Coffee stains and biomedical pathways: Finding my way as a medical student

“Go ahead and spill some coffee on it,” our biochemistry professor said to the lecture hall filled with jittery first-year Stanford medical students. Perhaps equal parts caffeine, excitement, and nervousness, the room was buzzing with anticipation. The quiet hum of the projector harmonized with the taps of iPad pencils and pens documenting the intricacies of human metabolism. Curious eyes darted from instructor to presentation screen, like passionate tennis spectators waiting to see what comes next. To put it simply, medical school felt very high stakes. 

That day in class was extra special – it was a milestone similar to the first day of anatomy lab or the first time performing a physical exam on a standardized patient. We had just received our biochemical pathways map, a large rolled-up poster of the major metabolic systems that keep our bodies going. If you hover your index finger over this map, left to right or top to bottom, each inch points to an enzyme, product, or cofactor with names and actions to be learned. Point diagonally across the map and you can observe the relationship between each step and system, bridging the way sugars are broken down to how fats are built up. While undoubtedly fascinating, staring at these maps can cause overwhelming mental paralysis. As we carefully shuffled the maps from table to backpack, trying to avoid creases to its fabric, our professor broke the tension in the room by encouraging damage to our posters. 

Beyond coffee stains, she added, “Go ahead and rip it up. I have more copies!” Perhaps a simple classroom disclaimer, her message de-emphasized perfectionism and instead invited a messy, genuine approach to learning. I finally took a deep breath. 

So, why medicine? 

Sometimes it can be hard to justify your truth when it is so apparent to you. When asked “Why Medicine?” by friends and family, I used to jokingly reply, “Why not?” There is no reality in which I don’t become a doctor. Medicine is not only the culmination of my professional experiences and goals but my personal duty as a daughter, granddaughter, sister, cousin, neighbor, and friend. 

As a first-year medical student only a few weeks into my journey at the Stanford School of Medicine, I was grappling with what medicine could mean to me and what I could mean to medicine. My story cannot be told without community at its core. Growing up in the Syrian American diaspora of New York, studying community health and civic engagement in Boston, building an academic-community research career across the country – these are essential parts of me. 

This work, predominantly with immigrant and marginalized communities, requires patience, time, trust, negotiation, advocacy, and adaptability. From two-hour-long phone calls with doulas and translators to hear reflections on the multilingual surveys they have been conducting with families to months of gathering feedback from health care providers to develop an anti-racism training curriculum, my pull to medicine has hardly been convenient.  

Simultaneously, medicine is a profession of delicacy, precision, punctuality, impact, and excellence. Deadlines, regulations, and deliverables help standardize health care and value efficiency. With both of these realities being true – medicine as a community health connector and as a hub for biomedical perfection – how can we reconcile our call to service with this scientific profession? How can we spill some coffee on our career plans? 

Identifying and de-identifying ourselves in medicine 

One approach to answering these questions is to reflect on identification and de-identification in medicine – that is, the parts of ourselves we are conditioned to keep or to dampen in order to succeed clinically. Recognizing this process of professional identity formation does not excuse us from the necessary hard work needed to become good doctors, nor does it prevent the loss of our core values and traits. Instead, it sparks necessary awareness and intentionality in navigating the process and figuring out our own personal non-negotiables. 

For me, serving vulnerable populations is something I am not willing to part ways with on my journey to becoming a physician. And I keep myself going by remembering who I am. Sticky notes with “I give myself permission to dream” and “If not me, then who? If not now, then when?” were the signposts that helped me navigate my way to Stanford. In hope of preserving my motivations and documenting my path through medical training, I launched a biweekly chronicle called Beyond the Palm Trees. From this past August when I started medical school until now, I have been sharing my experiences and reflections on medicine, holding true to who I am. 

If you are on your own journey to attend medical school, there will come a time when you get the call, literally. Stanford or another institution will contact you and offer congratulations for your acceptance into their program. You will feel a deep joy, shock, and gratitude that could almost transcend generations. But, after reality sets in, how will you show up the next day for your community or patients? And the day after that? 

Your answer to “why medicine,” despite the application parameters limiting your response to finite minutes, characters, and words, is not merely a key to unlocking admission but a vision that keeps you ticking. Your response can be raw, revised, and imperfect, but it must be your truth. My final piece of advice: When you’re editing your “why medicine” response for the millionth time, questioning word choice and syntax, debating your place in this field, just spill some coffee on the page. The answer will come through.

Siwaar Abouhala, from White Plains, New York, and Sweida, Syria, is pursuing an MD at Stanford School of Medicine. She strives to become a physician-advocate with a focus on community-engaged research methods.

Knight-Hennessy scholars represent a vast array of cultures, perspectives, and experiences. While we as an organization are committed to elevating their voices, the views expressed are those of the scholars, and not necessarily those of KHS.