Monday, March 24, 2014

Aiming at perfection

I am so proud today to share with you this lovely story written by my dear friend. She has chosen to remain anonymous, but I think you will agree with me that that the telling is brave, heartbreakingly beautiful, and ultimately redemptive. She is going to be an amazing doctor, a true healer.

Photo  by Amanda Munoz
Although encouraged in every way to succeed from infancy, I somehow initially escaped the illusion that one could “have it all.” When the neighborhood boys started teasing me about being fat, the choice was easy—I would give up on my body and would instead be really smart. I was already succeeding in school. What I liked most about math and science was that I was the best student at both subjects. While the “fat girl” taunting continued daily, it ended at the school bus stop. The school was sacred ground, and I was safe and confident when I was studying. 

I set my goals and I reached them.  I was first in my class, and I got the highest scholarship to college.  I continued to study math and science and decided to be a doctor.  At that point I think it was still the challenge that drew me to medicine. If I could perfect one domain of my life, I would work on my brainpartially because I despised my own body. 

Somewhere along the quest, I lost the security of the classroom as the challenges grew. I couldn’t rely on my confidence in my brain any longer and I turned my intense self-criticism on my appearance. That’s when I developed an eating disorder.

I was 20 years old when I started running. I began weighing myself daily. Initially, I thought I would be happy with a size 10, down from a size 14. With the same intensity I have always had for perfection, I passed that goal in 3 weeks, losing 20 pounds. And I was happier; I was healthier. 

With my small successes, I started needing to be perfect, not average. Once I set my eyes on perfection, I could no longer settle for less.  It was all-consuming. I embarked on a dieting routine that I still struggle with 8 years later. While I finished college and got into medical school, suddenly the dreams I was previously passionate about became less important—becoming a doctor, saving the world, being perfect.

Without noticing it, I dropped down to 114 pounds; my nadir BMI was less than 17. At that point I would still have described myself as “pudgy,” and I still wanted my bones to be more defined.  I could no longer sleep at night—I awoke after only a few hours of sleep due to my depression and because my joints hurt with no soft tissue to cushion them. I lost hunger cues and was nauseated; I would go more than a week without a bowel movement. I went 4 years without a menstrual period. I was unaware that both my mind and my body were in so much pain. 

I struggled through the worst of the eating disorder because I had friends and family who saw the whole person in me—a whole person who continued to exist although at times broken. My dream to learn medicine continued, and they encouraged me. I redirected my efforts to studying medicine and the intricacies of the human body. I labored over books of images of the ideal human body with rippling muscles; I studied the perfect principles of physiology. 

Then I met patients—and I immediately realized that no individual comes close to the perfected images.  We are each plagued by rashes, fractures, obesity, mental health disorders, and infections. I have learned about the body, heart, and brain in medical school. The whole person is greater than the sum of its pieces; there is an element to the human that will never be found in my textbooks. My journey ultimately has made me accept that no amount of perfection in body or mind will ever make me happy. I finally realized that no matter what the number on the scale read, I would still feel blemished—because I am blemished. We all are blemished. 

Becoming a doctor is an odd choice for someone who spent the first 22 years of my life despising my body. I have spent the last 21 years studying to prepare for my graduation this May. I still think medicine is my vocation. I come alive when a patient brings me into her life and allows me to see how she ails. It still shocks me that patients allow me—as a student—to perform a physical exam. It is an honor to try to alleviate their pain and to carry their burden.

I don’t think people can fit a mold or are entitled to “have it all.”  But I do not have to choose between my mind and my body. In order to be happy and to fulfill my role as a physician, I have found that I have to love and honor both my mind and my body.

This post is a part of my Women’s History Month project, “Honoring Women’s Stories.” You can read more about the project and see other women’s stories here.

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