Two years after that, I graduated as valedictorian of our competitive high school with a full academic scholarship to undergraduate. I delivered the address in front of two thousand people and walked off the field hoping for something I could not name precisely but which had to do with being seen. My parents were near the bleachers. My father was checking email. My mother adjusted her sunglasses and told me my speech had been long and full of complicated words and that next time I should try to be more entertaining. We drove home in silence. I ate cold chicken from the refrigerator while they watched television.
That night I made the decision that would cost me several years of sleep and one relationship with the banking system, which was to aim for something so significant they would have no choice but to look at it. I wanted to be a pediatric surgeon. I understood that this was not a rational response to a dinner where no one congratulated you on your valedictorian address, but rationality was not what was driving it. I wanted to build something undeniable.
I finished undergraduate at the top of my class. I took the MCATs, did the interviews, survived the waiting period that every pre-medical student knows is its own form of psychological endurance sport. In early spring of my senior year, on a rainy Tuesday afternoon, I received the acceptance letter from one of the top five medical programs in the country. I sat on my apartment floor and cried until I ran out of breath, then I bought a bottle of wine with the last twenty dollars in my checking account and drove to my parents’ house for Sunday dinner.
I waited until the plates were cleared, then I slid the acceptance letter across the polished mahogany table to my father. The financial aid packet was behind it. I explained that I was not asking for cash. I had partial academic scholarships. The remaining tuition and living costs required graduate loans, and because I was twenty-two years old with a student work history at minimum wage, I needed a parental co-signer to access them. Just a signature. A name on a form.
My father did not open the folder. He looked at the embossed logo on the cover and pushed it back across the table with one finger. He said the financial risk was too significant. He said they had been reviewing their portfolio and could not take on that kind of liability right now. He suggested I defer enrollment or consider a less expensive career path.
My mother refilled her wine and told me not to raise my voice at my father.
Tiffany looked up from her phone and told us she was launching a lifestyle and wellness boutique online the following month. She needed fifty thousand dollars in seed money for camera equipment, product inventory, and a professional website. My parents were her primary investors. They had, my father explained, made the decision to liquidate some assets to give Tiffany the capital she needed to build her brand properly, which was why their credit and their cash were currently committed elsewhere.
I sat at that table long enough to understand what I was being told. Then I picked up the acceptance letter, put it back in my bag, thanked them for dinner, and drove home.
In the morning I went to the financial aid office and applied for high-interest private loans that did not require a co-signer. The rates were punishing, but they covered tuition. They did not cover rent, textbooks, lab equipment, or food. I applied for a job as an overnight EMT with a company that ran ambulance shifts in the city, nine in the evening to five in the morning, six nights a week during the school term.
For two years, my life had a structure that I am only now able to describe without my chest tightening. I attended lectures and labs and clinical simulations from eight in the morning until late afternoon. I went back to my apartment and slept for three hours. I put on the uniform and worked until dawn. I came back, changed, went to class. On the ambulance I studied during the quiet hours, flashcards spread across my lap in the back of the vehicle, organic chemistry and anatomy and pharmacology in the yellow fluorescent light, with the smell of antiseptic and coffee and city air coming through the cracked window. I dealt with car accidents and overdoses and strokes and the specific particular helplessness of arriving somewhere after the worst has already happened. I learned more about what medicine actually was on those shifts than I learned in any lab.
