White Coat Reflections - Class of 2022

WHITE COAT REFLECTIONS

Class of 2022

for students,
by students

Growing
Sheri Li, MS1
Featured on the cover

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Between these pages are a collection of reflections on the first ten weeks of medi-
cal school contributed by first year medical students in the Class of 2022 and a few

of their professors at the University of Maryland School of Medicine.
This booklet represents our continued effort to create an inclusive outlet of expres-
sion tying together the intimate experiences of our students, faculty, and families.

Everyone in the Class of 2022 was invited to submit a piece.
We hope you enjoy them.

Congratulations on this milestone!
The Creative HeArts team

University of Maryland School of Medicine
Michael Sikorski, GS1

Zahur Fatima Sallman, MS3
Kathryn Champ, MS2
Molly Himmelrich, MS2
Saachi Nangia, MS2
Christine Server, MS2
Lucy Wang, MS2
Anna Gorman, MS1
Dahlia Kronfli, MS1
Amrita Sarkar, MS1

A special thank you to Dr. Sandra Quezada for your endless inspiration and support and
Mark Brodsky for your hours spent helping put together this booklet.

White Coat Reflections ◆ 2018

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Reflections on a White Coat, Dr. Devang Patel ........................................................................................................ 3
Anatomy Lab: Day 1 of 39, Cole Bailey ................................................................................................................. 4
From the First Weekend, Mary A. Melati .................................................................................................................. 5
Hands, Anonymous .................................................................................................................................................... 6
To Be Enough, Dahlia Kronfli ................................................................................................................................... 7
Big Ballers, Justin Kung ............................................................................................................................................ 8
Unanswered Questions, Aline Desmarais ................................................................................................................ 9
A Day in the Lab, Katie McGlone ............................................................................................................................ 10
A Simple Reminder, Stephen Jan .............................................................................................................................. 11
Perspective, Rachel Orlinsky .................................................................................................................................. 12
"The Checklist...", Dr. Adam Puche ...................................................................................................................... 13
Wet Practical, Claire Morton ................................................................................................................................... 14
Stop and Enjoy the Sunrise!, Anonymous ............................................................................................................... 15
Corny, Devika Agrawal .......................................................................................................................................... 16
Again, Anonymous ................................................................................................................................................... 17
Roses are Red, Anonymous ...................................................................................................................................... 17
Portraits of the Zygomaticus Major M., Elizabeth Olsen ....................................................................................... 18
On Sympathy, Patrick An ...................................................................................................................................... 22
Anatomical Studies: Part I, Katie McGlone .............................................................................................................. 23
UNLESS, Erica Jane Makar ................................................................................................................................. 24
Anatomical Studies: Part II, Katie McGlone ........................................................................................................ 25
Structure Music, Brian Lin ..................................................................................................................................... 26
Anatomical Studies: Part III, Katie McGlone .......................................................................................................... 27
Warnings, Anna Gorman .......................................................................................................................................... 28
Holding a Heart, Anonymous ................................................................................................................................... 29
First Exam Sketches, Caroline Benzel .................................................................................................................... 30
Anatomical Studies: Part IV, Katie McGlone ....................................................................................................... 31
Two Hands: Two Worlds, Dr. David Gens ........................................................................................................... 32
To Our First Patient, Thank You, Lavanya Garnepudi ......................................................................................... 33
Wilfred Grenfell, Dr. David Pumplin ..................................................................................................................... 34
Aptitude Does Not Equal Apathy, Jonathon Popham ............................................................................................ 35
These Breaths are Just the Beginning, Jennifer Drechsler ..................................................................................... 36
It is Bittersweet to Leave, Gaia Cicerchia ............................................................................................................... 37
The Heart in my Hands, Nita Danai Gombakomba ................................................................................................. 38
Untitled, Dr. Diana LaPasha ................................................................................................................................... 39

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Reflections on a White Coat
Dr. Devang Patel, Faculty

Ten years ago, I was an Infectious Diseases fellow working in a small mission hospital in rural Malawi. Because
of my interest in Global Health, I had the great fortune of spending many months of my training at this hospital
with my mentor Dr. Athanase Kiromera, the finest clinician I have ever met. As I made my way to the hospital
one morning, Athanase requested that I go on an outreach trip to some of the distant villages to provide pallia-
tive care for patients too sick to make it to the hospital. Accompanying me would be Alexander, an energetic
young nurse who ran the palliative care program for the hospital.
The next morning I was dressed in my finest “going into the bush” clothes. Knowing that I was going to spend
hours on a motorcycle on dusty roads, I had prepared myself by wearing an old brown T-shirt and cargo pants.
As I presented myself to Athanase, he gave me a look and said, “you look different.” It was a loaded comment
meant to make me question my choice of attire. At that moment, Alexander appeared on his motorcycle impec-
cably dressed in his starched white nurse’s uniform. He seemed unconcerned about what the red dirt would do
to his clothes. I looked at Athanse, sheepishly grabbed my white coat, and crumpled it into the bottom of my
backpack along with some medical supplies.
After two hours of riding through the bush praying the whole time that there would be no need for that non-
existent trauma center, we arrived at a small solitary mud hut that looked no different than the countless others
we had passed along the way. Outside we were greeted by a woman who looked at me with much skepticism.
She quickly spoke to Alexander in Chichewa - the only thing I understood was mazungu (white man). She was
not pleased with this particular mazungu and I quickly dismissed my initial instinct to explain to her that I was
in fact not a white man.
I realized in that moment, that I could easily be mistaken for a Peace Corps volunteer or a grubby backpacker in
Europe or any number of other things, but certainly not a doctor…and she was looking for a doctor.
I quickly put on my wrinkled white coat and draped my stethoscope around my neck so I could look even more
“doctorly”. Her face softened a bit and she led us into her home. Inside, we saw a man lying on a straw mat on
a dirt floor clearly in distress, his abdomen protruding due to the cancer that had destroyed his liver.
His breaths were fast and shallow unable to fills his lungs because of the fluid in his abdomen pushing up on his
diaphragm. In his wife’s eyes I could see a plea for help and yet I was paralyzed thinking, “Where am I and what
am I doing here?”
 
I asked myself “What would Kiromera do?” I quickly went to work using a urinary catheter, medical tape, IV
catheters and whatever else I could find to McGuyver a paracentesis kit to drain the fluid. Over the next hour,
I sat on that floor in my white coat watching his breathing become more comfortable – sweat dripping off my
brow in a race to keep up with the fluid dripping out of his abdomen.
He began to speak. He and his wife told us about their life, about their son, about the grandchild they were ex-
pecting – grateful to have a little more time waiting for his son to arrive. I knew I had not changed the eventual
trajectory of his disease, but I will always cherish that hour I spent with him and his wife – an hour that was only
available to me because of my white coat.

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Anatomy Lab: Day 1 of 39
Cole Bailey, MS1

160 student doctors line up outside the Anatomy Before the first dissection begins the body must
Lab be flipped over
A scrub sea of black, blue, green, tan, and pink The task proves difficult regardless of the habitus
Mixed feelings of apprehension and excitement of the cadaver
beam With the back exposed we prepare to make the
Catecholamine release into the bloodstream first incision
This scene is just another medical student meme Only to realize the scalpel blade is on backwards,
The doors open and the sea scatters to form 35 not ideal for precision
dissection teams Hallelujah for our knowledgeable preceptors and
Formaldehyde quickly overwhelms our olfactory their supervision
systems At last we begin reflecting the layers of the skin to
Unfamiliar yet distinct, the smell is not as nause- examine a world unknown
ating as it is made out to be Our first encounter, the superficial back muscles
Conversation fades as the unwrapping of the and some infinite substance called fascia
cadaver proceeds Each anatomical structure located precisely
Our very first patient, although deceased, is be- where the dissection manual said it should be
ginning to feel very real to me Two hours and eight skin flaps later everyone’s
A damp blanket covers the stiff body prolonging already certain they can be MDs
our first patient encounter I head for the exit doors naively thinking “anato-
The smell intensifies as the cadaver is exposed my lab is going to be a breeze…”
from neck to phalange
Garb hides the face, yet we sense the deceased
rests peacefully unclothed
Gratitude for this person’s gracious gift to benefit
our medical education and growth
No matter the patient we commit to always up-
hold the Hippocratic Oath

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From the First Weekend
Mary A. Melati, MS1

This drawing was the best way I made sense of that first week of anatomy lab when I couldn't
put my feelings into words yet. I was challenged when I first cut into my cadaver, masked
and lying on a metal table. It seemed cold and colorless. But I also felt deep gratitude and
profound humility to learn more and more about the amazing human body from my first

patient. Every day I was left speechless from his gift of knowledge to us. That was something
I could not see right away, but only in reflection through this drawing.
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Hands Medical school student…
Faint smell of the formaldehyde,
Anonymous, MS1 snap of the nitrile gloves, double-glov-
ing today
A baby… Walking to the anatomy table, pause.
Small hands with such flawless skin, A cadaver…
reaching out and grabbing, refusing to let go. Tough skin, so many wrinkles, cold to the
A toddler… touch,
Messy hands, so different, yet so similar
paint all over palms, all to make a present for because hidden within her hands is a story
Mother’s Day. of who she is, what she accomplished, and
Elementary school student… who or what she holds dear
Sticky, gluey fingers, A person
struggling to put together a poster for science who decided to donate her body to aid in our
class. growth as medical students.
Middle school student… Thank You.
Calluses on the fingertips of left hand,
but no shame, second chair viola for the or-
chestra concert.
High school student…
Hands slightly sweating, blister forming on
hand from hours of practice,
tight grip on racquet, step onto the court, all
the hard work leading up to this point.
College student…
Fumbling with the petri dishes and pipettes
as a freshman,
a pro by senior year.

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To Be Enough
Dahlia Kronfli, MS1

I said goodbye to the friends I had not seen for a while and walked down a familiar path.
I sat on a bench next to a five-tier fountain and looked around me.
I thought about the hundreds of times I had walked (or ran, late as usual) across these sidewalks. I saw myself in
the places I had reconnected with friends along the lawn. I saw myself leaving the library during the middle of
the night during a rough semester. I saw myself with so much self-doubt, wondering if I was good enough, smart
enough, or talented enough. I felt very lost then. I did not know what I wanted or who I wanted to be.
I watched undergraduate students sitting, chatting, and relaxing on the mall as I once had. I wondered if they
knew who they wanted to be yet, either.
It felt strangely emotional, sitting on this bench I had never thought to pause at, walking along these paths,
looking at that old familiar library, but now as a medical student. I had always been so preoccupied with looking
forward, worrying about how much I had left to go, that I had forgotten to pause and look at how far I had come.
Now, five years later, I am feeling much of the same thoughts I had as a college freshman. But this time, I know
I am enough for whatever comes next.
“Excuse me,” a student interrupted my thoughts. “Would you mind taking a picture of us?”
Their chapter here was just beginning. Mine had ended. But the best has yet to come, and it was my time to go.

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Big Ballers
Justin Kung, MS1

Whether it's playing basketball, eating
Potbelly, or spending time in the cadaver
lab, we're always a squad.

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Unanswered Questions
Aline Desmarais, MS1

We're advised not to think about our friends and family when we think of patients; it makes it too painful if they
don't make it.
But when I looked at our first patient, all I could think of was what it would be like if we took off that cloth and
saw someone we knew – a grandmother, grandfather.
Looking down at you, our first patient, I wondered what you would say if you could see us.
Would you be thrilled that you are living on in our memories, that your body will forever be ingrained in our
minds?
That we will eventually use what we learned from you to help other people?
Did your family want this for you too?
What thoughts were running through your mind when you decided to donate your body to medicine?
“Well I won’t need it anymore! Someone else should be able to use it.”
“These kids don’t know what they’re getting into! They won’t believe it when they see ‘X’ anomaly.”
“I hope they’ll learn from me the way I once learned from someone else…I hope I can continue teaching…I
hope…”
Did you know any of the secrets that we would find?
Would you have liked to know that you have an excellent phrenic nerve, or incredibly rare vasculature?
Did you know we would be exposing your most intimate parts and putting them on display?
Did you think of us as another kind of doctor, doing another kind of procedure – making that intimacy some-
thing familiar to you? That the pieces of yourself that you shared with us were “drops in the bucket” compared to
what you showed your doctors throughout your lifetime?
That the truly intimate parts of you could only come from talking with you?
Did we see everything you wanted us to see?
What expressions would your facial muscles be etching onto your skin right now?
Maybe a slight curve of your lip, maybe the raise of an eyebrow at a nearby family member?
What could your eyes and mouth have told us that they no longer can?
I hope we received your last message well.

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A Day in the Lab
Katie McGlone, MS1

White Coat Reflections ◆ 2018

A Simple Reminder 11
Stephen Jan, MS1

My first experience with death came when I was 13 years old. It was the beginning of the summer when
one day my mother had difficulty breathing and was rushed to the hospital. “It’s okay, Stevie. Everything will be
all right,” my mother said as she held me tighter. No one was sure of what was going on at the time, yet she was
surprisingly optimistic. Moments later, her physician came into the room. They suspected that my mother had
cancer and explained the next steps in diagnosing and treating her.
I remember going to bed that night feeling anxious, but I thought hey, maybe everything will be all right.
As I drifted off to sleep, I imagined the next few months ahead of us. I knew it would be difficult, but I held onto
the belief that my mother would get through this and that one day she’d be annoyed that we think of her as one
big miracle.
When I woke up the next morning, I found my father and sister sitting in silence in the living room. At
that moment, I knew my mother was gone. Within two days, my mother went from watching Scrubs at night
with me to being admitted to the hospital and taking her last breath.
Curious and confused, I sifted through the pages of her Autopsy Report, hoping to find some answers.

1. Lungs with:
a. Acute pulmonary embolus with blood clot filling the main right pulmonary artery with extension into
the right middle and lower lobar pulmonary arteries.
2. Probable Primary Lung Carcinoma with:
a. Metastases to the left ovary, liver, bilateral adrenal glands, right middle and lower lobes, and left
upper and lower lobes of the bilateral lungs, right kidney, mediastinal and right hilar lymph nodes and
the thoracic spine.
b. Metastatic carcinoma to the cervical and lumbar spine, sacrum, pelvis, and multiple left ribs.
3. Infiltrating ductal carcinoma of the left breast.
4. Benign uterine leiomyomas.

Immediate cause of death: Acute pulmonary embolism
Main disease: Carcinomatosis


I had no idea what these words meant. Frustrated, I put the report back into its envelope. I wanted to
learn all about the anatomy, how her disease occurred, treatments for her disease, etc. hoping it would bring me
some closure. That’s when I knew I wanted to pursue Medicine.
Fast-forward almost a decade, it’s two days before our first Anatomy Exam. Tired, hangry, and wondering
why I willingly made studying into a full-time job, I’m standing in the Anatomy Lab running through the check-
list. Erector Spinae? Check. Coronary arteries? Check. Lungs?
I look down. In my hand is our Donor’s right lung and that’s when it hit me. I rushed home and read
through my mother’s Autopsy Report for the first time in years. Metastases to the left upper and lower lobes of
the bilateral lungs? Check. Infiltrating ductal carcinoma of the left breast? Check.
I was finally able to understand the anatomy behind her disease. I had waited years for this moment, but
I was so tired and blinded by getting a good grade that I lost sight of why I was even here. I even started to resent
learning.
Although there’s still a long way to go before fully deciphering this 14-page report, it’s a reminder of why
we started this journey in the first place. As classes pick up, it’s only natural to feel stressed, but it’s also encourag-
ing to remind ourselves that the knowledge we’re gaining now will be essential to helping improve others’ lives.
I’m grateful for the opportunity to study Medicine and, more importantly, I’m grateful to be here, learning how
to help people.

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Perspective
Rachel Orlinsky, MS1

So far in med school, I've learned you have to try to keep balance and perspective, as hard as that may be.
If you don't focus on studying and learning how to be the best future physician, you'll fail med school.
However, if you focus solely on studying and never notice the beauty around you, you'll fail at living life.
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"The Checklist..."
Dr. Adam Puche, Faculty

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Wet Practical
Claire Morton, MS1

Beep. Step forward, bend towards the table, glance at the ceiling to think, look back, scribble fast
bracing against your forearm. Beep. Step forward, crane your neck, look at the floor, thinking,
readjust your clipboard, jot down an answer, don’t forget n., a., v., L, or R. Beep. Step forward.
Pause.
Beep. Walk up to another person (remember that they’re a person) then begin. Try to decode
what their body is showing you and what the instructors are trying to get you to see. All these
layers of communication, from what the patient gives, the instructor highlights, and you inter-
pret. It’s a conversation, a dance even in that tense interaction between three distinct individuals
all headed towards the same direction, landing on a common word. Beep. Step forward. How did
she get to be here? Who’s waiting on him when we’re finished learning his secrets? What made
her decide to do this? What made him trust us? What were they like? What do we call this small
piece of the arm that they wrapped around their children? The hand that they held with their
spouse? The heart whose beating kept them company from before they were born? Beep. Step
forward. Pause.
The pauses are the best part. In the pauses, you can look around the room at everyone else doing
this strange dance. Maybe even catch a glimpse of friends making eye contact, offering small
signs of support. Maybe watching as someone smiles to themselves after finally finding the right
answer buried in some recess of their brain. Each rapid scribbling against a clipboard is hours
upon hours of study, after years and years of dedication, backed up by a network of support;
there is a cosmos of factors that came together to bring each person to this room, at this time, to
make those scribbles on that sheet. Check your own sheet, looking again for the n., a., v.’s, and
take a deep breath of that formaldehyde tinged air. You can only take it as it comes, one minute
at a time. Beep.

White Coat Reflections ◆ 2018

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Stop and Enjoy the Sunrise!
Anonymous, MS1

The further I gaze,
The more I ponder.
What was hidden in the pines?
If only I looked closer!
The closer I look,
The less I see clearer.
What lies beyond the mountains?
Maybe I should gaze further.

White Coat Reflections ◆ 2018

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Corny

Devika Agrawal, MS1

It was my first time seeing corn today.
Fresh, clean air has never felt crisper and sunshine has never looked so
Good, basking over pumpkin lined hills and golden barrels of hay.
I never thought I would find friends so fast.
But they are as excited as me to breathe the air, watch the corn, marvel at the bees.
Octobers are usually my favorite.
I like watching the leaves, like fallen stars furiously blushing
scarlet, clay orange, banana yellow.
They fall from trees like swimmers diving deep
Into pools of crippling melancholy.
Also, I was born in October.
I never realized stalks of corn would be so large.
I lose sight of the pastel colored pumpkins as we enter the maze.
As it turns colder, I feel my reddened knees dizzy with elation.
My friends are laughing, talking about the difference between cow corn and people corn.
I thought it was all the same.
I can sense the cosmos swimming sleepless
among the muddy baskets of leaves.
I am brimming with honey covered thoughts,
Lost, confused, but finally at ease.

White Coat Reflections ◆ 2018

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Again

Anonymous, MS1

Again I leave anatomy lab,
Feeling defeated.
But tomorrow
Is a new day,

And I will try again

Roses are Red
Anonymous, MS1

Roses are red
We thank our donors for treating us so well
Cadavers taught us everything
Except that mitochondria is the powerhouse of the cell

White Coat Reflections ◆ 2018

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portraits of the
zygomaticus major m.

flexed by the class of 2022
at the university of maryland school of medicine

captured by
elizabeth olson

White Coat Reflections ◆ 2018

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White Coat Reflections ◆ 2018

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On Sympathy
Patrick An, MS1

I’ll be honest. It’s very easy to feel apathetic towards a nameless cadaver when you willingly eviscerate its body
week by week and then throw away its vital organs in the garbage at the end of the block.
Of course, when those who aren’t in the medical field ask me about my experiences in the cadaver lab, I tell them
what they expect to hear. I rhapsodize about how grateful I am to the nonagenarian on my table for teaching me
the human anatomy, about how throughout these 10 weeks, I have developed a bond with my cadaver, and often
imagine with care of what her life might have been like and if we could have related on certain things.
These are not lies, but sometimes I contemplate if the emotional impact I tell others that my cadaver has made on
me is nothing more than the product of my pretending. I can’t help but feel a bit disingenuous when I talk with
such fondness and intimacy about a person whose only truth I know is that she is the cadaver on table two who
died of cardiopulmonary arrest at the age of 94.
My course instructors discourage referring to our donors this way and rightfully so because it suggests a disre-
spectful ignorance of their humanity. But throughout these 10 weeks I have wondered if it is right to fabricate
someone’s humanity during times when information is unavailable just for the sake of appearing respectful or
sympathetic.
Sympathy and respect must come from an intimate understanding of the other. Sometimes achieving this level
understanding, to no fault of our own, is impossible, either through a complete absence of information in the
case of our cadavers, or through differences in life experiences. The complexity of the human condition will nec-
essarily produce encounters when the pain or challenges of a patient is incomprehensible to us. This is fine. We
must sometimes concede our inability to understand and connect with human beings instead of pretending that
we do, because if we ignore our limitations, we expose ourselves to contrivance, distrust, and burnout. We ex-
pose ourselves to just feeling sorry for people without enacting substantial impact, or worse, we fill in the blanks
with our own assumptions and projections that betrays the entire being of our patient.
My preceptor once mentioned, with no hint of bravado, that he paid the five-dollar co-pay that his patient
couldn’t afford to spend on filling her prescription. At first I was confused by what compelled him to do some-
thing so out of the ordinary. But now I understand what had compelled him was nothing more than the beating
of his own heart, and that this is sympathy in its truest form, born from trust, respect, and a genuine understand-
ing of his patient’s condition, the kind of sympathy that goes beyond posturing and leads to results.
I’m not ashamed to admit that I didn’t feel anything emotionally profound while dissecting my cadaver. She was
simply someone who I did not have the privilege to know as a person and any speculation of her real life would
have been abstraction. What she did leave me however was her physical body which has provided me with the
knowledge I can use to better understand and benefit my future patients. And that is a beautiful thing.

White Coat Reflections ◆ 2018

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Anatomical Studies: Part I
Katie McGlone, MS1
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her extension of stratified non-keratinized squamous epithelium
connecting her fused paramesonephric ducts to the environment
is more than a birth canal;
she is a doctor in training
gathering pebbles and shells from the shores of this body
of water
ingraining what the lectures taught her
UN|LESS arranging the knowledge methodically
she’s reviewing periodically integrating it logically

until she can apply it independently
she sings loudly and unapologetically
Erica Jane Makar, MS1 Adele, P!nk, and of course Whitney

but as if on key
she deepens her voice during your office hours
because of the day in class you told her not to use that “girl voice”
yes, it’s her choice
to wear running shorts some days and others, clogs with a sharp business top
but is it a choice
to avoid the locker room where the residents’
unsolicited comments on her appearance
hang like a red letter A clouding her M.D. confidence
now she’s M.A.D.
with an anger that drives her to memorize
but her eyes keep returning to one textbook structure
carefully drawn between her thighs but
not on you
Do men really not have pubic hair?
plus, hers is all wrong
it’s thin, light, neatly trimmed, only covering white skin
while her own natural 3B hair tumbles out of her crown refusing to be
sexualized for your demographic
but objectified is today’s aesthetic
or is it just a
“joke”?

Did you notice her exasperation when you asked whether she’s going into
OB/GYN or PEDS?

Did you realize your limited assumption denies her monumental potential in
every other field?

Do you feel the discomfort in her smile acknowledging that her attending just
told her she’s cute and should find a nice boyfriend?

Will you listen to her when she’s interrupted at the conference?
Will you hear her assuring and explaining and persuading that she’s already

there when patients ask to see the “real doctor”?
Will you notice her work just as hard but earn 8% less?

Unless.
you are that attending
you are that resident
you are that textbook
you are the default, unless
we create a safe and respectful environment for women in medicine.

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Anatomical Studies: Part II
Katie McGlone, MS1
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Structure Music
Brian Lin, MS1

Her left recurrent laryngeal nerve branches off from her vagus nerve, loops under the arch of her aorta,
and continues superiorly to innervate the muscles of her larynx. The structure is burned into our memory, but
we’ll never know the voice that it produced. Our donors’ bodies confuse us with anatomy while our own bodies
confuse us with moral ambiguity. The joy of finally learning medicine after years of preparation. The guilt of
remembering that this is not a textbook, this is a person.
My lab group and I have nicknamed her Edith. It sounds better than “the cadaver by the gloves” or “the
body on Table 7”. To clarify, we haven’t named her Edith. She already has a name; we just don’t know it, so we
gave her a nickname. All we know is her cause of death, that she lived until she was 100 years old, and that she
donated her body to help educate the next generation of physicians. We do our best to not waste her generosity.
We examine her lungs and her heart. Ribs provide bony protection for these organs, but Edith’s ribs are so brittle
they are barely bone. Sometimes I wonder whether giving her a nickname was the right decision. On the up side,
it makes her seem more human. On the down side, it makes her seem more human.
We need hints to remind us that we are human too. Mine arrives inside a box. The excessive layers of tape
sealing the edges indicate that my parents sent this package. Inside I find a pile of pears with each fruit wrapped
in its own paper towel blanket, my mom’s method of ensuring none of them bruised during the long flight over.
Because my hands are dirty, I keep the paper towel draped around one half of a pear as I bite into the other side.
My nose grazes the paper towel and notices the slightest odor. I follow the scent to its origin.
Food stains engrave the old tablecloth. 10-year-old Brian sits down at his designated spot, where the
stains are most concentrated. His mom has prepared his favorite dish: ribs marinated in soy sauce and garlic. He
makes quick work of them and builds a structure with the residual bones. The blueprint is faulty; 5 bones tall
with no base to support. His structure can hardly discover its own voice before falling apart. 10-year-old Brian
wonders what structures he could create with all the marinated ribs he will eat in his lifetime.
24-year-old Brian wonders what structures 100-year-old Edith created with all the marinated ribs she ate
in her lifetime. He imagines a strong foundation beneath an ensemble of bones. The structures reverberate with
a voice that must be hers. Their song is a recollection of the eponymous character. Their song is called _______.
10-year-old Brian floats in the fragrance of marinated ribs. The scent enters his nostrils and finds a haven
somewhere in his mind. It stays hidden for years until his mom cooks his favorite food again, thousands of miles
away. A newborn aroma saturates the kitchen and weaves itself into the fabric of a paper towel roll. It clings onto
these fibers as it travels across the country with its fruit companion. Only when my nose brushes against it does
the remaining wisp loosen its grasp. The particles enter my body and follow a trail left by their ancestors long ago.
White and grey matter translate their input into the music of structures, a genre for 10-year-olds, 24-year-olds
and 100-year-olds.

White Coat Reflections ◆ 2018

28 Warnings
Anna Gorman, MS1

From the time I first realized medicine would be my life, I began to get warnings. From doctors, from family
members, from guidance counselors and other students; even from people whose knowledge of medicine came
from little more than their own visits to the doctor and marathons of Grey’s Anatomy. I was warned about the
workload, the challenges of treating various patient populations, the risk of stress and burnout, and the inev-
itable lack of sleep. I was even warned about friends and family who would call at random hours with trivial
medical questions.
About anatomy lab in particular, I had heard a lot. Second year students, so recently where I was, were always
happy to pass down various tips and tricks. Even doctors thirty years separated from their own time in medical
school had memories to share, fond or otherwise, preserved with unshakeable clarity.
Unsettling though this steady barrage of cautionary words could be at times, I did my best to embrace the
warnings. I thought that if I could collect enough pieces of advice, I could string them together into a successful
medical school experience, starting with anatomy.
So when I arrived in the lab on our first day, clad in new scrubs and eager to get started, I thought I knew what
to expect. It didn’t take me long, however, to realize that no words of warning could have prepared me for the
reality of the experience.
Because when we unzipped that pristine white body bag, it was not a collection of anatomical structures waiting
for us inside, not a list of terms to be mastered and remembered with the proper strategies. On that table was a
person, a human being, whose final act had been to give me the most personal gift anyone possibly can.
It was her wish to be our teacher, for her body to be the most valuable learning tool we would ever have. The
selfless generosity of such an act was staggering, and I was determined to appreciate it to the fullest.
But when my teammate made the first cut, I found myself hovering back. As skin was parted and muscle ex-
posed, my head grew lighter and my stomach churned. I tried to take deep breaths, to avert my gaze. Yet wher-
ever I turned, the same scene was playing out at another table.
A few minutes later, I was sitting on the floor outside the lab, head pressed against my knees.
No one had warned me about this. No one had coached me through what it would feel like to be the one who
couldn’t handle it, who abandoned her team. I felt weak and ungrateful, an impostor. My very future in medicine
seemed called into question.
I didn’t have long to wallow in these thoughts. Less than five minutes went by before one of my teammates came
to check on me. Instead of the judgments and doubts I was heaping upon myself, she extended me nothing but
kindness and understanding. With her support, I returned to the lab, where I was welcomed back at my table
with the same warmth and empathy.
Ten weeks later, I am at peace with the knowledge that we have made the most of our donor’s gift. Each day
brought with it new challenges, and each of these I got through because of the brilliant, genuine, funny, kind
people on my team. If they are the future of medicine, then the world has one less thing to worry about.
Someday soon, I will be another source of advice for the students who will come after me. Even now, understand-
ing the futility of describing the indescribable, I know what I will say: no amount of warnings or advice can get
you through medical school alone. And guess what? You are never alone.

White Coat Reflections ◆ 2018

29

Holding a Heart

Anonymous, MS1

“Let the young know they will never find a more interesting, more instructive book than the patient himself.” –
Giorgio Baglivi

The first time I held our donor’s heart in my hands, I was flooded with an array of realizations. I was holding an
amazing machine, one that allowed our patient to do, speak, and experience for the better part of a century. This
organ may have allowed him to be a soldier, a husband, a father, and a grandfather, among many other things.
His reality was just as rich and full as any of ours, the type of life experience that everyone deserves to have. I

was reminded of why I chose this path in the first place.
White Coat Reflections ◆ 2018

27

Anatomical Studies: Part III
Katie McGlone, MS1
White Coat Reflections ◆ 2018

30

First Exam Sketches
Caroline Benzel, MS1
White Coat Reflections ◆ 2018

31

Anatomical Studies: Part IV
Katie McGlone, MS1

White Coat Reflections ◆ 2018

32

Two Hands: Two Worlds
Dr. David Gens, Faculty

I had “that moment again” this year in Gross Anatomy.
Last year, I noticed the bright red nail polish on her toes and that struck me: was she expecting a special
visitor the day she died. What were her thoughts? Did she expect that day was going to be her last?

Last week in gross dissection, while working on the upper arm muscles, a student was grasping the large,
perfect, undissected left hand, while abducting the arm for us. We were all totally engrossed in the arm
muscles.
Then, I happened to look over my shoulder at the student’s hand holding the cadaver’s hand:
The way I would hold a dying trauma patient’s hand before being anesthetized for emergency surgery:
A lifeless hand, marble white from blood loss, barely alive;
And mine, very alive in a blue shiny glove, hoping to give life back.
And now I saw
Her hand: petite, gloved in shiny, metallic dark blue latex.
His hand: large, gray but fingers perfectly normal looking: fingernails, knuckles with normal skin creases,
fingers naturally curled as if purposefully holding the student’s hand.
The color contrast: dark shiny metallic blue fingers curled in the palm of a dull, gray hand. Made it seem
for a brief moment as if his hand were alive.
It caught me: the two hands together, for a second looking so much alive, but then so very far away from
life. So far apart.
Two hands, Two worlds.

White Coat Reflections ◆ 2018

33

To our first patient, thank you.
Our role as future physicians is to heal, nurture, and build relations with our patients.
Oddly enough, we begin our first endeavor towards that journey doing the exact opposite. For
ten weeks, 100+ hours, we cut, dissect, reflect, retract. We compartmentalize our checklist. Wash,
rinse, repeat. What innervates the biceps brachii muscle? The musculocutaneous nerve. The in-

ternal thoracic artery is a branch of what? The subclavian.
Upon closer introspection however, I see beauty in the process. While superficially we are dis-
secting, internally we are understanding, gaining a new appreciation for the human build a net-
work of peers and confidants. We grow a unique appreciation and respect for those who have

donated their body to science.
When we had to hold our patients' hand in supine position to be able to better dissect the arm, I
found my gloved hands slip into hers. While her hands showed age, her nails were painted a deep
and lively red. On the contrary, the science was black and white. But it was instances such as this
one that served as a daily reminder that our patient was a complex individual who had hopes,
dreams, wishes, and loved ones. She was a 98-year old woman who had lived an entire life full of

experiences. She was a reminder that life is so much more complex than science.
As a future physician, I imagine that my patients will teach me a lot, about medicine, life, and
myself. In this first step of my journey- my first patient has most definitely taught me so much.

For that, I will be forever grateful.

To our first patient, thank you.
Lavanya Garnepudi, MS1
White Coat Reflections ◆ 2018

34

Wilfred Grenfell
Dr. David Pumplin, Faculty

This past summer, my wife and I spent two weeks on a tour of Newfoundland in Canada. In the far northern
town of St. Anthony, we visited a museum commemorating the life of Sir Wilfred Grenfell. I’d like to share a
couple of “take-home lessons” from that visit with the class. At the age of 16, Grenfell had still not determined on
a course in life. His father suggested he talk to a local doctor who, during the interview, spoke of the functions of
the human body and showed him a pickled brain. He said, “I was filled with entirely new emotions. I had never
thought of man’s body as a machine.” The body’s physical functions fascinated him, and he entered the London
Hospital Medical School in 1883, at the age of 18. Five years later, he qualified as a physician and surgeon. In
1892, Grenfell was a medical missionary with the Royal National Mission to Deep Sea fishermen. He visited
northern Newfoundland and coastal Labrador to investigate reports of inadequate medical services for New-
foundland migratory fishing crews and local residents. Seeing an urgent need to provide improved health care,
Grenfell returned in 1893 with two nurses and two doctors, determined to establish a system of medical care.
They set up small hospitals in two villages along the Labrador coast and secured a hospital ship which undertook
summer visits. Eventually Grenfell and his associates became involved in promoting social and economic devel-
opment for both the aboriginal people and new settlers in the isolated region. The hospitals he established are
the basis of the medical system of Newfoundland today. In honor of his service, Grenfell was knighted in 1927.
The following is attributed to him, although it cannot be found in any of his books: “The service we render to
others is really the rent we pay for our room on this earth. The purpose of this world is not ‘to have and to hold’
but ‘to give and serve’. There can be no other meaning.”

White Coat Reflections ◆ 2018

35

Aptitude Does Not Equal Apathy
Jonathan Popham, MS1

Walking in to lab on Friday, Oct 12th, excited for an as-relaxing-as-possible post-exam weekend ahead, I lament-
ed with my group over a fantastic 56-step procedure for dissection of the anterior forearm and hand. We fol-
lowed the normal pre-dissection grumble: Scroll through the first few steps, make comments to the group beside
us--“You see how long this one is? No chance we’re out by noon”—and begrudgingly prepare the scalpels while
complaining that our current accumulation of hemostats (easily 6 pairs) was still inadequate for our needs. This
day, though, was among the first I took a chance to reflect on how far we’d come in nearly 7 weeks of intensive
study coupled with an amazingly intimate view of the human body.
“Do you guys remember when we took 2 hours to reflect the skin of the back on the first day?” I asked my group.
“Just the skin!”
They poured out a litany of replies: “I wish we could go back to that!” and “how could we ever be so slow?” I
agreed; the day prior, we took just over 2 minutes to remove most skin from the posterior forearm and hand. In
under 2 hours, we then finished a summary of most every nerve, artery, vein, and bone in the posterior compart-
ment of the forearm and the dorsal hand. We barely took notice of the growing speed with which we progressed
through lab. Suddenly, laying out how incredibly different lab had become, the juxtaposition felt more fitting as
the plot of a horror movie than a true story about the education of a medical student.
Had we become callous to the nature of dissection? Had we chosen to ignore what we were doing? Was the extra
time we took on day one a reflection of our sensitivity or our inadequacy?
Of course I let myself ruminate over these questions—even worry I was, in the words of Paul Kalanithi (reflecting
on cadaver dissection), “transform[ing from] the somber, respectful student into the callous, arrogant doctor.”
Looking around the room, though, I saw no arrogant faces, no hardened individuals, no futures clouded by mal-
content for patients. I saw very tired, very kind peers I am proud to call my classmates. I saw people engage in a
simultaneously awe-inspiring and strange experience together, cooperating and laughing and learning.
In brief moments, we might feel callous and we might feel tired. We might feel like abandoning the branches of
the maxillary artery, which we can all certainly agree do not exist. We might feel, with our increased acumen for
dissection and the incredible array of skills we’ve accumulated, that we have lost the delicacy we once used in
making our first cuts.
Let us remind ourselves that with our aptitude will not come apathy. Let us learn from those that donated them-
selves to be our first patients how to treat our future patients. The workload is incredible; the job is demanding;
the tasks placed on our shoulders will only bear more weight. But, with our increased skills and knowledge will
never come impassivity toward our patients. The abilities we learn and the knowledge we obtain will mean only
that we are more able to help our patients in their times of need. Let us remind ourselves that our donors were
the first to teach us this lesson—that every skill we acquire will be used in an effort to heal. No matter our skills,
our knowledge, or our stature, our calling will forever be to care.

White Coat Reflections ◆ 2018

36

It’s amazing to think that without being taught or told, we are innately able to breathe. In, out, in, out, without
even thinking about it. Before we could even walk or talk, we would just breathe.
Look at where we are now. We have finally made it to medical school. The place we only dreamt about is now
our reality. We stand in anatomy lab, we take a moment of silence for the cadavers who so kindly donated
themselves to our educational pursuits, and we breathe.
We begin anatomy lectures. And together as a class, we breathe in all the information.
As we begin to learn more material, and have more concepts to condense, we each try to keep up. We realize
that this information will eventually lead us to save a life. And with this reality, we sometimes struggle to catch
our breath.
But we continue on with our medical education. We take our first anatomy exam. And then we start again. The
rush of information, the exciting knowledge, the effort to keep up, all while trying our best to just breathe.
Throughout this 10-week journey, I have seen so many class members adapt to the stresses of medical school.
Whether that be studying individually or in a group, taking time to run, sing, or dance, or spending time with
family and friends, we all figure out how to breathe just a little more easily.
We have come into medical school as successful, strong, intelligent human beings, and we have been pushed
and challenged to do our very best. We began this journey wondering how we could do it all. But over time, we
have learned to take advantage of this opportunity and to breathe it all in.
Each one of us has accomplished so much. In receiving our white coats, we can truly look back at how much
we have grown in 10 weeks and look forward to how much we will continue to grow.
But in this moment, this white coat moment, we can all remember that the most important part of this journey
is being proud we took the time to breathe it in, because these breaths are just the beginning.

aTBrheegeJsiunesnBtirntehgaeths

Jennifer Drechsler, MS1

White Coat Reflections ◆ 2018

37

It is Bittersweet to Leave
Gaia Cicerchia, MS1

How to express my gratitude?
To you who let me see your heart...
To those with whom I shared this start...
I can simply say thank you.
To my first patient and teacher...
I can only imagine how it will be...
to apply what you taught me.
I will never forget it, just wait and see!
And to table twenty-eight, forever my first teammates...
I extend a thanks to thee.
For our shared laughter and purpose,
impatience and days that left us wordless,
we made it...can you believe?
It's been a long ten weeks...
Full beyond belief...
of nervous excitement
and phrenetic enlightenment,
and it is bittersweet to leave.

White Coat Reflections ◆ 2018

38

The Heart In My Hands
Nita Danai Gombakomba, MS1

The heart in my hands
I remember the first time I held you in the lab. The exhilarating feeling will never escape me. Looking back,
what you represent is beyond just completing a checklist.
You represent opportunity. My younger Zimbabwean self couldn’t have dreamed that I would be learning all
your ins, outs, and arounds at a great university across the Atlantic Ocean.
You represent pride. The bright glow in the faces of my family and friends each time I talk about my experience
as a medical student is priceless.
You represent joy. However challenging, the moments with you in the lab will always be a reminder of how I
am indeed living my best life.
Above all, you represent gratitude. I couldn’t give God enough praise for what you’ve helped me learn. For the
new best friends that I’ve made that I couldn’t get through medical school without. For pushing me to do and
be better.
You, the heart in my hands, are truly the best thing that has ever happened to me.

White Coat Reflections ◆ 2018

39

Untitled

Dr. Diana LaPasha, Faculty

Dear Friends,
Congratulations on the awarding of your White Coat and your en-
trance into the Profession of Medicine! I am so proud of you and am
honored to be part of your journey.
With best wishes for a brilliant future,
Dr. LaPasha

White Coat Reflections ◆ 2018



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in any manner whatsoever without written permission from the publisher and authors of original works.

Published October 2018 • Printed in Maryland, USA

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