It was day two of a national cheerleading competition in Atlantic City, NJ and my team was in second place entering the finals. My knee was throbbing from a bad sprain I suffered the day before but hid from my parents and coaches. Since there was no alternate to take my place, benching me meant the team had no chance of winning. I ran onstage for the longest two-and-a half minutes of my life to perform a challenging routine where I had to lift a girl my weight over my head, throw her into a full up, and catch her. As soon as the music ended, I collapsed into a teammate’s arms. We didn’t win, but we came close. That mental and physical toughness defined me until I realized that it was both a strength and a blind spot. I’ve always been a “tough cookie”. When something went wrong, I would calmly assess how to fix it, do what was needed, and move on. That perseverance served me well through high school. But college exposed me to people feeling pain in a way I had not imagined. For me, pain was a physical attribute that came from knee injuries, wrist sprains, and muscle soreness from overdoing a workout. Now I was faced with two people I loved who were in more pain than I could imagine: invisible pain that eats away at you over time, affecting your relationships and well-being. My freshman roommate and I had dinner together every night and each time she ate nothing but a few cucumbers and beets. I noticed her normally slender frame dwindle to 90 pounds. The more weight she lost, the more people praised her. I struggled with what to do. Should I get involved? Finally, I initiated a conversation where we discussed the anxiety she felt about her appearance. I told her about the counseling center at UMiami where professional therapists and psychologists are adept at helping students overcome eating disorders and other mental health struggles. But my roommate was afraid to go. Over the coming weeks, together we made three attempts to visit the counseling center and she bailed each time. Finally, one day she walked into our dorm room with a big smile and announced that she had gone on her own. She told me about the help she was getting and thanked me. Two years later she is maintaining a healthy lifestyle, and I became a COPE Peer Educator. COPE is an organization where we help bridge the gap between the student body and the counseling center, educating students on different mental health issues and the resources that are available to them. When I returned home on break, I was awakened by our landline ringing loudly in the middle of the night. My uncle had attempted suicide and was in the hospital. As my dad ran out of the house, I thought about my cousins who were my age. I could not fully understand what they were going through, but I knew I had to let them know that I was there for them. Recalling my psychology classes, I reassured them they had nothing to do with their dad’s situation, and that it was important not to blame him for his actions. It was probably the toughest conversation I have ever had in my life. It also inspired me to earn a minor in psychology. And then I learned about the pain people feel when their loved ones are sick, but they don’t know how to get help. As a part of my experience in the Health Professions Mentoring Program (HPM), I shadowed physicians at Jackson Memorial Hospital, rotating across specialties. It was an eye-opening experience. Miami has one of the highest poverty rates in the US, in contrast to the luxurious resorts lining its beaches. I saw a three year-old child with early onset of childhood diabetes. He weighed over 100 pounds and was nearly taken away from his anguished mother because of the family’s lack of nutritional education and beliefs. In this family’s culture, obesity was a sign of prosperity and the grandmother was secretly overfeeding the child. Fortunately we were able to counsel the family on proper nutrition and the negative health effects of obesity, sending the child home. Over the last three years, I learned that it is just as important to help resolve mental pain and anxiety as the physical issues. I discovered that listening to uncover the real “Whys”, not just from a clinical perspective can make a significant difference in a person’s outcome. Why is a young adult starving herself? Why does a man in mid-life want to kill himself? Why does a mother not take proper care of her child? My experiences have fueled my interest in shaping a more impactful way of practicing medicine that helps to alleviate both physical and mental pain. One where physicians really listen and address all the “Whys”. How can we be successful in medicine without exploring culture, education, socio-economic factors, and the influences of family and friends? I also know the challenges: insurance rules, time limits, HIPAA. But I am optimistic that there are things we can do even if it's just taking an extra moment to ask tough questions and have real conversations with people to uncover their hidden pains. The pivotal difference in medicine is often in the small, quiet moments, not the big ones.

After “retiring” from competitive cheerleading several years ago, I began a journey to return to peak physical condition by delving into the study of nutrition and fitness. I have researched various diets, their effects on the body, and for whom they may or may not work. I have analyzed many forms of exercise: cycling, running, HIIT, weight lifting, and cross fit to see how each feels and the ways these regimens impact the body. I have studied macronutrients, muscle recomposition, and hypertrophy. I also consider the science behind the balance of carbs, fats, and protein, and how everything from stress to sleep intersect to affect outcomes. My gym time each day has become my “me time” and is how I release stress. But educating hundreds of people on nutrition and exercise through my Instagram page is also important to me. I provide healthy recipes that I have tested and sample workouts. I am passionate about sharing my findings because there are many myths in the fitness and diet culture world that can be harmful. It is rewarding when people tell me I have inspired them to begin their own health and wellness journey. The COVID-19 pandemic spotlighted the importance of ensuring patients have a good baseline of physical health. People who had pre-existing conditions suffered the most from this virus, with a higher rate of death. And even though as a country we have made amazing advances in medicine, we also have increasingly higher rates of obesity, cancer, diabetes and heart disease. Essentially, people are sicker than ever before. The medical profession has gotten really good at treating illnesses, but not as good at preventing them. As a future doctor, I recognize that we must assume more responsibility for proactively educating patients about maintaining good health. People are complex, multi-dimensional and do not always “follow the textbook”. Physicians must listen to their patients as a whole being and read between the lines. Medical students would benefit from learning how to really listen to people instead of analyzing them like a book. Physicians struggle to have impactful conversations with their overweight/obese patients, or people at risk of developing type 2 diabetes, regarding the need for proper nutrition and exercise. To be effective, they need to sharpen their interpersonal and listening skills. I also believe that it is imperative to foster a common commitment to delivering healthcare with empathy, compassion, and respect. Future physicians must be aware of the social determinants and inequities that impact a patient’s access to, and quality of care. This was reinforced when I shadowed at Jackson Memorial in Miami, a city where 20% of its population live below the poverty line, exposing me to unfathomable situations. I learned firsthand the challenges of treating a patient with mental illness, disadvantaged social determinants, and an extremely rare medical condition all at once. I saw a three year old boy weighing 100 pounds that was almost removed from his family. I shadowed at an urgent care facility serving a large population of recent Central and South American immigrants who needed a safety net. I have experience helping find solutions for people who lack insurance (I was a Patient Navigator at Jackson) and know there are many resources that can help disadvantaged patients, but they don’t know they exist.

My freshman roommate and I had dinner together every night and each time she ate nothing but a few cucumbers and beets. I struggled with what to do. Should I get involved? I initiated a conversation where we discussed the anxiety she felt about her appearance. I told her about the counseling center at UMiami where therapists and psychologists are adept at helping students overcome eating disorders and other mental health struggles. Together we made three attempts to visit the counseling center and she bailed each time. Finally, one day she walked into our dorm room with a big smile and announced that she had gone on her own. She told me about the help she was getting and thanked me. Two years later she is maintaining a healthy lifestyle, and I became a COPE Peer Educator. COPE is an organization where we help bridge the gap between the student body and the counseling center, educating students on different mental health issues and the resources that are available to them. When I returned home on break, I was awakened by our landline ringing loudly in the middle of the night. My uncle had attempted suicide and was in the hospital. As my dad ran out of the house, I thought about my cousins who were my age. I could not fully understand what they were going through, but I knew I had to let them know that I was there for them. Recalling my psychology classes, I reassured them they had nothing to do with their dad’s situation, and that it was important not to blame him for his actions. It was probably the toughest conversation I have ever had in my life. It also inspired me to earn a minor in psychology. And then I learned about the pain people feel when their loved ones are sick, but they don’t know how to get help. I shadowed physicians at Jackson Memorial Hospital, rotating across specialties. It was an eye-opening experience. I saw a three year-old child with early onset of childhood diabetes. He weighed over 100 pounds and was nearly taken away from his anguished mother because of the family’s lack of nutritional education and beliefs. In this family’s culture, obesity was a sign of prosperity and the grandmother was secretly overfeeding the child. Fortunately we were able to counsel the family on proper nutrition and the negative health effects of obesity, sending the child home. Over the last three years, I learned that it is just as important to help resolve mental pain and anxiety as the physical issues. I discovered that listening to uncover the real “Whys”, not just from a clinical perspective can make a significant difference in a person’s outcome. Why is a young adult starving herself? Why does a man in mid-life want to kill himself? Why does a mother not take proper care of her child? My experiences have fueled my interest in shaping a more impactful way of practicing medicine that helps to alleviate both physical and mental pain. One where physicians really listen and address all the “Whys”. How can we be successful in medicine without exploring culture, education, socio-economic factors, and the influences of family and friends? I also know the challenges: insurance rules, time limits, HIPAA. But I am optimistic that there are things we can do even if it's just taking an extra moment to ask tough questions and have real conversations with people to uncover their hidden pains. The pivotal difference in medicine is often in the small, quiet moments, not the big ones.