I hide my tears as we begin to watch the movie.

I am the new kid in a small school where everyone has known each other since kindergarten. They ask if I am in the wrong classroom. I look too young to be in 5th grade. At my new ice-skating rink, there is the group of big girls and the group of little girls. I am seen as too young, too bad of a skater, to be invited with the rest of the little girls. Besides, to get close to them, I would need to do synchro with them. You are not allowed to wear gloves for synchro and my circulation is too bad. My hands will turn translucent and then blue again. In every group number at our yearly Nutcracker, I am too young for someone to start a conversation with, too introverted to reach out myself. I am content with my own company at least. It does not matter that I actually am older than them. In high school, I get louder though. I beat others to the punchline. “I know, I look like a child. Maybe when I graduate high school, I will look 14! But hey, that’s cancer for you.” When I first get my driver’s license, I drop off my sister at rock climbing and go to pick up Taco Bell for her. At the drive through, the cashier sees me pull up and begins to laugh. “Are you old enough to be driving without an adult in the passenger seat?” I ascent wearily. She laughs more and tells her friend to come over here and see the youngest looking 16-year-old that he will ever see. I turn red.   

For the first five years after treatment, that is when cancer is most likely to recur. My body was a ticking time bomb. Every abnormal pain is the beginning of terror. Does this stomachache mean I have cancer in my stomach? Every year, I get strep throat and the lymph nodes around my throat swell into imaginary tumors. Any moment, my body could betray me, leave me without treatment options. “We can’t give you chemo again. There is a maximum dosage and you already received it.” I am told the next best thing we can do is find it early though, if it does recur. So, they hold me down again. They do CT scans, MRIs. All donut-shaped tubes, but at least these machines don’t burn me. They pronate my legs so that my toes touch and heels sit apart and then they tape me still. My heart pounds, tells me to run so that they can’t hurt me again. I focus on what I read about how kidneys work while they scan me. The doctors are always more comfortable when I want to learn more. It is something to talk about, something other than the silence, the small talk. I pass the five-year mark. Then they focus on the long-term effects of the cancer, of the chemo. They check my heart. Social workers ask how I am doing in school. I tell them I want to be a pediatric oncologist, or later a cancer researcher. They tell me what a good thing it is. I see them relax. I am saying the right things, I am telling the good story, the right one, the one they want to hear.

Am I healthy? Am I sick? I am healthy enough to the sight that any physical failing must be a moral one. I am healed, but I hurt. My kidneys grew with me during puberty, scarred and disfigured as they are, so I will not need another kidney until I grow old. Regular menstrual cycles, no matter how physically painful, mean that I am fertile, at least for now. But why would I want my own kids anyways? With my biology, I offer a 50% chance of damnation. My heart passes my yearly screening exams though and my liver continues unscathed. “You are doing so well.” They tell me that every year I go to my annual Long-Term Cancer Survivor Clinic appointments. How can I disappoint them? The doctors and nurses and social workers did so much to make my treatment manageable. To distract me from the horrors of it.

But that is not fair to me. 

Just because I have good grades, just because I am involved in extracurriculars, just because I have a long-term relationship does not mean that I am healed. It does not mean that my cancer basically never happened, just an unfortunate start.

Cancer is not my origin story either. In the pursuit of telling a good, satisfying, palpable story, I did not get the freedom to explore multiple visions of my own future. There was one path and it stretched on for years, a funnel into the perfect ending to my cancer story. Instead of exploring my interests, I obsessed over cancer and was lauded for my work ethic. No one thought to suggest that this might be a coping mechanism to understand my trauma. Even when I disliked every job related to cancer that I tried. I liked cancer most when I was learning about it, analyzing it at a higher level and connecting it to myself. But how could I tell people I did not see myself in a cancer career anymore? Because I only ever was interested in understanding it to understand myself? Because of trauma? But I am healed, that is the way this story is supposed to go. It is not like I do not have the talent. In fact, I would be wasting it if I do not stay in science or in medicine. It does not matter that I grew a distaste for so many other parts of it. Deviations are unimaginable.

But it is imaginable. Kids with cancer can grow up. It is not our duty to make others comfortable with that idea. I do not owe anyone a tidy ending. My ability to heal from my cancer was delayed, not hastened by the story of the long-term cancer survivor. I am not healed! I am tired of pretending that I am. But I will make up for the lost time, now that I can understand that I still bear wounds from my trauma, now that I understand that my story and my trauma did not end when I “beat” cancer. I am freeing myself from the shackles of other’s expectations. I feel the catharsis that I never found in the last 15 years of my life. I can begin to reintegrate cancer into my life story, but finally on my own terms.

About the Author

Ashley Brown is a senior at Northeastern University with a double major in Biochemistry and Health Humanities with a minor in history. She is currently applying to master’s in history programs where she plans to study historical cases of health inequities.

By Alexandria Raspanti

Women learn from a young age that their bodies are not inherently theirs. I was not an exception. I grew to understand that I live in a system where autonomy is earned. I was born to be sexualized, my breasts grew to grab, my clothes made to take off, body made to be used. I had a concrete understanding at age 13 that sex was a pivotal part of being desired as a woman. I sat in my bedroom watching the show The Girls Next Door and pushing my boobs up in the mirror. I daydreamed about looking like one of Hugh Hefner’s girlfriends. Tiny waist, pouty lips, bouncy hair, and big boobs. I thought that life would be easy for girls that look like that.

I met Aaron when I was 14. After one month of dating, grade 9 began. He decided that we were ready to have sex. I agreed that that weekend we would. We lay in bed and I knew that all I needed to do was get through this and wait for it to be over. It would not last forever. However, when the time came, the nerves interfered. I did not have sex that night, but he did. He left my house, went to a party, and had sex with another girl. I could never make that mistake again. I learned that my reservations make me replaceable. I was grateful to Aaron for not forcing me to have sex with him and finding someone else instead. I felt bad for wasting his time.

At the age of 15, I was in a turbulent relationship with an addict. I never experimented with drugs, but I was an expert on them. Day by day I cared for him, I stayed up at night checking his pulse, dipping his feet in cold water, wiping blood off of his face. I thought that mothering him would make him less inclined to hurt me. I don’t remember many of these events anymore, but my friends remember my recountings of them. By the time he left for good, I was 18 and he was gone, along with my childhood. He broke up with me when he was done with me. Psychopaths follow a specific routine in their romantic relationships: seduce, love bomb, bond, trauma bond, entrap, use up, and discard. Loving someone who could care less if you were breathing is an incredibly embarrassing and degrading experience. I wish I could say this is where everything changed, but it didn’t, not for a few years.

Older men have always found a liking for me, although it dramatically declined when I turned 18 and the thrill of an underage girl didn’t exist for them anymore. I was 19 and working at a hair salon, and I asked my boss if we could talk about my schedule. He said he would pick me up at 7 p.m. to talk about it over dinner. When I searched up the restaurant and saw the four dollar signs, I figured I should wear a skirt. “I love that you wore a skirt for me,” he said while I got into his car. He didn’t speak to me about my schedule that night. He told me about his ex-wife, his kids, and the nanny he cheated on his wife with. He told me that I was young and had never experienced a real man. When he dropped me off, he said “You’re not even going to invite me in? How rude.” Worried about my job, I responded, “Oh, would you like to come in?” We were in the elevator as I texted my roommate, “We’re coming up, be in the kitchen so I’m not alone with him,” and she responded, “Lexi, I just left the house.” We went into my living room where he climbed on top of me and started kissing me. He was 43 years old. I can’t even try to describe the feeling I had in my throat as I felt his tongue in my mouth. After a few minutes, I said that I had to wake up early tomorrow and that he should go. Reluctantly, he left. The next day at work he called me into his office saying he had my new schedule, and I walked into a pitch-black room. He said, “I just wanted to get some time with you.” I quit a few days later.

Eventually, I stumbled across a YouTube video on relationships with psychopaths. My eyes were glued to the screen, clinging to every word as she flawlessly described my first love. My breaths becoming heavier as she explained the hows and the whys. The questions I had asked repeatedly in my head for years. She talked about how they choose their victims, and patterns in their mannerisms. I truly UNDERSTOOD for the first time that it was not my fault. In that moment, I felt my soul clinging to my body for the first time, its hands grasping at the insides of my skin, holding me with pinching fingers in a silent promise to never let go. It was in that moment that I let go of my responsibility to men and took on a new responsibility. Myself. 

I found a lot of my power through learning. I came into college majoring in psychology with an interest in behavioral neuroscience as well as a minor in women, gender, and sexuality studies. I hoped to one day focus on the neurological underpinnings of psychopathy. My mission was to uncover irrefutable proof that abusive behaviors are unrelated to the victims themselves. Unfortunately, awareness alone cannot shield you from the harm inflicted upon you; it merely has the power to shape your responses.

I no longer fear people. I am not scared because everything that I would be scared of has already happened to me. There is a certain comfort in the aftermath of abuse – a comfort that stems from knowing that there is nothing you can’t get through. Abuse doesn't simply vanish; it lingers, leaving its mark. I deal with obsessive guilt, replaying daily scenarios in my mind, and endlessly questioning what I could have done differently to the point where I could barely leave my home out of fear that I would make a mistake. Yes, lessons were learned and at one point I would have said I was grateful for my experiences, but now, I do not. I believe that the growth I've achieved could have been attained on my own, without the help of my abusers. I now stand, not as a product of my abusers' influence, but as a testament to my own strength and resilience.

About the Author

Alexandria is a fifth-year psychology student at Northeastern University with minors in English and women, gender, and sexuality studies. After college, she aspires to go to law school and seeks to use writing as a powerful tool for advocacy and change.

By Ella

The luminous natural light shining into my all-white shower illuminates a heavenly gaze onto my bleeding, blistered body. I wouldn’t consider myself particularly religious, but today I'm certain there's a divine presence holding me upright as I feebly fight for stability. Today my open wounds leave a sea of crimson dancing down the drain, my neck frozen straight to combat the blaring whiplash. 

Today I believe in God.

Earlier, a pouring shower of glass had left me concussed and upside down. It was a tranquil roller-coaster ride, a seemingly peaceful experience as my body ascended and accepted the force. Constantly burdened by an intrusive inner monologue, I was surprisingly soothed by the sharp dissociation. It was a near-death car crash, but somehow one of the most relaxing experiences of my life.   

My life had been spared by a 1999 tow truck housing an unbelievably rare interior design that ultimately guarded my life. The sight of the truck alone was enough to send people at the scene into hysterics. I gather when a car looks like that, you are supposed to die. The eccentric EMT called it a miracle. God called it a favor. I call it my most bittersweet memory. 

Vacantly wiping the blood away, I am surreally empty as I shower. This is new for me, the chronic overthinker staring into the distance with sullen eyes. I hyper-fixate on the ceiling as I shower, void of meaning. Without any medication in my system, my dazed reflection acts as the most potent narcotic.

It's bewildering how fast life ebbs and flows. Just a month earlier, the suffocatingly humid air of Miami smelled like success and teen spirit. Up until a few days before, my mother had ardently refused to let me go, exclaiming how ridiculous and unsafe it was. We were 17. I agreed, even then. But I craved it, longing for the exhilaration of me and my friends dancing in the sun and acting older than we actually were. It all seemed so grand.

Suddenly, my friends were discussing reservations at trendy restaurants without a mention of going anywhere other than Miami. That must be why my mother caved on her own accord, quietly pulling up the airfare for that weekend while weakly uttering “I don’t want you to miss out”. Quickly, all my savings were down the drain, and I was packing my yellow polka-dot bikini in a small, battered carry-on.

On our first night there, we shuffled back to our hotel rooms eager to prolong the night. We energetically jumped on the massive white bed in our way-too-short dresses. My head hit the ceiling, and I rolled around laughing as background music roared on. It felt like a scene from an unrealistic teen drama, and I joyfully thanked my lucky stars I had made it. 

After everyone went back to their room, I got in bed eager to doze off. It was close to 2 AM, and I stared vacantly into the darkness to calm my body. My inner monologue flowed relentlessly, only exciting my nerves to stay up. There was a creeping void inside my stomach that only seemed to grow as it got later and later. My strange uneasiness was only fueled as I began to fixate on time, physically feeling as if I was going to run out of seconds. Or out of air, as my chest tightened and the butterflies in my stomach sharpened their wings. I felt viciously hot as every manual breath stung my diaphragm. The heaviness weighing on me forced me to take large gulps, choking to find whatever air was left in my lungs. Laying immobile, I silently prayed for my well-being. 

My breath finally came back after what felt like hours, and I looked at the time. It was 4:37 AM. I then laid awake all night in an anxious, stomach-severing, pit of nerves. Finally, when the sun rose, I got out of bed nonchalantly to put on sunscreen and my yellow polka-dot bikini. I had just had my first panic attack (and certainly not my last) in a beautiful hotel room overlooking the beach. Yawning profusely from my lack of sleep, I didn’t tell anyone about my nightmare of a night. I assured myself nothing was wrong while consciously sequestering any sentiments of anxiety. Miami was picture-perfect, and I tried to be as well. 

Later that month, my body felt uneasy during the most celebratory of times. When I blew out my candles on my 18th birthday cake, my dad reminded me to “make a wish!” Every year I wished for the happiness and health of me and my loved ones, taking a moment to relish the warmth of those around me. But this year, my mood regressed sourly as I thought about the ways happiness and especially health can regress. An intrusive chain of thoughts urged me to think about growing older and the possibility of death waiting mercilessly around the corner. 

As I eat my chocolate cake, that familiar pit-like sensation returns to my stomach. I try to push it to the deepest parts of my being, wondering if it's inherently selfish to ruin your own happiness. 

It was in these moments that I always seemed to think of God the most, specifically when I needed something. I was the equivalent of that friend who only comes around when she has a bad breakup, forgetting about you when there's a new swooning love interest. I now think I was rather human, which doesn’t equate to a “get out of jail free card” but is certainly worth something.  

A month later, my parents prayed when I was in the hospital. I wonder if the people on the street had also prayed when they saw the utter collapse of the 1999 pickup truck. Even if they were selfless in their desires, they still wanted something. It's rather ironic. When my cuts sting in the shower, I do not feel the sentiment of needing anything. I grasp desperately for emotion or even words, without tangibly holding anything. 

And there it is. A subtle juxtaposition to all that I have ever known; a dissonance in the looming anxiety that had gradually piled up. Like a weatherman, I had lived life constantly dreading the storm, overanalyzing every mere drizzle of rain. But now it had rained and poured, and I was burnt out from caring at all. 

My minimal stability is jolted by a robust tap on the shower curtain. In my drowsy state, I cannot comprehend why my kitten is staring into my shower with bright blue eyes. My cat enhances my sense of disbelief, perching herself on the shower ledge and focusing her gaze on me. 

All of a sudden, I can't look away from the disturbing pool of blood juxtaposing the beautiful white marble shower. I realize the severity of the situation, the bitter truth separating before and after. I realize I'm in the after, because my body is gashed and there's broken glass everywhere. 

Upon seeing my kitten in the shower there's a silent catharsis. The shower covers the sounds as I begin to cry, naked and exposed. As cold tears pour, I mourn all the moments I shed away in worry. As if accepting my survival could take back all my previous doubts, I feel somber clarity. The anxiety reaching its peak throughout the last few months suddenly halts, seeming trivial now in the scope of things. 

I ask myself what it was all for, the stream of constant anxiety that has progressively plagued me. Now the coin had flipped, and my worst anxieties had come true. What now? Will my fear of everything rise like the tide, or will it flow back and retreat? 

 I’m not sure who I am with a constant rain cloud hanging over me. Maybe I'm lucky enough to have things worth missing, desires worth yearning for. I suddenly noticed my cat’s brown fur was soaked from the shower’s stream. She stays put, a strange phenomenon for felines who are typically hydrophobic. Somehow this validates that there's a plan for me, more life left ahead.

I think about God and all those times I anxiously craved something beyond minor. It's funny now as I delicately extract glass shards out of my hair. I wonder how many people prayed in the hospital at the same time as my parents. I wonder if those prayers were more genuine, more emotionally volatile than the ones in church.  

I implore myself to be better than I have been as the cold water sinks deeper into my open cuts. I reminisce on everything I'm grateful for, everything that has continuously gone right when I worried it wouldn't. At this very moment, I don’t feel like I need anything, for I am overcome by gratitude. I simply put my face under the cold tap to reinvigorate my feeling of being alive.   

Then, I put my hands together because this seems like a good time to pray. 

 About the Author

Ella is a third-year student at Northeastern University, studying psychology and behavioral neuroscience. In her free time, she is a part of numerous research groups on campus and loves creative writing and fictional storytelling.

Photo credit: Joy Stamp

by Milena Kozlowska

One of my earliest memories is awash in the bright fluorescent lights of a preschool classroom, surrounded by bold blocky colors and the smell of Elmer's glue. I sat with my legs crissed-crossed on the colorful squares of the carpet, in the center of a cluster of other students. From her chair in the front of the classroom, my teacher asked me a question.

The details have long since faded from my mind. All I remember is the heat of the other kids' eyes on my neck as I stared ahead, unable to answer. Instead, I shrugged. The teacher prodded me for an answer; the kids around me tittered. Fear cemented my silence. I shrugged again. Frozen, I couldn't speak. Instead, I chewed on my lip, peeling all the skin off.

I never spoke. My teachers grew frustrated with me. I would whisper in the ear of my best friend Talia during recess, but otherwise I stayed silent.

Talia tried to persuade me to talk to her other friends. You can whisper to them too, she said. I shook my head and stared down at the woodchips, hiding behind a curtain of long blonde hair. I could speak to my parents and siblings at home because they already knew me. But around everyone else, my throat closed up. My voice fled.

Silence sheltered me. I built walls around my inner world like a fortress. As if I could escape by making myself as small and still and silent as possible.

In kindergarten, all the kids sat in a circle and the teachers led us in song and dance. I never opened my mouth or moved my hands, just watched the other kids.

After class, I went to the bathroom at my house and climbed up onto the sink. There were multiple mirrors, so I could see dozens of versions of myself spreading beyond me, one after another after another after another. Surrounded by reflections, I went through all the moves we'd learned in class, sang the songs under my breath. All versions of me sang and danced along.

Only in that white-tiled world, with its expansive mirrors stretching infinitely on, could I speak. In the classroom, I could only watch. Silence paralyzed me. Like a princess trapped in a tower, I couldn’t break down the walls of my own fortress. Even when I longed to.

Teachers thought I had a developmental disorder, at first. Then I was diagnosed with selective mutism. My mom took me to see a speech therapist, a woman who sat next to me on the floor with stacks of colorful pictures. As my trust in her slowly grew, I started being able to whisper answers to her questions.

Eventually, I'd been in speech therapy for long enough that I could answer direct questions if prompted. Teachers were no longer frustrated. They liked that I was quiet, polite. I didn't raise my voice or interrupt others or goof off like other kids. I kept my head down and my mouth closed and was praised for it. Meanwhile, I chewed up my lips til they were sore, scratched at my scalp till it bled, clenched my jaw till it ached. Bit my nails down to stubs, then dug them through skin already red and raw with eczema.

On worksheets, I wrote in tiny handwriting, the letters as small as I could make them. As if I was trying to make myself as small as possible, disappear between the pages.

Silence stifled me. I felt like I could scream, and no one would hear behind the walls.

By high school, I was speaking: shy, but no longer clinically so. At my waitressing job, cooks snapped at me for calling out orders too quietly. Whenever he saw me trying to get a cook's attention, one of my coworkers would give me a look of sympathy and ask my order, before shouting it to the kitchen himself. "Thanks," I'd say with an abashed smile.

"Why do you talk like that?" one of the cooks asked me once, in his thick accent. "You always whisper." I'd ordered food for one of the residents, and he was piling the mushy vegetables onto a plate.

"This is just my voice," I said as he handed me the plate.

"No, it isn't."

I laughed nervously and left to serve the food. Heat flared somewhere in the back of my throat. I'm not whispering. This is my voice.

What if it wasn't? What if my real voice was still stuck somewhere I couldn't reach it? What if I'd buried it somewhere in the wood chips of my preschool playground and it was gone forever?

Still, I liked some things about being quiet. I liked that people told me things they wouldn't tell others, that people called me a good listener, that most of my life was hidden, that I could keep a little mystery, a little distance. Silence protected me, both as my weapon and my refuge. Behind its walls, I could observe others without being seen, or known.

But when I started college, I wanted to be someone else. I wanted to leave the mute girl behind, somewhere on the outskirts of a school playground with her knees drawn to her chest. I tried to outgrow her, outrun her, in a new place where no one would start off already knowing me as the quiet girl. I joined rugby, a sport where I had to shout at the top of my lungs. I raised my hand in classes. I placed myself in social situations as often as possible, surrounded myself with people. I shaved my head so that I couldn't hide behind my hair anymore, even if I tried.

And yet. And yet. People still kept asking me to repeat myself, became frustrated with my voice. I'm sorry, I said, over and over again. I know I'm a little soft-spoken. No matter how often I tried to raise my voice, that never seemed to change.

Silence found me, again and again and again. I tried to knock down the stone walls that wrapped around my vocal cords, but I could only ever break away parts of them. The rest crumbled into rocks in my throat: I could speak, but it was never easy. It loosened its hold in me, but I could never escape it completely.

And yet. At one time, silence kept me safe. In some ways, it still does. It has been with me so long, I don’t know who I’d be without it.

It’s a part of me— for better or worse.

Milena is a third-year student at Northeastern University majoring in behavioral neuroscience. In her free time, she enjoys painting, reading, writing, and playing rugby.

I am 16 years old, desperately clinging on to the last few weeks of summer before my junior year of high school. The days are long and sticky with humidity, and I mostly spend them sequestered in my room, lulled into midday naps by the hum of air conditioning. In the past few years, I’ve sunk deep into the comforts of my room, only emerging to run and catch the bus each morning. There I am alone, and maybe that’s preferable to being with you.

I don’t go out with you and your friends anymore. Not to eat ice cream from the shop in town or sit in someone’s basement and drink. Each time you do see me you urge me to come out sometime. You say I would be less depressed if I did. I want so badly for you to be right. 

My phone lights up, and I flinch when I see your name. When I was younger (much younger), the sight might have been a welcome one, but not anymore. By this point I know what you are capable of. This night’s incident would not be the first, nor the last. 

You want to meet for dinner. I stare blankly at the time. It’s 10:00 pm. I ate hours ago, and I tell you so, but you just got off work and you’re hungry. I type out a resounding no thanks, see you when school starts, but I hesitate. Maybe you’re right. Maybe if I go out I’ll be happier. I’m so desperate to lessen the heavy weight that sits on my chest each day that it outweighs the trepidation I feel towards you. So I tell you I’m not hungry, but I’ll keep you company. You say we can go to the pizza place around the corner. 

I scurry out of my house, meeting you halfway up the street. I don’t want you coming to my house, even just to stand on the porch. Something about your presence on my doorstep would feel like a stain, a contamination. I don’t want my parents seeing you either. Irrationally, I worry they could look in your eyes and see what you’ve done. 

As we begin to walk you tell me you have no money. That strikes me as strange, seeing as you’re the one who wanted dinner. But I say nothing. My ability to question, to protest, has mysteriously evaporated. As we near the pizza place, I see the windows are dark, the chairs placed upside down on the tables. They’re closed, and they have been for a while. That seems odd, too, seeing as you must have walked by on your way to meet me. You barely even spare it a glance, walking straight past. You suggest we go to the park. My legs betray the dread that’s made a home in my body and I follow dutifully. That's what we’re supposed to do, right? Be compliant? But the tiny grains of unease prick at the nape of my neck, urging me to turn around. I suppose those were my instincts, which I excel at ignoring. So I agree, because that’s what I’m good at. 

Our town is dark and deserted, so I shouldn’t be surprised when the park is too. The sole inhabitant is a man crouched low on a bench, fumbling with a cigarette. He asks you for a light but you have none, so you apologize as we descend into the playground. I haven’t been here since I was a little kid. It’s different now. They’ve updated the equipment, the plastic slides bright and shiny, even in the darkness. You take off your apron and fold it neatly on a swing. You’ve been washing dishes all day. You start to tell me a story as I stand there, my feet shuffling in the wood chips. 

You were texting your friend at work all day talking about how horny you were. How all you wanted was a blowjob. He said he could hook you up with someone but you said no. I don’t know how I’m supposed to respond to this, but a cool girl wouldn’t bat an eye at this kind of talk, so I say nothing, the ghostly light of the street lamps illuminating your face. You keep peeking at me, gauging my expression. This feels like a test so I try to look as nonchalant as possible. I don’t think it works, and you look away again. Then you’re fumbling with your belt, and the metal of the buckle is like wind chimes but also fills me with dread. You apologize, that same genuinely sorry tone you used when you didn’t have a lighter for that man, but you just have to take a piss. I stare anywhere but at you as you piss against some poor tree. Then I go and sit at the top of the slide, wondering why you would do that. Now I know you wanted an excuse to take your dick out. 

You clamber up the slide to sit near me, our legs touching. I feel a sense of real revulsion. And then I see you didn’t put it away, and that image burns into my brain like hot metal on flesh. You’re still talking because that’s what you know how to do best, and the seal on my mouth breaks open, the words tumbling out like water: my dad wants me home i need to go home he’s texting me i have to leave i’m sorry—

But you’re calm, like you expected this resistance, and you insist that we have plenty of time. There’s enough time (for what?) before I have to leave. You lay across my lap, and my back reflexively presses against the bars until it’s painful. I’m a statue made of stone and you are the bird shit that covers it. You tell me to guide my hand towards it but I don’t want to and I don’t know how to and even if I wanted to say that I couldn’t anyway. A list of excuses tumbles out of my mouth and you deflect each one deftly like a star athlete. My heart is pounding so hard I feel like you must be able to hear it, you’re so close to me. I stare down at you, trying to focus on your face instead of everything else, and childishly, I wonder if you will kiss me. Not because I want you to, but because some part of me wants to be the object of someone’s boyhood crush. I wanted a single rose because a dozen was too expensive and cheap chocolates from the grocery store and a tacky heart shaped necklace from the mall. This is not how high school relationships are supposed to happen. I don’t even like you in that way, but you seem to want me and I wish someone would but not like this. 

I make a final plea, I need to leave, and you press your full body weight into my lap, murmuring, you can’t leave if I do this. Fruitlessly, I try to stand up, but your weight impedes me completely. I can’t get up, as much as I try, struggling with the effort. I resign myself to my fate, the task ahead of me that you’ve assigned, but I’m paralyzed. I stare back blankly as you look up at me, expectation clear in your eyes. Finally you sigh, annoyed, buckling your pants back up and standing. I scramble up, murmuring apologies (for what?) and jumping back down into the wood chips, my knees smarting in pain at the rough landing. You say you’ll walk me home because it’s late, which I find ironic, because who do I need to be protected from but you? 

Of course, I acquiesce, and we walk together, the silence heavy. My mind is blank. I just want to be alone again. Alone can be lonely but it doesn’t hurt me like you do. You pluck a leaf from a nearby plant, your fingers punching holes in its veiny surface like two eyes. As we reach my street you hand it to me wordlessly, telling me you’ll see me at school in a few weeks. You walk away, hands shoved deep in your pockets, and the fluorescent glow of the streetlamps makes the world look like a movie set at nighttime turned artificially into day.

I twist the leaf in my hands and walk the rest of the way home alone. My parents are sitting in the living room like always. I walk straight up the stairs silently, taking out my diary and sitting on my bed. I don’t remember what I wrote, but afterwards I took that leaf and pasted it into the pages. I wonder if it’s brown and crumbling now, or if the scotch tape has kept it intact, green and smooth, chlorophyll staining the pages and the tips of my fingers. 

Lily is a fourth-year student at Northeastern University studying Biology and English. Her writing has been published in Spectrum Literary Arts Magazine, Queen City Writers, and The Foundationalist. She hopes to pursue medical school after college and continue writing as much as she can.

I have taken approximately 2,604 birth control pills in my life. Every night for almost seven years, the incessant alarm on my phone sounds at 10pm reminding me to grab my water bottle and swallow my pill. They are a consistent aspect of my life, which being on a first-name-basis friendship with the pharmacist at my local Walgreens epitomizes. They feel like a core part of me, determining when, where, and how I start to bleed.

I began taking them in the seventh grade to regulate my hormones in order to control acne. Contrary to popular belief, I am not alone in this, as many women use birth control to regulate their periods, lessen their cramps, and curtail the debilitating symptoms of PMS.

My experience with these pills has been tumultuous, to say the least. At first, I could not say enough about their strength and success. My skin was clear, I knew exactly when my periods were starting, and I felt so grown-up taking a pill from an aluminum case every day. But that honeymoon period (pun intended) did not last long. About six months after taking my first pill, I returned to the doctor that had initially prescribed them. The pills were changing who I was as a person. My entire family had noticed that the week before my period, I became withdrawn and extremely moody, crying multiple times a day. At first, this was attributed to a combination of cliché teenage mood swings and PMS. However, it wasn’t long until the characteristics that had defined my personality– a quick sense of humor, a happy-go-lucky attitude, and a passion for pulling pranks– had all but disappeared. To my shock, my doctor explained that this was not unusual or uncommon for women taking oral contraceptives. She told me we could experiment with different formulas of pills, but some bodies simply could not handle the pills. I was devastated.

I have tried eight different kinds of birth control pills with varying levels of success. Although an inconvenience in my life, I came to terms over the years with the pill being a core aspect of my womanhood. But after spending a semester enrolled in Women, Gender and Sexuality Studies exploring why women deserve more than what society often expects them to accept, I have come to believe that we deserve more from our birth control products.

 My experience is not unique. Women have learned to expect serious side-effects with any form of birth control. These side-effects include, but are not limited to: nausea, weight fluctuations, headaches, anxiety, depression, and suicidal thoughts.

Strangely, there is no outrage about this extreme failure in medication efficacy. In the US, 62% of women are currently on some form of birth control, yet any action being taken to improve it is underfunded and under-appreciated. Women accept less effective medications with more side effects because we, as a society, have learned to be comfortable with a lower standard of care for women.

Widespread apathy towards women’s health is extremely evident when one looks at a recent study experimenting with men’s birth control. In this study, 320 men were given birth control shots every night for eight weeks, in an effort to share out the responsibility of avoiding unwanted pregnancies. The sample considered men of varying backgrounds and levels of sexual activity. Despite potentially optimistic results, we will never see this study brought to fruition. It was halted due to the men experiencing “severe” side effects, such as mood swings and acne. Prior to the termination of the study, many women were hopeful that men’s birth control was finally a solution to their own undesirable experiences. However, the scientists would not allow men to endure these negative side effects for even eight weeks, when millions of women experience them for the entirety of their reproductive years.

This begs the question of why society is untroubled by the less than ideal standard of care given to women yet does not believe it is acceptable for men to tolerate comparable experiences. The lack of women in STEM careers, a reluctance to believe women’s symptom descriptions, and a greed-driven pharmaceutical industry are all connected to this double standard. The compounding of these three elements creates structural inequalities in healthcare that put women in physical danger and must be addressed sooner rather than later.

Women are underrepresented and undervalued in STEM careers. I am a two-year member of WashU’s Women in STEM Club, which aims to increase support and mentoring for women in STEM fields so that they can be better prepared to endure the journey ahead of them. As a college student aspiring to have a future career in the field of medicine, this cause directly affects the trajectory of my life. A 2013 study called “What's So Special about STEM? A Comparison of Women's Retention in STEM and Professional Occupations” explored the environment faced by women in different careers. The results found that women in STEM have a statistically significant increased tendency to remove themselves from their fields. Due to careful consideration of any confounding variables, the study uncovered that the main cause for the mass exodus from upper STEM fields by women is not due to children, as many people tend to believe, but rather because of a “hostile work environment.”

This unsustainable work environment is evident at a well-known and iconic leader in the technology field, Google headquarters. In August of 2017, an executive engineer penned an internal memo to the entirety of Google named, “Google’s Ideological Echo Chamber.” In this memo, the employee explains that women are biologically more predisposed to neuroticism, have less drive for higher status, and are more agreeable than assertive. He claims, “This may contribute to the higher levels of anxiety women report on Googlegeist and to the lower number of women in high stress jobs.” He later explains that accommodations should never be made for any employees on the basis of gender or race, as the only reason women and minority groups are underrepresented in tech is because of “biological disadvantages.” This memo went unaddressed by Google leadership for many days. Eventually, an apologetic email that contained plans for improvement was sent out to the company staff, but the damage was already done.

Women’s perspectives are integral to the creation of a successful product for women, yet the vast majority of scientists creating, testing, and marketing birth control products are men. I believe men cannot possibly comprehend the debilitating side effects of birth control pills, and therefore will not fight as hard as women would to find a solution. Because of this, it is essential that we encourage and support young women considering careers in science–which must occur early in a girl’s life. A 2004 research study done by Patricia VanLeuvan uncovered that there is a massive dip in interest in science careers of young girls between the seventh grade and the first year of high school. Careers that have better representation of women, such as medicine and biological sciences, experienced a lesser decrease in interest than less represented fields, such as engineering. This research shows that when one generation of women are inspired to pursue fields in STEM, a domino effect will result in the coming generations.

A recent episode of Grey’s Anatomy, one of my personal favorite shows, explored society’s shortcomings at recognizing and treating women’s self-reported symptoms . Dr. Miranda Bailey, a world-renowned and extremely respected Chief of Surgery, goes to a rival hospital’s ER and calmly explains that she believes she is having a heart attack. The ER doctors and cardiologists, all her friends and all white males, immediately begin questioning her history of OCD and anxiety, blaming these disorders as the reason for her symptoms. Chief Bailey responds with authority and confidence, relaying that heart attacks often manifest themselves differently in women, with symptoms such as shortness of breath without pain, anxiety attacks, and jaw and neck pain. Even with her expertise and obvious medical savviness, the other doctors refuse to believe her until her heart literally stops beating for two minutes. It is no wonder that doctors regularly disregard women’s self-reported symptoms, when Dr. Miranda Bailey, one of the most beloved doctors in the TV world, was not believed when she described her condition.

A study aptly named, “The Girl Who Cried Pain,” exposed the unfortunate truth that female patients are “more likely to be treated less aggressively in their initial encounters with the health-care system until they ‘prove that they are as sick as male patients.” This statement translates more tangibly to a nationwide average 49-minute wait time for men compared to a 65-minute wait time for women after reporting the same acute abdominal pain in an ER.

The lower standard of care given to women who choose to take birth control is ignored by those who have the power to improve it, specifically a greed-driven pharmaceutical industry. “Big pharma” makes billions of dollars every year off of birth control products, including pills, IUDs, vaginal rings, patches, and shots. These profit margins are only increased by women trying multiple versions of each product, as they are forced to do when side effects are too debilitating for them to function. These profits serve as positive reinforcement for big pharma to continue making imperfect products.

For many years, big pharma companies have gotten away with imperfect pills, knowing that they are the preferred choice of birth control for sexually active women. A recent study in the UK shows that these tides are turning. Bayer Healthcare, a leader in the market of contraception products, conducted a research study investigating women’s attitude towards varying forms of birth control. This research was confirmed by the Office of National Statistics, and found that 31% of women chose, at some point in their lives, to switch from the pill to Long Acting Reversible Contraception, or LARC’s. These women were totally unsatisfied with the side effects and overall effectiveness of the pill and decided that their bodies and minds deserved better.

Society has taught women to expect a lower standard of care from all healthcare providers, ranging from doctors to CEO’s of pharmaceutical companies. This custom is dangerous for the physical and mental well-being of women, which further effects all aspects of society. Therefore, it is time that we, as women, demand more for ourselves. We deserve birth control that does its job with no side effects. We deserve to be heard when we go to the Emergency Room asking for help. We deserve to be represented in fields that make decisions about our health. We deserve (birth) control.

Works Cited:

“(Don’t Fear) The Reaper.” Grey’s Anatomy, season 14, episode 11, ABC, 1 Feb. 2018. https://www.hulu.com/watch/1215330.

Fassler, Joe. “How Doctors Take Women's Pain Less Seriously.” The Atlantic, Atlantic Media Company, 15 Oct. 2015, www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/.

Glass, Jennifer L., et al. “What's So Special about STEM? A Comparison of Women's  Retention in STEM and Professional Occupations.” Social Forces, vol. 92, no. 2,  2013,  pp. 723–756. JSTOR, JSTOR, www.jstor.org/stable/43287810.

Haelle, Tara. “Does Some Birth Control Raise Depression Risk? That's Complicated.” NPR, NPR, 9 Oct. 2016, www.npr.org/sections/health-shots/2016/10/09/497087838/does-some-birth-control-raise-depression-risk-thats-complicated.

JV. “Side Effects Are OK for Women's Birth Control - but Not for Men's?” USA Today, Gannett Satellite Information Network, 1 Nov. 2016, college.usatoday.com/2016/11/01/male-birth-control-side-effects-come-on/.

Planned Parenthood. “Birth Control Methods & Options | Types of Birth Control.” Planned Parenthood, National - PPFA, www.plannedparenthood.org/learn/birth-control.

VanLeuvan, Patricia. “Young Women's Science/Mathematics Career Goals from Seventh Grade  to High School Graduation.” The Journal of Educational Research, vol. 97, no. 5, 2004,  pp. 248–267. JSTOR, JSTOR, www.jstor.org/stable/27548037.

Sarah is currently a junior at Washington University in St. Louis, studying Psychological and Brain Sciences. She strives to one day incorporate her passion for women's health into a career in the medical field.

Dear Andy,

Wow, it’s been a while since we last spoke. I’m about to start my junior year—can you believe that? It still seems like yesterday that you and I met through South Boston Afterschool. On the T-ride to South Boston, we talked in Chinese (I had just started; you helped me with my tones). We talked about girls (we talked a lot about girls). And sometimes we talked about more serious things. About how we were so afraid to fail, about how we constantly felt pulled in all directions. About how hopeless we felt.

When you quit South Boston Afterschool, I just figured it was a sophomore slump. Maybe your economics tutorial was taking up too much of your time, or maybe you were working on a new start-up, trying to be the next Mark Zuckerberg. You were stressed out the last time I saw you. I wasn’t too worried, though. I thought what everyone else here thinks: Junior year will be better than sophomore year. Senior year might be a bit tougher because of job searching, but you’ll be set after that. You’ll be a Harvard grad the rest of your life.

But then you jumped off a tower in downtown Boston. I thought wrong.

Andy, I spent a long time trying to figure out how to write this letter. It’s been on my mind every single day now for months. I almost gave up, because the words just wouldn’t come to me. It was too painful to express.

Then, in May, my best friend since we were babies ended his own life. He had just gotten into Georgia Tech. He had so much talent. He had such an incredible life ahead of him. His mom found his body. They couldn’t show it at the service.

His death inspired me to write this to you. Because it’s not just him, and it’s not just you. Writing this next part terrifies me, Andy. I’m scared because we live in a world where I can’t even write this letter without knowing in my heart that no matter what people will say, they will look at me differently. I want to make a big impact after I graduate, but I know that publicly discussing my complicated history with mental health—a conversation that should not be any more damning than talking about asthma or a heart condition—might prevent me from doing this. But that is exactly why I have to write this letter. It is time for us to reconcile with the reality of the world that we live in. It is time for me to say now what I should have told you before: You are not alone.

I should have told you about fifth grade, when I would stay up every single night thinking terrible thoughts. I had to make sure once, twice, three, four, five times that our doors and windows were locked, because I had to be sure. I had to know that no one would come in and slit my parents’ throats, and then beat my head in with a baseball bat.

I should have told you about sixth grade, when I touched flowers, and leaves, and people’s hair. My classmates did not understand, so they signed a petition asking me to stop. They gave it to the teacher, who presented it to me. Even today I remember the hurt and shame I felt when I saw the names of so many friends written on that piece of paper. They didn’t know that I could not help it; they did not know that it was outside of my control.

I should have told you about seventh grade, when germs consumed me. Bacteria crawled all over my body and inside my mouth. I would go to the bathroom repeatedly in the middle of class to frantically rinse my mouth and scrub my hands. When my best friend sneezed on me to see my reaction, and another spat in my juice and forced me to drink it, and another threw meat at me because she knew I was a vegetarian. I wondered if I had any friends at all. Maybe they were just pretending to like me because I was so funny to watch. I felt worthless; I felt hopeless; I felt powerless. I felt like I didn’t deserve to live.

But more important than any of that, Andy, I should have told you about how finally enough was enough. My mom got me help. She got me help, even when my teacher asked, “Why does he need therapy? He makes all A’s—he’ll be fine.” My mom replied, “I will be sure to write on his tombstone that he had all A’s after he kills himself because he hates his brain.” She knew what too few understand, that objective achievement means very little when life is nothing but shame and darkness.

Because of her intervention, I acquired tools to deal with my compulsions, to say “It Don’t Matter” until it really did not matter. Overcoming my compulsions was the hardest thing I’ve ever done, but it was worth it. I’m here today Andy, writing this letter to you, because my mom got me help.

Andy, I am sorry that I never told you about my middle school self. And I am sorry that I never told you how therapy empowered me to reclaim the beauty in life.

But I hope this letter to you will help change things for others. I hope it will convince someone who is like me all those years ago to find the support that they need. I hope it will encourage someone like me now—too busy with their midterms, their finals, and their papers—to check in on a friend. I hope it will encourage us as a community to fight against the stigma surrounding mental health issues both in our college and in our nation. And most of all, I am sorry that we live in a society where we could not talk openly to each other.

I miss you more than you can know, Andy. By relating this story—of what I did wrong with you, and what my mom did right with me—I want us to make a difference in the world. Then I will know that I am doing your memory proud.

Will

Originally published in the Harvard Crimson, September 2, 2015

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

In Reflection: Will’s thoughts on the process of writing and publishing this letter

At first, writing Dear Andy was pure catharsis. It was also extremely difficult. For years I had not been able to even talk about my history with mental health and the tragedies of my friends' suicides. To put my feelings into words for thousands of people to see would have been unthinkable to me. But after receiving support from my friends and my fraternity brothers, I found the voice to write my article. As a result of the attention that my article received, I am now working with a number of organizations on and off campus as well as Harvard administrators to improve mental health services. The feedback I have received since writing Dear Andy has inspired me to fight for mental health reform, both on campus and beyond. This has become my passion, and I am not going to give up until I have done everything in my power to change things.

William F. Morris IV is a member of the Harvard College Class of 2017 and is a joint concentrator in history and East Asian Studies.

My social anxiety plays me like a deceitful little game, except I spent the last 15 years pretending like I wasn’t on the court. The painful shyness I faced as a child, my inability to smile at any adults except my parents until the age of eight, the meeting with my fourth-grade teacher that my concerned mother sat through, afraid her daughter wasn’t voicing her needs: it’s always been you, dear social anxiety. My conviction in middle school that my friends didn’t care about having me around: that was you, too, wasn’t it? You pushed and pushed with such excruciating force until that stupid conviction became my reality. As did tears, insecurity, and a lack of reassurance I desperately needed. In high school you hid behind black skinny jeans, punk rock band t-shirts, and an eating disorder that wasn’t glamorous like in the movies. You danced around obsession, meticulous numbers, and crippling self-judgment. This is my reality, and the reality of millions of other people. And we are being ignored.

What if our society ignored the number of people who suffered from cancer each year? What if we claimed that cancer wasn’t real and its effect on lives was simply a conjugation of one’s imagination? If we stigmatized this illness, how would it impact those 15 million Americans who live with it? How would it make them feel? We don’t ignore those battling a physical illness because it’s usually easy to see how they manifest, yet mental health disorders can be harder to see and are thus treated differently.

The number of people who live with cancer every year is equivalent to the number of North Americans who live with social anxiety. That’s roughly 7 percent of our continent’s population. The disorder is more prevalent among teenagers and college students: an estimated 10 percent of college students suffer from significant social anxiety disorder, and general anxiety disorder affects an astounding 25 percent of teenagers. So why is the second most commonly diagnosed form of anxiety disorder is also so commonly overlooked? It’s challenging enough to live with a mental illness: its stigmatized reputation is an additional obstacle to overcome.

The stigma American society has so carelessly placed upon those struggling with social anxiety is rooted in insensitivity and judgment. The ignorance that drives this stigma not only discourages people from seeking help but attempts to convince them they have no problem to begin with. The pressure to break out of the shyness and nervousness becomes debilitating. When someone is repeatedly told their struggles don’t exist or their social awkwardness is just something they need to suck up and get over, we begin to believe it. I know I did.

My social anxiety made me question all the wrong things. I questioned the value of my curvy physique. I questioned my ability to be alone for hours at a time and not crave any verbal exchange. I questioned why people assumed I was so shy when I didn’t raise my hand in class, even though I always knew I had something to offer. At the time, I didn’t know what kept restricting me. I had questioned why everyone I knew was making friends at college, while my “friends” kicked me out of their roommate pool instead.

My first semester in college drained me. The pressure of constant socialization and having to present my best, bubbly, and agreeable self to everyone I confronted took a toll on my mental health. If I was anything but outgoing and always eager to go out on a weeknight, I was afraid my worst internal fear would come true—people would only pretend to be my friend because they felt a sense of pity towards me. I spend an exorbitant amount of energy and time rehearsing what tone I would use to respond to my name during attendance call in class, or considering which shoes would make the least noise when I walked into a 300-student lecture. One night my roommate asked me to make a phone call to the resident hall janitor because our window was jammed. I knew exactly the look I shot her, one brimming with such nerves and astonishment that makes someone wonder if they’ve suddenly sprouted a second head. She stared back at me quizzically and within seconds quickly muttered, “Never mind, I’ll do it.” The conversation ended abruptly. Why couldn’t I do it? Social anxiety.

But now I know it’s you, anxiety. Things make sense now: why I over-think the most basic social interactions, why I can’t present an accurate first impression no matter how hard I try, and why making friends is a hurdle I never fail to trip over. I need constant reassurance from the people in my life that I matter to them; that they want me to be there, and I haven’t just shoved my way in. I understand now that you are the driving force behind that heavy weight of insecurity that has traveled with me throughout my first year of college. But I want you to know that I am not afraid of you. Coming to college has given me the courage to speak openly about the daily challenges you provide. Because of you, I have discovered my passion of advocating for mental health awareness. I have overcome my eating disorder. I have made a friend or two, and I’m working on making some more. Thank you for being a constant in my life, dear social anxiety. Yes, you are a piece of me. But if you think you are going to define me, you are so painfully mistaken.

Mikayla is a sophomore at Boston College studying Communication with a minor in Management and Leadership. She is an active writer for Spoon University, an online food publication, and also enjoys playing guitar and spending time in New York City.

My mistakes are like wildfires: disfiguring the entire landscape, forests turned black and flat and charred beneath my feet. After something like that, people will always look at you like a walking natural disaster, always smell the air for smoke. I would do anything to take it back, to just pop the cap back on that bottle and move on with my life, but that didn’t happen. There’s that saying about something being a tough pill to swallow, but I guess I never had that problem. Pills were easy. Too easy.

The summer before I started high school, my dad and I moved to a small town in rural Oregon. It was deceptively picturesque, with a historic downtown and snow-capped mountains lining the horizon. My dad said it looked like a Christmas card, but to me, it felt like a snow globe. “Come on, it’s a fresh start in God’s country. It’ll be good for us,” he said. I knew the divorce hadn’t been easy on my dad, but this didn’t feel like a fresh start. It felt like a life sentence.

The town felt barren. Untouched. Lonely. Of course, there were other kids my age in the town, and I went to school with all of them. You’d think this would help with the overwhelming isolation, but it had the opposite effect. Throwing together a few hundred chronically bored, desperate-for-trouble teens is about as good of an idea as it sounds. It became us against the world, a case study in desperation and mob mentality. Without that anger and desire for more, what did we have? There was nothing for us to look forward to besides escape. Every day in that tiny school and that tiny town felt the same, like we were living in a time loop. It would almost be cool, like a science fiction movie, if it wasn't so abysmally boring. So we determined that if we couldn’t get to the outside world just yet, we would bring the outside world to us. Like the stupid kids we were, we thought the outside world was like one giant rager, so we threw some pretty killer parties. I never understood how the word “killer” could both mean something good and bad at the same time. Now I do.

Flash forward to a Friday night sometime during my senior year. We had survived yet another week of classes and teachers and homework; graduation was just around the corner. We were so close to being done. So close. Naturally, we decided to celebrate the only way we knew how: we threw a party. We kept the house dark, the music loud, and the blinds drawn. For those few brief hours in whoever’s house we were crashing that weekend, we weren’t trapped in rural Oregon. We were living in L.A. or New York or some other far away city. Our hearts slammed inside our chests, echoing the beat of the music and chanting for more, more, more. For those few brief hours, we were free.

Freedom has a price, though. That’s the part they skip in the movies. The characters have a crazy night, something goes wrong, chaos ensues as the characters try to fix whatever sticky situation they had gotten themselves into, the problem works itself out, and the characters laugh about it afterwards and have a sentimental moment. Cue happy music. Roll credits. The end. That’s not how it happens in real life. That night, we made a mistake. We started a wildfire. The moment my friend switched out a beer bottle for a pill bottle, I should have known to walk away. I should have said no, but that night, I felt invincible. I thought nothing would hurt me, not when I was so close to my life finally starting. I looked around at all my friends, drunk and high and so alive, and I took one. Oxycodone didn’t sound scary, not like heroin or cocaine or meth. They gave it to kids when they got their teeth pulled, so how bad could it be? One pill wouldn’t hurt. I had stopped saying no a long time ago.

If only I had known that one pill would turn into a habit, and a habit would turn into a full blown addiction. Soon, I had pills in my locker, in my car, in my bookbag, in my purse. Any space I inhabited on a regular basis became my drug cabinet, my hiding place. It became increasingly difficult, however, to keep my addiction going. I was in high school, and my dad would be furious if he found out. I didn’t have nearly enough money to keep buying the pills I wanted—no, needed. I found myself at a new low.

Hooked on the high and stupid enough to keep my problem a secret, I used up the last of my money from my summer job and bought heroin for the first time. It was from a kid at my school; the deal was cheap and quick. The needle was intimidating at first, but not as scary as the thought of withdrawal. The tremors, the sweating, the chills, the pain. Itching for a high in the tiny bathroom attached to my bedroom, I closed my eyes to not focus on the pinch of the needle. I didn’t think about what would happen once this high wore off. I just let the wave of euphoria wash over me and felt a sudden calm. Looking in the mirror, I could see my first bruise already beginning to show. I changed into a sweatshirt before my dad came home. I would wear long sleeves for years to come.

If taking oxycodone for the first time crossed a line, shooting up with heroin for the first time obliterated it. Every day, the drugs worked less and less, and I had to buy more and more. I was covered in bruises. Anywhere that could be hidden with jeans or long sleeves was a canvas of blue and brown bruises and puncture marks. If there was anything drugs taught me, it was that I was a good liar. It seemed I could hide anything from my dad. Until three years later, when I finally hit rock bottom.

I was in college. I mean, I was enrolled in college, but I rarely even showed up to class. My grades were slipping and my attendance was a disaster, but I could never seem to make it through the day. Not without getting high. I’d gone home early that day, exhausted and ready to add another bruise to the collection. If I had counted how many times I had felt the sting of a needle, it probably would have been enough to have given myself a full tattoo. One minute I was in the bathroom, pulling my sleeves down to hide the shameful thing I had just done, and the next, I had stumbled into my room. I laid down and closed my eyes, which is apparently how my dad found me. Prone. Unresponsive. Barely breathing. I woke up a day later in the hospital, my dad sitting next to the hospital bed with his head in his hands. He lifted his head and looked at me, my eyes red and bloodshot. He didn’t say anything. He just looked at me. I told him it wasn’t his fault, but I could tell he didn’t believe me. He felt the burden of my secret as much as I did. He sat there and looked at my arms, a stark picture of my addiction. He checked me into rehab the next week.

Rehab was not like the hospital. The hospital was cold and smelled like rubbing alcohol and formaldehyde. It was sterile and felt like death. Rehab, on the other hand, was filled with warm colors and art classes and friendly faces. Withdrawal felt like dying, but at least it wasn’t death. It was resuscitation. Revival. Resurrection. I left a month later detoxified and rejuvenated, ready to pick up the pieces of my life and live as if that night at that fated party never happened. Too bad good things almost never last.

I would overdose three more times. Each time, my dad sent me back to rehab with a little less hope in his eyes. I had given up a little, too. During my fourth stint in rehab, I met Rachel. She was nineteen, bone thin, and pregnant. It turns out that if you do heroin while you’re pregnant, the baby gets addicted, too. If the mom tries to go cold turkey and stop feeding her addiction, the baby also goes through withdrawal and can die. So there sat Rachel, medicated on methadone and just waiting until her nine-and-a-half month wait was up so that she could get her act together. When I asked her about her situation, she said, “If it was just me, I probably would have never gotten clean. But it’s not just me anymore, and Child Protective Services can get involved at any time. My family doesn’t think I’ll make a good mom. I need to prove them wrong. I just made a mistake. It was one time.” It was this heartbreaking admission that made me see that if I didn’t get clean, I could be in Rachel’s shoes in five, ten, maybe fifteen years. I could never drag my kids into this. Never. That was my last trip to rehab. I never touched a needle again.

Five Years Later

“And that’s how I got here. I’m almost five years clean, and I’m finishing community college in a couple of months. I already have a job lined up after I graduate.” Claps and congratulations filled the room as I announced this news, a success story that the other recovering addicts in the room could aspire to. Heroin Anonymous had taken up my Monday nights for the past four years, and in every meeting I attended I felt like I was earning my place back in society. Rachel sat across the room with her daughter, who was fast asleep in her lap. I wondered if Rachel would ever tell her what these meetings were, who she used to be. My father sat next to me, smiling and proud of my recovery.

It is true that some mistakes are like wildfires. They burn down everything that was once familiar, and you are left with only the ashes. But that’s the incredible thing about wildfires: after the flames have died down and the heat no longer persists, the scorched ground becomes green again. Life always finds a way. Things grow back. It may never be the same, but it sure is something worthwhile.

Shannon Lally is currently pursuing a double major in Psychology BS and English with a concentration in Creative Writing. After college, she hopes to pursue law in a creative field, such as book publication.

Elaine Scarry, Harvard English professor and advocate for narrative medicine, said: “To have great pain is to have certainty; to hear that another person has pain is to have doubt.”

We can never truly know what someone else’s pain feels like, or truly understand another’s experience with illness or injury.  But we are mistaken if we think that this gives us reason not to try.

As two sophomore Nursing majors and Medical Humanities minors at Boston College, we feel a personal responsibility to give voice to stories of pain—including the suffering associated with physical, emotional, and mental illness and stress we have heard from our peers. We also feel called to elicit and validate the stories of pain which haven’t yet been told. Many suffer silently every day on campus, and our hope is to provide space for these people to share their stories and thus feel less isolated.

“Underheard HSC” (@underheard_hsc), the Instagram account we’ve launched, is dedicated to sharing anonymous short health stories and art pieces by and from college students. It aims to make stories of illness, disability, and loss in college more accessible to the students facing these challenges, to encourage those who aren’t naturally inclined to write about their experiences to share their stories, and to help those who haven’t experienced such challenges to join in conversations about health and illness with those around them.

In college, there is great stigma around diseases or injuries that are considered unusual in our age group. We are expected to be young, strong, and resilient to whatever comes our way. This presumption of healthiness makes it challenging for those who undergo debilitating illnesses to express themselves. When these experiences are under-discussed, it leads to misunderstandings about the reality of being sick, and about how to best respond to and care for those around us who are experiencing these challenges. For this reason, we are particularly interested in reaching college students through our work as interns at Health Story Collaborative.

Our hope is that Underheard HSC becomes a space where young people feel less alone in their pain and comfortable enough to submit quotes or short stories about their own health.

View fullsize

Each of us has or will deal with health challenges in our lifetime. It’s time to start talking about it.  By taking the time to listen to and express care for the stories of our peers, we will not only be showing them kindness, but we will also begin to make space for a kind of storytelling which can lead to emotional healing. Our greatest ambition is to inspire better communication and deeper human connection. We hope that this platform welcomes students to share and serves to validate and honor every health story.

Supporting unique projects and starting new conversations can sometimes be scary, but the barriers to discussing the difficulties of illness which we have comfortably hidden behind until now are the very reason we must take a leap and open our minds to the infinite stories of illness and pain existing around us.  Please join us in taking a small but important step in showing our peers that we care: follow @underheard_hsc on Instagram.

For questions or to submit a story, please email Evelyn and Heena at hscinterns@gmail.com.

Heena Nissaraly is a sophomore at Boston College majoring in Nursing and minoring in Medical Humanities. She aims to become an empathic nurse specialized in anesthesia or hospice care, and hopes to eventually improve healthcare in Madagascar.

Evelyn Caty is a sophomore at Boston College majoring in Nursing and minoring in Medical Humanities.  She discovered for herself the utter inexpressibility of pain when she suffered from undiagnosed back pain for many years, and she hopes to use this knowledge to encourage her peers struggling with health challenges to begin healing through the telling of their own stories. She, too, hopes to use her passion for the medical humanities and for storytelling to become a compassionate and effective nurse.

The fact that Dominicans of Haitian descent are treated as foreigners in their own country was hinted at before we even arrived on the island. Contemporary Haitian immigrants to the Dominican Republic and prior generations experience racism and economic exploitation on a daily basis. Our Global Health service trip team was mostly white, so this discrimination would not affect me or many of the other students. However, a black girl from New Jersey was warned that if our guagua (bus) was stopped while in transit, she would likely be asked to step out by military personnel in an effort to control immigration from Haiti to the Dominican Republic. Luckily, we avoided this situation, but during my week on the island I observed many occasions of blatant racism that interfered with healthcare access for Haitians.

Each day our team traveled into “bateys” – communities – outside of Monte Cristi to support the local health center and their mission of guaranteeing patients the right to health. In the early 1900s, banana companies established bateys for the Haitians and Dominicans who worked the fields during the day, to provide them with a place to stay overnight. Many banana companies have stopped supporting the bateys, making life extremely difficult for those who live there – fruit pickers have been left without the means to support their families, and the economy suffers.

While I witnessed impoverished living conditions in all of the bateys, the Haitian batey was the most disadvantaged by far. We arrived at 7:00am to the abandoned banana packing plant and quickly transformed the area into a clinic. 30-40 patients were already lined up. Many of them had walked miles. Some of them had no shoes. Others were carrying one child on their back and another in their arms. I quickly gobbled down my granola bar while huddled over; in hindsight, I should have eaten it on the bus beforehand, away from the patients, considering many of them don’t have such easily accessible food.

As a pre-dental student, I had been assigned to spend the morning helping the dentist and her assistant. What struck me most were the Haitian children’s reactions to seeing the dentist, or lack thereof. In the U.S., it is not unexpected for a child to tantrum when propped up in the dentist’s chair. They clench their teeth closed and turn away from the approaching dentist’s hands. They cry for Mom or Dad whenever it’s deemed safe to open their mouth and howl. In contrast, not once at the pop-up clinic did I see a Haitian child fight the dentist. Not once did I hear them scream at the top of their lungs. Instead, often there without a parent, the child would lie on the chair with his or her mouth wide open, totally vulnerable, and not make a move or a sound. The dentist would scan and scrub and scrape, and then the child would sit up, lean over the side, and spit a mouth full of blood and plaque into a cardboard box filled with dirt. There were no stickers to reward their bravery or high fives from Mom or Dad. The kids were sent off with the only toothbrushes we had (boring adult ones instead of the fun, cartoon-themed ones often handed out in the U.S.), and started the long journey home.

I also experienced the impact a language barrier can have. Communication is perhaps the most important element in building a positive doctor-patient relationship. My day in the Haitian batey where everyone spoke Creole reminded me of this. Not being able to greet, instruct, or comfort these patients made me feel helpless. I still remember a middle-aged woman who let out groans so deep I couldn’t help but furrow my brow as I imagined her pain. “¿Qué le duele? / What hurts?” I asked. It was challenging enough to understand the woman’s response as she gritted her teeth and whimpered in agony, but when she answered in Creole instead of Spanish, I was filled with frustration. The language barrier made it difficult for me to clearly listen to or readily comfort her. Fortunately, we had a team of translators helping us. They translated from Creole to Spanish, and then another group translated from Spanish to English. Nonetheless, there was no way for us students or the non-Creole-speaking American doctors to directly communicate with her. I found this to be extremely limiting in assessing complaints and prescribing medicine.

As a pre-dental student majoring in Spanish, I hope to one day be able to combine my passions in order to communicate and empathize with both English and Spanish-speaking patients. My week in the D.R. affirmed the value of incorporating a Spanish language education into my dental career. Had the groaning woman spoken Spanish, I could have reassured her: “You were right to come here. Everything is going to be ok. We are going to help you.”

My week in the Dominican Republic ignited in me a desire to fight for equal access to healthcare worldwide. I will never forget the struggle of those who live in the bateys. Indeed, they will inspire me as I continue on my journey, and I hope to return one day as a practicing dentist. Until then, I plan to serve in my local community, as great disparities also exist in our own backyard.

Rachel is a junior at Washington University in St. Louis, majoring in Spanish and minoring in medical humanities. She aspires to practice dentistry and cultural humility in a medically under served area.

When a heavy object falls on one’s foot, it exerts pressure on the skin and muscles, and that hurts. Raw sensation is the pressure, and everything beyond that is interpretation. To feel is a combination of raw sensation and interpretation from the brain based on past experiences.

But when one loses the ability to recall, one loses the ability to interpret and sometimes even the ability to feel.

My grandmother’s gradual decline all started over a decade ago, in the Malagasy province of Morondava, in Madagascar. My father remembers the day when everything radically pivoted and his world turned upside down: after a strenuous day of housework, my grandmother —for just a moment — confused day and night.

A few years later, the diagnosis was given: Alzheimer’s disease, coupled with brain aging and a strong 25-year-old depression. My grandmother moved to the capital city of Madagascar to become the sixth resident of our household. My parents, sisters and I shaped our lives and schedules according to what we thought my grandmother would feel most comfortable with. She was the beloved center of our lives.

Within several years, all my grandmother could remember clearly was her name. It seemed as if she had entered a parallel universe she had created herself. She got lost in her thoughts while tracing flower patterns with her feet and counting the number of lights out loud. There was no way of telling what she was thinking. I could not bare thinking about how often she felt lost, alone, or misunderstood. The thought haunted me for days; it made me feel utterly helpless.

As her amnesia worsened and her brain activity declined, my grandmother stopped interpreting raw sensation, and, slowly lost her reflexes. She sometimes forgot to drink water after putting a pill in her mouth, and chewed on the medicine instead. The bitter taste surely made its way through the taste buds on the back of her tongue, and was probably sent to her central nervous system, but somehow was not interpreted. Not a single cringe showed on her face.

One may say that her inability to interpret sensation caused her to stop feeling. Indeed, not once did my grandmother show signs of anger, sadness, or even slight feelings of impatience. But she often laughed. Each time she disappeared into her parallel world, I witnessed genuine happiness.

Some people believe that acts of kindness and empathy do not make a difference in a world in which man has already reached the moon. But I believe that it is the little steps we make that end up being the most precious ones. Offering to share her popcorn while watching cartoons on TV made my grandmother happy. When I simply asked about her day, or commented on the flowers that grew in the garden, a smile appeared on her face.

As I grew older, I understood the importance of empathizing with my grandmother. And how could I possibly attempt to do so without her collaboration? I could not change the way she perceived her world, but I could change the way I perceived her world: it all had to do with acceptance.

Empathy, I feel, is the ultimate solution to alleviate one’s pain and help someone make peace with their condition. Within empathy lies acceptance. Coming to terms with a condition is the first step towards wellness. My grandmother was not part of the world I knew so well — this was a fact I could not argue against. There was no use in me trying to include her in the present by constantly reminding her of the time of day or the year, trying to bring her back into my reality only confused her.

In the last years before my grandmother passed away, my family and I ceased trying to heal her by forcing her to remember. We let her imagination go free, and even took part in her adventures. Her imagination, stimulated by compassion and attention, helped her recall certain pleasures of places, smells, sights, tastes, and faces from her past. This seemed to allow her to reconnect with small part of her old self, and make her feel more comfortable in her daily life. I am eternally grateful for all I learned from my grandmother. Her story taught me the immense powers of compassion.

Heena Nissaraly is a sophomore at Boston College majoring in Nursing and minoring in Medical Humanities. She aims to become an empathic nurse specialized in anesthesia or hospice care, and hopes to eventually improve healthcare in Madagascar.

My younger brother, Simon, will always be my best friend. He was born with a mitochondrial disease and was never able to speak or walk, yet he exuded kindness through his unique and loving personality. Simon's gratitude radiated during each of his days, no matter how tough. He often needed nebulizer treatments and suctioning to aid his breathing, but he flashed us huge grins despite the discomfort of the mask and tube, as if we were all in on the same joke. He truly loved and appreciated the things that many of us take for granted, like taking long naps, getting off the bus after a day spent at his special education school, going to music class, and spending a sunny afternoon sitting outside. He especially loved spending his birthday with family, friends, and colorful balloons tied to his wheelchair. I will always remember the huge smile he had whenever he caught a glimpse of the Perry the Platypus balloon I gave him for his twelfth birthday, which somehow remained inflated for months.

Several months after his twelfth birthday, Simon’s respiratory problems became severe. We learned that he likely had less than six months to live. This news was difficult for me to handle as a sixteen-year-old, but my parents and friends offered immense support. My best friend often escorted me out of the classroom when I needed to cry, and my mom frequently picked me up early from school and took me to our favorite coffee shop. In November, Simon began a hospice program and continued to enjoy each day through massage therapy, music, his teachers and caregivers, and our family.

On March 26th, less than three weeks after Simon’s thirteenth birthday, I received the call from my parents that I had been dreading. They told me that they raced home after an urgent call from his caregiver. He was having more trouble breathing than they had ever seen, and they weren't sure how much time we had left with him. Since he had survived many rough days in the past, I clung to the hope that when I got home he would still be smiling at his orange thirteenth birthday balloons.

My mom stopped me at the door on my way inside the house. She told me Simon had passed away a few minutes prior. My vision blurred and I dropped my backpack. I ran into my parents’ room where Simon lay, still believing that he would be okay. Once I physically reached his body and could no longer hope for another day with him, it felt like my whole life shattered. I hugged him, crying, and wondered how we would continue on without our favorite ray of sunshine.

While losing Simon was unbelievably traumatic and devastating, it motivated me to spend time with other children and adults with special needs. Two summers after Simon’s passing, I worked as an assistant teacher at his special education school and as a respite caregiver for people of all ages with disabilities. I am grateful to have had the ongoing opportunity to work with individuals with exceptional needs and to teach and learn from them. My experiences with Simon and other members of the special needs community with whom I connected have inspired me to work toward a career in medicine. I plan to dedicate my life to offering care and love to children with disabilities.

Isabel is a junior at Vanderbilt University majoring in Medicine, Health, and Society. She grew up in Michigan but currently lives in Boise, Idaho with her Great Dane, Arthur.

Putting the pieces of pain together can’t be done by just asking, “Where does it hurt?”

I have always been somewhat accident-prone. Each time I tripped and fell as a child brought the same routine. I would sit on the edge of the tub in my parents’ bathroom with a bleeding knee and a tear-streaked face as my mom or dad got out the Band-Aids, Neosporin, and the despised hydrogen peroxide (it stung too much when it fizzed). I would point to the scrape and roll up my sleeve to reveal any other “boo-boos.” I would leave their bathroom with my lacerations clean, my face dry of tears, and feeling okay, albeit a little achy.

Nearly fifteen later, as a sophomore in college, I shadowed Dr. X every Wednesday afternoon for the practicum component of a semester-long course on Medical Professionalism. In Dr. X’s office, many patients would come in with a laundry list of pain, soreness, discomfort, and hurt. The question “Where does it hurt?” seemed insufficient to understanding their pain fully. The patient may have struggled to push back on Dr. X’s hand with their face. They sometimes found it difficult to answer inquiries such as, “When did the pain start?” or, “Is it radiating?” All of these are pieces of the understanding required to provide adequate and appropriate treatment. Doing so demands the asking the patient multiple pointed questions while also testing them physically. This understanding appeared to be elusive and difficult to acquire for three main reasons: time, creativity, and trust.

Time

During my Wednesdays with Dr. X, I often noticed a tension between the care patients want and the realities of care in our current healthcare system. Patients would often try to show her pictures of their grandchildren or a recent vacation. Sometimes, they, an aging parent, wanted her to explain over the phone what was wrong with them to a concerned child who could not make the appointment. She always obliged as best she could but the system in which she provided care made it difficult. Dr. X was known in her practice for seeing roughly half as many patients as her fellow physicians. She often mentioned to me how difficult it was to accommodate these seemingly irrelevant components of a patient visit when they were often what made the patient most comfortable and most inclined to tell their story.

The doctor’s visit with the patient can only last so long, for other patients need care too, and there are only so many hours in the day. Thus, even when the “right” questions are being asked, patients may not have the opportunity to fully translate their feelings, aches, and pains into words with context (a mosaic of experiences, emotions, environment, and everything in between). As a result, it is challenging to gain a strong understanding of what they are experiencing and subsequently make a suggestion about how to treat their condition(s).

Creativity

I often noted Dr. X’s inventiveness on our Wednesdays together, inspired by her ability to ask questions that led her closer to a diagnostic truth regarding the patient’s experiences. Sometimes people are insecure about their diets, how much they exercise, how often they take a prescribed medicine, and other areas of their lives in which they are not perfectly compliant with doctors’ orders. Thus, we are less likely to offer responses to a provider’s question that allow them to help us, for we are trying to protect ourselves without even realizing it.

This reminds me of visits to the dentist. When the hygienist asks if I’ve been flossing as she scrapes and polishes my teeth, I know that I have to be honest because she has the proof right in front of her. But we all often lie, feeling sheepish for not doing what was asked of us.

Sometimes a matter-of-fact question like, “Do you go to the gym regularly?” is sufficient for a useful answer that guides the doctor to a diagnosis. However, sometimes it seems more appropriate and productive to ask, “What is your daily schedule?” This gives the patient a chance to tell the doctor what they want, be it that the entirety of their exercise regimen consists of walking to work, or that they stop at Chick-fil-A on their way home for dinner. Although this question may not have appeared at the start to have a direct correlation with healthy eating/regular exercise, it may make the patient more comfortable and allow for a more organic conversation. When Doctor X asks more flexible and open questions, this allows for more creative and varied responses that are generally more constructive toward devising a care plan.

Trust

Meeting a patient where they are in a non-judging, kind, and sensible manner, they are much more likely to open up and let the provider know what hurts and how they feel. I trusted my parents to clean my wounds after a fall off my bike and bandage me all up, pointing them to the areas in need of a little love. Similarly, I observed Dr. X’s patients explain pain “at a level eight” that keeps them up at night with a trust that she will take their words and turn them into a diagnosis and treatment that gives them relief.

---

Although all patients are different, everyone expects individualized care from their doctor and are usually hoping to be healed. Time, creativity, and trust are crucial pillars that support how the provider meets their patient’s needs by putting their symptomatic puzzle together into a diagnosis.

When I was a little girl, I expected my parents to take my skinned knee and clean it up so that I was good as new. With Dr. X’s patients, their complicated aches and pains require more than just a Band-Aid, but she does have the power to offer them solace. I hope one day to be able to provide antidotes for my patients’ pain, and will strive to ask questions that allow me to do so.

Hannah Todd is a rising senior at Rice University, where she is majoring in Spanish and Policy Studies with a minor in Medical Humanities. Additionally, she is concurrently pursuing her Master's in Public Health at the University of Texas and ultimately plans to attend medical school, which would allow her to integrate personal, academic, and professional experience into care for and policy regarding children with medical complexity.

It was a humid night in June,
One of the hottest days of the year.

You could feel your hair standing up on its end,
As a cold and warm front collided.

It left passers-by wondering if the lightning would ever stop.

It did.

So people believed that the storm was over,
That all was well.

I was too loose.

A group of us were going to Fenway,
First game of the summer,
First beer of the week.

The change in weather felt like a good omen,
We bantered as we walked up to Yawkey,
Taking in the smells of Franks,
The shouts of vendors,
And the sight of RED.

As we moved past security,
And scalpers that hounded,
We made our way to our seats.

Suddenly,
To the right of me,
I heard a sickening sound.

Like the thump of a bird as it hits a window,
Or the crack of a gun as it soars through the air,
Or the split of a head as it meets concrete.

A man lay,
Cane sprawled in front,
Unmoving.

RED blood started pooling,
Pouring out of both ears,
Like my beer pouring out of its tap.

People were screaming,
But I couldn’t hear.

I kept thinking,
He is right next to me,
DO SOMETHING.

I thought back to the CPR training I had taken two summers before,
Was this it?
Is this what I was supposed to do?
Is this the final test?

I got confused and spun in a circle,
Walking around next to him,
Hoping that suddenly I would know his diagnosis,
As the loops straightened out in my head.

Looking,
Gaging,
Watching,
But not acting.

THANK GOD.

Someone else nudged him
Someone else was on a phone,
Someone else said help is on the way.

THANK GOD SOMEONE ELSE IS HERE.

My friends call me over,
Terrified,
But they know they are ok.

They don’t know him,
He’s not their dad,
Uncle,
Or brother,
But I know him.

He was standing right next to ME.

Just that morning,
I was telling someone about my degree.

What do you study?
Medical Humanities.
What does that mean?
EMPATHY.
HELP.
CARE.
LOVE.
SUPPORT.
Oh ok. I get it. We need more people like that.
I AGREE.  We need more people like that.

NOT
Running away,
Waiting for someone else to step in,
A FRAUD.
A PHONY.
A DISGRACE.

As the stretcher wheeled itself,
And four EMTs rushed after it,
I considered chasing after them,
I felt sick.

I’m sorry man!
I didn’t know what to do.
I’m sorry man!
I panicked.
I’m sorry man!
I’ve never seen blood pouring out of a brain.
I’m sorry man!
I haven’t signed up for this.

But I didn’t.

Maybe I’m not EMPATHETIC.
Maybe I’m not destined to:
HELP.
CARE.
LOVE.
SUPPORT.
Maybe we need more people like that.
I AGREE. We need more people like that

Sarah Ramsey is an incoming senior at Boston College with a major in Operations Management and a minor in Medical Humanities.  She is the Managing Editor of the Medical Humanities Journal of Boston College and a trip leader for the Appalachia Volunteers.  Sarah aspires to use her business background to improve and expand health opportunities.

The day I learned that I needed hip surgery, I cried tears of relief.

On September 23, 2013, I was playing in a JV field hockey game when all of a sudden, after passing the ball to a teammate, I felt something go wrong.  It was… a pop?… a snap?… a tear?… and it came from somewhere in my left backside.  I could not identify precisely where—in my lower back, upper hip, or glute—I felt it.  As I crawled off the field, I struggled to assemble an explanation to provide the athletic trainer.  To this day, I cannot say exactly where it was or what it felt like, but I do know, as the past three and a half years have proven, that something was not right.

For the first eleven months after my injury I was diagnosed with a torn muscle in my hip, but physical therapy did little to relieve my pain.  I began to see an orthopedic surgeon specializing in hips, who saw nothing notable on my MRIs and encouraged me to continue treating with physical therapy.  After months and months of hard work without relief from the pain, I started to worry that I was somehow doing it wrong.  Finally, a new MRI of my hip, this time done with contrast dye, showed torn cartilage in the joint.  This would require surgery to repair.  When, after a year of persistent and unidentifiable pain, as well as numerous consultations with hip specialists, a surgeon walked into my examination room and claimed that he knew exactly how to cure my pain, I sat on the table in front of him and sobbed.  The recovery would be long and painful, but at least it would mean I was healing.  At this point I would have done anything.

After my surgery, I completed nine months of physical therapy to rehabilitate my hip and the rest of my body.  But as the physical therapy came to an end, I noticed that something still felt off.  I occasionally had that same original pain; it was a pain distinctly different from the normal soreness of post-operative recovery, and I was all too familiar with how it felt.  Worried that the operation had failed, I tried to ignore my discomfort for a year and a half.  I was terrified that if the surgery had not provided a cure, then nothing could.  This past December, after the pain suddenly grew much worse, I finally decided that I could no longer ignore my fears.  I scheduled a follow-up appointment with my hip surgeon, who referred me to a spine center to look for other possible causes for my pain.  To this day, my doctors and I are still searching for its source.

My pain taunts me.  It comes and goes.  It moves from place to place.  It floats, it hovers, over my mind and body, cruelly defying articulation.  The English language offers a myriad of terms to describe pain: sharp, dull, burning, throbbing, sore, stiff, tender… the list goes on.  And yet, my three-and-a-half-year search for the words to most accurately capture my experience has left me with the following clumsy explanation: most of the time it does not feel quite like a throb, but more like a series of discrete pinching and tugging sensations with each movement of my lower body, located somewhere between my sacroiliac joint and L5 disc; other times—when I sit or stand for too long—it aches across most of my lower back.  Sometimes, though, the pain deviates from both of these descriptions.

Without looking at a calendar or an MRI report, I can list off the top of my head everything I have done in the past three and a half years to try to relieve this pain—five MRIs, a CT scan, countless X-rays, six specialists, two chiropractors, two injections, and one unsuccessful surgery—including the dates on which most of them took place.  But, despite my three and a half years of familiarity with this injury, I cannot explain how it physically feels.

Three years ago, I spent my time training for the sport I loved, pushing through the pain of conditioning and doing everything I could to prevent the pain of injury.  Now, I spend my time catering to physical pain, altering my movements and avoiding certain motions altogether.  I prepare for each doctor’s appointment by obsessively practicing my story—the words I’ve carefully picked to best convey how the pain feels—in my head.  I brace myself for the disappointment of watching yet another medical professional fumble for a diagnosis.  And I desperately hope for the opposite: I hope that one of these appointments will lead to definitive answers.  I hope to one day again cry tears of relief like those I cried the day I believed in the miraculous powers of hip surgery.

This piece was originally published in The Medical Humanities Journal of Boston College, Volume 3, Issue 1, Spring 2017.

Evelyn Caty is currently a sophomore at Boston College majoring in Biology and planning to minor in Medical Humanities.  She works as an EMT for Boston College Emergency Medical Services, and hopes to pursue a career in health care in the future.

This week in shadowing, we saw a coronary artery bypass. Because we shadow anesthesiology, we get to see the doctors and nurses set up. It is like setting up a show, everything must be done a certain way in a certain order. From inserting the catheter to carefully draping him so only the necessary areas of his body were exposed (in his case, his entire torso and his legs) and even unwrapping the towels a certain way, everything must be done just so and this was all before he was even cut open. A nurse got us step stools to stand on so we could see. The surgeons walked in at the last minute, taking the drill and the blade and adjusting the lights above. Then, they got to work and we stood there mesmerized until we had to go back to class.

On the walk back to campus, I was in a daze. Upon reflecting on the experience, I found it to be simply bizarre to consider how the show and many others like it are continuing in operating rooms all over the world while we walk outside in the light of day. I couldn't stop thinking about the aftermath of the show. When I was in fourth grade, I was the wicked witch of the west for my class’ version of the Wizard of the Oz and the face paint dyed my face green for three days after. The show was over but I felt like it was still happening to me.

The man who underwent surgery today is going to wake up and hurt. But the surgeons had to break him to fix him. It was simply another day of work for these doctors. The anesthesiologists likely won’t see the patient again, but the surgeons, the ones who weren’t even there from start to finish, will be the ones to see him again when he wakes up. He will go home eventually and have a long, difficult recovery from this invasive surgery.

I admired the patient’s bravery and the surgeons’ dexterity. I was amazed at the anesthesiologists’ ability to compute complex body statistics against powerful medications. If I walked out in a daze and the man under the knife walks out in pain, how do the doctors walk out? Do they hurt, too, when they imagine what it feels like later to have the many sutures down your chest? Do they smile when they think about the years of life they added to his by just doing their job? In the operating room, they are all one show: surgeons, anesthesiologists, nurses, perfusionists, and even us undergraduate students. Outside, we are a fragmented entity that carries only our unique perspective of the show, combined with some input from their explanations.

As a doctor, I will need to learn how to make sense of the show every day. To care for children with medical complexity, children whose needs do not fit inside a single diagnosis or a single medication, I will need to work in teams to put on good shows. But at the end of the day, when I will go home hopefully to my family, I wonder where I will put it. I am an empathic, emotional, and sensitive human being, but I am also driven and dedicated. I believe that I will learn how to integrate what I see of and the role I play in the show into who I am, without losing myself in the process.

Hannah Todd is a rising senior at Rice University, where she is majoring in Spanish and Policy Studies with a minor in Medical Humanities. Additionally, she is concurrently pursuing her Master's in Public Health at the University of Texas and ultimately plans to attend medical school, which would allow her to integrate personal, academic, and professional experience into care for and policy regarding children with medical complexity.