“Is there anything else I can do for you?”

Republished in JPR Vol 11 #1 January 4, 2022

Leighton Schreyer

CMAJ August 03, 2021 193 (30) E1180-E1181.

DOI: https://doi:10.1503/cmaj.210704

Leighton Schreyer

Department of Neuroscience, Western University, London, Ont.

It’s a simple question — one that my doctor asks me at the end of every appointment. It’s her way of extending a helping hand and letting me know that I’m not alone, but usually her offer barely registers in my mind. I’ve grown accustomed to brushing off support, to dismissing genuine compassion and concern, to believing that I’m alone in this: that it’s me against the world.

The word “No” dances on the tip of my tongue. Will I dare say “Yes,” dare to display myself on centre stage? Or will I say “No” and stay in the wings, overlooking reality? No conscious thought, selfreflection, or truth involved. “No” is an easy way out. It’s the rusty armour I unconsciously drape over my body before leaving the house, protecting a vulnerable core.

I am about to say “No,” as always, but when I glance down briefly, I face reality: my forearms are laced with jagged scars interwoven by pinpoint pricks — an unrelenting reminder of the selfharm that swallowed my childhood and the ruthless doctors who tried to patch me back together.

“I do have one question.” I wait for her to retract the previous offer. Nothing.

Cautiously, I tell her about the chance to interview for medical school, and in turn hear her voice swell with pride. I know that, in addition to appreciating the long hours and sleepless nights that every pre-med student puts into getting this offer, she understands the hurdles I’ve jumped. She held my hand when I was at rock bottom, pressed her stethoscope to my chest, reminding me that I was alive when I didn’t want to be, and coached me through my insecurities. She followed me into a dark cocoon of despair without ever doubting that I would emerge as a beautiful, bold butterfly with my wings spread wide.

My voice wavers with uncertainty, as I briefly crawl back into the cocoon. “Can I tell them the truth?”

I don’t need to elaborate. I hear her sharp inhale, desperately followed by a deflating exhale. I sit with the silence, replaying the day I received the offer. The beat my heart skipped when an email arrived at 10:13 am. Subject line: MD Program Interview Invitation. My shaking hands and short-lived excitement as it dawned on me that I had only two weeks to prepare. Two weeks to unravel my story, sift through the messy middle, cut and paste the memories into a comprehensive journey, and edit out the parts that don’t meet admission criteria. Two weeks to determine whether our medical system is ready to look past labels — to see all of me.

“That’s a good question,” she says.

She’s buying herself time, trying to piece together how to explain that my story is not the story they want to hear. She’s grasping for something, anything, to reassure me of what I know: that it’s not my fault.

“I want to say yes, but …”

There’s always a “but” — an excuse for why we jump over the cracks, rather than seal them.

“I know,” I reply.

I know that people associate mental illness with weakness and instability. I’ve had nurses tell me that I’m looking for attention and doctors banish me from hospitals, claiming that I was a lost cause and that I’ve cost the system too much money. I’ve been poked and prodded without a sense of humanity. I’ve had IV lines, nasogastric tubes, surgeries and stitches mercilessly threaded through me without so much as a pause to make eye contact. I was diminished to a number, defined by a label, and stripped of my dignity.

“Am I contributing to the stigma by saying that?” she asks.

I think of a previous doctor who took one look at my medical history and called the police. The way they arrived in bulletproof vests, surrounded the building, and marched me into a cruiser without seeing the person — the child, sibling, friend, student, advocate and leader — who stood in the shadow of the diagnoses.

I’m tired of fighting to be seen, screaming for my voice to be heard, and needing to justify my rights. I take the easy way out. I say “No,” reassuring my doctor that she’s not contributing to the stigma and letting those two letters sweep reality away. I want to scream YES, but I feel two-faced because I know that, on interview day, I too will contribute to and sustain the stigma.

I will pull my sleeves down to cover the scars that mark my resilience. When I’m asked why I want to be a doctor, I will glaze over my past and simply say that I was sick as a child. I will let them write their own story, creating a protagonist who fights cancer or slays the dragons of diabetes. When they ask me why I’m such an avid mental-health advocate, I will say that I had family members who struggled with their mental health. I will edit my story for the interview, cutting out four years of my life.

I will spread my wings — daring them to ask me to fly — but never tell the truth about how I learned to crawl.

Footnotes

• This article has been peer reviewed.
• Editor’s note: The physician in this piece is a composite inspired by many different, actual encounters: all identifying traits having been carefully removed or modified.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/