Issue link: https://tmcpulse.uberflip.com/i/1010198
T M C » P U L S E | A U G U S T 2 0 1 8 26 W hat keeps me alive? High- calorie liquid nutrition—aka Nutren 2.0—running continuously through my feeding tube into my small intestine, and IV fluids run- ning through my port into my heart. I'm not your typical medical student. Beneath my white coat lives a patient. In 2011, as an undergraduate, I was diagnosed with Chiari mal- formation, a condition in which a portion of the cerebellum herniates out of the bottom of the skull and compresses the brain stem, and Syringomyelia, the development of a fluid-filled cyst within the spinal cord. Since then, I've undergone six major brain surgeries, multiple shunt surgeries, multiple feeding tube and port surgeries, as well as countless procedures and hospital- izations. Along the way I've been diagnosed with hydrocephalus (a buildup of cerebrospinal fluid in the brain), trigeminal neuralgia (a chronic pain condition that affects the fifth cranial nerve), adrenal insufficiency (a condition in which the adrenal glands do not pro- duce adequate amounts of steroid hormones), gastroparesis (partial paralysis of the stomach) and a teth- ered brain stem (in which the brain stem becomes pinned to the dura, or outer covering of the brain). On Feb. 6, 2017, my life was forever changed. I went into the operating room as one person and came out as another. Although I'm no stranger to brain surgery, this time was different. I underwent an experimental surgery to untether my brain stem, which had attached itself to the outer covering of my brain and was pulling some of the surrounding cranial nerves along with it. Because of this, my vision was compromised and I had lost nearly all muscle control in my pharynx and esopha- gus, making it extremely difficult to swallow. My body was deteriorating. After searching the literature, I found only a handful of patients who had undergone this surgery, and most of the cases didn't end well. With all odds against me, I agreed to this risky operation. As I awoke from surgery, the doctors and I quickly realized something was wrong. Although the surgery was successful, I had suffered a stroke to my brain stem during the operation, leaving me, initially, unable to function from the neck down. I couldn't sit up on my own, move to turn in bed, walk, bathe or dress myself. All I could do was lie in bed. My dream of becoming a doctor felt like it was shattering before me, once again, but I've never allowed my health to keep me from continu- ing my journey and I wasn't going to let it start now. • • • After a few weeks, I was trans- ferred to TIRR Memorial Hermann to undergo intense inpatient neurorehabilitation. Each day was filled with physical, speech and occupational therapy, among other activities. Every simple thing we do and take for granted in everyday life I had to relearn. Absolutely every- thing. When asked what my goal was, I always said, "I just want to be able to take care of patients and go back to school to become a doctor." I spent many months at TIRR Memorial Hermann, first working on gaining the strength to sit up unassisted and then slowly advanc- ing to standing on my own. The REX robotic exoskeleton was one of the devices that helped teach me how to walk again. The days were hard, long and, at times, frustrating, but every sensation and movement gained was rewarding. As a medical student, I still had tests to study for and assignments to complete. Initially, I couldn't operate my computer, write or even turn the pages in a book. When I could finally see clearly and listen, my mother placed ear buds in my ears and played lectures for me to watch. She typed my essays as I called out my thoughts, turned the pages in my books and wrote my notes. We started studying early—before my doctors came in to round and the long days of ther- apy began—or stayed up late after exhausting days. It was extremely Back to School When the medical student is also a patient A n e s s a y b y C l a u d i a M a r t i n e z Credit: Courtesy photo I'm here to represent and bring light to those in the medical profession who have a disability, who battle health issues, who have been underrepresented for far too long. As health care providers, we're not immune to illness. — CLAUDIA MARTINEZ Claudia Martinez is an ambassador for Fight Like a Warrior (fightlikeawarrior.org), an organization that unites people with chronic and/or invisible illnesses.