The first chapter of “How Things Work” details the mechanics in a doorknob. What lays hidden and confined in the door panel is a complex system that produced a simple action. Hearing my father read this to me at the age of six was the onset of my scientific curiosity and eventually my passion for the complex systems found in medicine. I eventually became fascinated by the work of intensivists who vigilantly maintain homeostasis within the human body, a complex system in and of itself. Therefore, I find myself especially drawn to the field of critical care and intensive care medicine. My dream to become an intensivist would be highly complimented by a residency in surgery.

In critical care, each patient in the ICU is usually in a general state of shock, and the patient’s condition can be further complicated by comorbidities and chronic diseases that may require further intensive medical intervention. This dynamic nature of the ICU does not characterize every unit of the hospital and the high level of acuity does not suit everyone. As someone who enjoys the high energy of the engaging and exciting environment offered by the ICU, I am personally energized by managing patients with surgically altered physiology coupled with comorbidities. There is an overwhelming satisfaction when, after days of being bedridden following a bilateral lung transplant, a patient gets up from his bed and walks through the unit, or the moment we can discontinue the lines we had the patient on and finally talk to them after two weeks of intubation and sedation. There are also days when ICU throws you into an emotional seesaw of going from a successful patient case to a room in which a family has just decided that comfort care is the best way to proceed. However, these experiences serve not to discourage, but to motivate me to embed myself deeper in this environment to serve the members of my community in their most vulnerable moments.

Though I have always been a strong communicator, my rotation in the ICU has illuminated how foundational it is to the work of an intensivist, which has made me appreciate this field even more. I saw that, whether assessing a patient’s condition, discussing surgical procedures with physicians in the OR, or relaying postoperative information to family members, effective communication must be carried out in a fast-paced environment to quickly engender physician-patient trust, convey empathy and professionalism, and prevent perioperative complications. I demonstrated my ability to achieve this during my clerkship at [removed identifier] where I often acted as the communication bridge between surgeons in the OR and patients or their family members. I was able to synthesize technical information regarding operative procedures in a concise but easily digestible way while easing the anxieties of those undergoing the surgery. It was incredibly humbling to receive tokens of appreciation from our patients, thanking me for the small contributions I made to their care. I therefore look forward to completing my surgical residency, which would allow me to continue my training and thrive in this environment that I have come to love.

Having studied medicine in Europe, I have also had a high level of exposure to diversity of thought, particularly conceptions about healthcare. In [removed identifier], people of all socioeconomic statuses feel comfortable visiting a physician and obtaining treatments for a broad spectrum of ailments due to the countries excellently structured system. This has to lead to an outstanding environment to study medicine and to see textbook presentations of various pathologies and their management in socially and ethnically varied populations. Studying medicine in two languages has additionally taught me that medicine is a language; the way a patient presents, conveys themselves, and the findings of the physical examination all represent the syntax of the diagnosis. As a result, I am now acutely aware that patient care and relief of patient suffering transcends the grammatical rules of the patient’s native tongue, and I am committed to maintaining this attitude when I treat patients from different backgrounds, particularly those who are marginalized. My clinical experience in [removed identifier] will aid me in providing equitable and thoughtful care to my future patients.

I am now ready to leave my home of the last four years and come back to the United States to enter the next stage of my life and career. I am excited to work harder than ever, to prove myself to my future residency program and most importantly, acquire the knowledge and skills so that I may be a suitable candidate for a future fellowship program in critical care. My experiences abroad have constantly pushed me to new horizons and encouraged responsibilities that I don’t believe I would otherwise have. I’ve developed a new level of human connection through my work in the ICU, the OR, and my travels throughout Europe. These experiences will aid me in working with a diverse patient population and physician team. I look forward to the prospect of serving the critically ill in a challenging yet rewarding environment.

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