Shining a Light on the MCWFusion Curriculum

Welcome - Wendy Peltier, MD

Faculty voices
Navigators, LCs, and MCWFusion - Kurt Pfeifer, MD, FACP, SFHM, DFPM 
The Scalpel in My Pocket - Ashley Pavlic, MD, MA

 
Student voices
The Good Doctor: Combating Perfectionism - Molly Brennan 
The Good Doctor: Between Obligation and Wisdom - Song Kim 

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Welcome 

Wendy Peltier, MD

When you learn a little, you feel you know a lot. But when you learn a lot, you realize you know very little… if you can build a muscle, you can build a mindset.                                                                                                                               -Jay Shetty

This collection of essays shines a light on the unique offerings of The Good Doctor course and MCW Learning Communities, which launched last July. We invited two curricular leaders, Dr. Kurt Pfeifer, Director of Learning Communities, and Dr. Ashley Pavlic, Director of The Good Doctor course, to share their reflections on the curriculum’s first semester.  We also invited two M1 students, Molly Brennan, and Song Kim, to share their experiences with the new curriculum. 

I am so lucky to have a front-row seat to this evolution as a long-time faculty member who has seen several curricular redesigns (phases), and in my new role as a faculty Learning Community Navigator.

The Good Doctor course and MCW Learning Communities highlight important and evidence-based changes to the curriculum by moving us away from standard, lecture-style teaching methods to experiential, small-group learning formats that promote team-based learning, growth mindset, and discovery. The new curriculum development and evolution has included a shared mission of promoting Character, Caring and Excellence in Medical Education at MCW. 

As a faculty navigator, sitting with my group of eight students weekly in The Good Doctor course, change is palpable. This has been an opportunity for me to be close to day-to-day aspects of the curriculum that students experience, and close to this generation of new doctors as they explore concepts pivotal to personal growth and resilience in tandem with learning the basic science and core clinical foundation of medicine. 

As Dr. Pavlic so poignantly outlines in her essay, faculty navigators have commented that this type of teaching was not offered in our ‘era’ of medical training, and many of these important concepts were learned ‘on the fly’, perhaps using the ‘See one, do one, teach one’ model, as opposed to truly reviewing and practicing key skills before entering high-stakes clinical situations. There is an authentic sense of faculty and students learning together. Being part of this course reinforces my own growth mindset, as I become a PGY- 26! 

It has been a weekly reminder of the joy in learning and the power of connection. 

Wendy Peltier, MD, is an Associate Professor of Neurology and Medicine in the Division of Geriatric and Palliative Medicine at Medical College of Wisconsin. 

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Kurt Pfeifer: Navigators, Learning Communities, and the MCWFusion Curriculum

Kurt Pfeifer, MD, FACP, SFHM, DFPM

Dr. Pfeifer, director of MCW Learning Communities, shares his experiences and observations since the new MCWFusion curriculum launched in July 2023, creating small Learning Community cohorts of eight students each who progress together through all four years of medical school in sequential courses starting with The Good Doctor. These courses focus on character and both personal and professional development … 

What has surprised you the most?

Kurt Pfeifer, MD: While we anticipated that faculty navigators would serve a role in connecting students to resources at MCW, we thought of this as a more secondary goal. It clearly was one of the biggest early benefits. Students get so much information when they start that it's easy for them to miss an important piece of information or resource. Or sometimes, they just don't connect how a particular resource can help them. Navigators have provided frequent assistance in these matters that I don't think would happen without students having such a faculty connection. It was also surprising to see how strongly some groups bonded and dove deep into the challenging material of The Good Doctor course. So much so, that our plans for merging groups to make up for navigator absences had to be put aside because students didn't want to disrupt the rapport they had established within their groups of 8. 

What you are most grateful for? 

Kurt Pfeifer, MD: How invested the vast majority of students and navigators are in the content of The Good Doctor course, as well as the purpose of learning communities. We aren't even a semester in, and I've heard much feedback suggesting that learning communities have served a critical role in fostering student support of each other through the challenges of transitioning into medical school. Similarly, navigators have shared some inspiring stories of interactions they have had with their students and their students with each other. 

What has been most meaningful for you in the outcomes thus far? 

Kurt Pfeifer, MD: Since it is too early to have "harder" outcomes, I think the feedback above has been the most meaningful. Launching a new curriculum is daunting. Launching one with the unique focus on character and personal and professional development is even more challenging. I have been so impressed about how people have responded to this challenge by investing themselves in the process.  

Kurt Pfeifer, MD, FACP, SFHM, DFPM, is chief of the Section of Perioperative & Consulting Medicine and a Professor of General Internal Medicine at MCW. He created the MCW 4C program as a pilot project that served as a model for the Learning Communities of the new MCWFusion curriculum. 

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The Scalpel in My Pocket 

Ashley Pavlic, MD, MA 

Dr. Pavlic, director of The Good Doctor course, reflects on her journey to develop this offering in the new MCWFusion curriculum and her hopes for our new students as they participate…

What does directing The Good Doctor course – a new, required Phase 1 course on character and professional development – mean to me? A flood of thoughts comes to mind, but one memory stands out: 

I’m an emergency medicine intern. My attending and I are hurrying to a patient with severe angioedema. My attending hands me a scalpel and says, “Put this in your pocket, just in case.”  

I knew what that meant. If we needed to place a breathing tube but could not do it through the patient’s mouth, this would be the only tool I should need to open their neck to access their airway. All EM residents practice this procedure over and over on plastic models, cadavers, pig models. You don’t want to be in that situation and think, “Oh no, I wish I had seen this before, thought of this before, practiced this before.”  

And yet, so many life-altering moments in medicine are like that.  

In both medical school and practice, we are confronted with unexpected situations that demand an immediate response. How we respond can have profound consequences for our patients, our teams, and ourselves.  

During my general surgery rotation as an M3, I went in to check on a patient whose metastatic cancer was discovered during an operation the afternoon before. It was 5:30 AM, and she looked at me and said, “It’s cancer, isn’t it?” My thoughts began to race: Wait, she doesn’t know? No one told her? Do I tell her now? Would my team be upset if I did? How could I not? I wish I had thought about this before … 

Early in my residency, my team received a middle-aged woman in critical condition, transported by helicopter to our facility. She had decompensated en route; she died shortly after arrival. My attending asked me to update her family, who had also just arrived. As I walk into the room, the husband and teenage children were joking with each other. They paused and looked at me with half-smiles still on their faces. With a pit in my stomach, I realized death was not even on this family’s radar: What do I say? And how do I get this out without crying? I wish I had practiced this before … 

In late residency, case managers sometimes called us if they could not determine from available documentation whether a patient should be admitted under observation or inpatient status. During one extremely busy shift, a case manager called to ask me about a patient whose note I had not started. (In fact, I had not started notes on any patient.) I was condescending and rude. She became angry with me, and rightly so. As I hung up the phone, I was angry with myself: What kind of physician leadership was that? Who am I becoming? I wish I had reflected on who I want to be before …  

When I was an early attending, I had a patient who my entire team thought was faking an injury to get narcotics. I will never forget watching her struggling to leave the ED and thinking this does not seem right. I should stop this. While I deliberated, she was gone. I wished I had practiced going against the grain before I needed to do it. I did call the patient the next day to ask her to come back. I later found out she returned and was admitted, suddenly and unexpectedly got worse, and died within days. I will never forget her: If I had had the courage to change course, would she still be alive? ...

The Good Doctor is a new, mandatory Phase 1 course for all our medical students. It involves weekly meetings to discuss issues surrounding leadership, ethics, character development, well-being, and communication skills.  

Students are introduced to topics considered central to the life experience of a physician. They are then given the opportunity to practice in a psychologically safe space what they would do in hypothetical situations related to those topics. It’s been an incredible investment by MCW leadership, an investment with many hopes. 

The hope is we can examine who we are and who we want to be. We discuss our character strengths, those that physicians “ought” to have, and how to build ours. We dedicate time to talking through complex scenarios involving bias, personal beliefs, and truth-telling to promote practical wisdom. We practice leadership in our small groups, and the character that comes with respectfully disagreeing with each other. We dig into what it means to flourish and reflect on what a life of flourishing would look like.  

Not everyone thinks it’s a great course. It’s hard to start thinking about things that feel far away when a basic science exam is always looming.  

We continue to work on doing our best to make it feel more relevant. We continue to chip away at traditional lectures to maximize time in small groups. We continue to modify case scenarios to make them feel more concrete and real. But even with the “perfect” course, some students may not buy in. As I know well, we cannot help everyone who enters our department.    

• My hope is that my students feel better equipped than I was to navigate the many ways truth-telling manifests in medicine; that they learn the relevant laws and ethical codes, but also get to think through and practice what they would do when abruptly confronted with an unexpected scenario. 
• My hope is that my students have more tools than I had when resiliency was needed; that they have a jump start on developing a “hard back and soft front” when they want to run but their profession demands they stand and bear witness to profound human suffering. 
• My hope is my students have more time than I did to think about who they want to be – the type of physician and team leader, and how they want to treat others in times of great adversity. 
• My hope is my students have opportunity to develop their character through all the activities of the course, the uncomfortable situations they are put in, and the leadership that we ask of them.  

My hope is they don’t make the same mistakes that I made because there were not enough opportunities in advance to reflect, practice, or develop. 

Here’s a scalpel; keep it in your pocket. Just in case.  

Ashley Pavlic MD, MA, is an Assistant Professor in Emergency Medicine, and Director of the MCWFusion ‘The Good Doctor’ course.  In addition, she is Co-Director of the Bioethics and Humanities Pathway and Educational Co-Leader for the Division of Global and Population Health.  

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The Good Doctor: Combating Perfectionism 

A student's perspective

Molly Brennan 

A first-year medical student in The Good Doctor course--the first course of the new, four-year MCWFusion curriculum--reflects on unlearning perfectionism in the organic chemistry lab … 

Add Enough Magnesium 

Four-and-a-half hours into a four-hour lab, my organic chemistry professor told me to add magnesium to the flask. My lab partner and I were in the dregs of the protocol. The Wisconsin winter sun had set and everyone else had already left for dinner. 

“How much magnesium?” I asked. 

He shrugged. “Some.” 

My insides writhed. “What’s some?” 

He shrugged again. “I don’t know. Enough.” 

The edges of the metal scoop dug into my fingers. Enough? The wall clock ticked on oppressively. It was already so dark outside. My friends were eating dinner. I didn’t understand what I was doing wrong, or why my classmates moved seamlessly through the lab, adding an unspecified amount of magnesium without question, while I stared at the glassware in a state of frenzied hesitation. 

In that first year of undergrad, I was constantly stuck. Stuck between twin fears: making a mistake and not finishing. And they ate at each other, like Ouroboros, the snake from Greek mythology that eats its own tail. They were, in the end, the same snake—the same fear. An error was a flaw. Not finishing was failure. And how was I supposed to cope when those seemed to be my only options? That wasn’t how I got straight A’s in high school. I accomplished that by spending hours on labs, quadruple-checking tests, and asking questions constantly.  

Anything worth doing is worth doing well, was tattooed on my psyche.  

The word perfectionist was batted around, and I owned it. Perhaps for some, perfectionism was toxic, but for me, it was the only reason I was successful. And, although I couldn’t speak it yet, I was afraid of who I was without it. Some people, clearly, succeeded without perfectionism. But I—I wasn’t smart enough, diligent enough, or just plain good enough to be successful without perfectionism. 

And yet, it was also why I wasn’t finishing lab. Ouroboros. 

Enough, I thought, scooping the magnesium sulfate. What’s enough? 

Methanol amplifies the problem  

In the second term of organic chemistry, I got a new lab partner. 

She was wonderfully cavalier. She read a lab protocol once, maybe twice. After she measured, she poured, and didn’t wonder if she’d measured correctly. 

During one lab, I had to pour methanol into a flask that was positioned over a heating element. The methanol had to be poured carefully so that it didn’t ignite. I hesitated and looked at my lab partner. “Should I pour it?” 

She gave me a look. “Yeah, pour it.” 

I gripped the graduated cylinder. “I don’t want to pour it.” 

“Just pour it.” She took me very literally by the hand, and before I knew it, the methanol was in the flask. Nothing exploded. We poured the methanol and we lived. The lab carried on. And I began to realize that the perfectionism I clung to like a shield was not a shield at all, but a dead weight. It was an anchor of the worst possible kind, tethering me to old thought processes and habits, and not allowing me to move anywhere. 

It was hard to let go of the need to get perfect values and to simply move with the flow of a scientific lab, which is often, by its nature, messy, imperfect, and fluid. But I realized that perfectionism hinders performance in many situations, especially ones where time is of the essence. 

Pouring the methanol was not the start of the change, nor, certainly, the end of it, but it was a moment of transformation. (A few years after I graduated, I looked up my old lab partner on Facebook and laughed. It made complete sense that she had become a chemistry teacher.) 

One day, I finished lab an hour early—not because I had done well, but because our reaction failed so catastrophically that there was nothing more to do. My high school-self would have panicked. My college-self went to the cafeteria and ate a plate of chicken nuggets. 

Carbon breaks free 

My organic chemistry class was mostly pre-meds, much to the chagrin of my professor, who knew us to be twitchy students there only to collect A’s and, God forbid, B’s. 

In a bid to reach our GPA-addled brains, he explained two things: first, that carbon takes four bonds, except when it doesn’t. And second, that organic chemistry was less important for the content and more important for how it would change the way we thought—most especially, how it would make us work through uncertainty. 

I did re-learn how to think that year. Eventually, through trial and, most importantly, error, I came to understand that perfectionism was not a strength. It was paralysis and fear. It was a snake that could only be defeated by starting—by beginning the homework, by adding a vague amount of magnesium, and by pouring the methanol—and accepting whatever outcome amounted. 

I developed a new mantra: Anything worth doing is worth doing poorly.  

If it was worth anything at all, then it was worth a shaky beginning and even, perhaps, a subpar finish. It was better to do something incorrectly, to create something imperfect, and to be less-than-ideal, than to vacillate in fear in front of an audience of laboratory glassware. 

This new mantra carried me as I applied to medical school. When thoughts of delaying my application for yet another year began to surface, I reminded myself that it was worth applying, even though I could never be perfect.  

In my first few months of medical school, the course The Good Doctor challenged me to reflect on my history of perfectionism as well as my future. I realized all the ways in which my new mantra continues to support me as I move through this first year: taking tests I don’t feel ready for, answering questions when I am uncertain, and throwing myself into a deep end of new knowledge and new experiences. 

I have reflected, too, on my need to continue combating my perfectionistic tendencies as I edge closer toward patient care. I think perfectionism can make patient care difficult, slower, and could contribute to frustration between doctors and patients. For myself, I know that my fear of making a mistake could paralyze me in a critical moment, and it will be important that I continue to challenge myself so that I do not freeze up when action is necessary. Once, I would have been afraid that healing my perfectionism would have led to me becoming overly cavalier; now, I know that the goal is not to be flippant but to be clear-headed, and perfectionism is not necessary to being a careful and dutiful physician. 

Revisiting Magnesium  

I added too much magnesium, by the way, and it was rather difficult to remedy. I did not get full points for that lab. I did not get an A in Organic Chemistry. And none of it held me back, or ruined my dreams, or did any of the terrible things I once feared they would. Instead, I did many things. I did many of them poorly. And all of them were worth doing. 

Mary “Molly” Brennan is a first-year medical student at Medical College of Wisconsin-Milwaukee. She graduated from Lawrence University and is grateful for the many people there who helped her become a more confident learner. In her free time, she writes and crochets, most of it poorly. 

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The Good Doctor: Between Obligation and Wisdom 

A student's perspective

 Song Kim 

A first-year medical student reflects on the concept of flourishing as part of The Good Doctor course in the new MCWFusion curriculum...  

My friends from college have begun to suspect I haven’t been telling them the whole story of what being in medical school is like. The truth is, there are too many sentiments and far too few words to describe the experience.  

A new beginning  

I will always remember the day I was accepted to MCW. Hysterically screaming on the phone with my best friend--who had already received 14 acceptances of her own--I printed out my acceptance email, heart pounding while I counted down the seconds until my parents would get home. It would only hit me several hours later that I wasn’t going to have to move to Iowa anymore. I clicked the elusive Commit to Enroll button that had been beating me in a staring contest for the past eleven months. I was met with the very abrupt end to my seven-year-long, self-identification of being “pre-med.”  

Continuing to grow when we finally have what we’ve always wanted 

I think I can speak for many of my hand-picked classmates in our cohort of 265, when I say I believe from the bottom of my heart that medicine and I belong together. Medical students find deep comfort in knowing we have uncovered a career that will always lead us toward a deeper understanding of the human condition, toward more scientific knowledge, and toward more altruistic versions of ourselves. But when my best friend’s father was diagnosed with metastatic pancreatic adenocarcinoma in October, I found it difficult to grasp how much more I understand about the human body than I did just seven months ago. I’ve realized that while ignorance is bliss and knowledge is power, medicine walks the line between obligation and wisdom. I’m still not quite sure I will ever get used to everything I now know, or if I will ever know enough--I'll be a walking paradox for now.  

“But what have you been doing outside of school?”  

To be honest, not much. As I’m writing this, I’ve just left school at 10 p.m. on a Friday. I spent the last hour with three of my friends, reviewing musculoskeletal structures in anatomy lab before our exam in three days. We weren’t the only ones there; in fact, we saw the familiar faces of many of our classmates tonight. We exchanged waves, mnemonics, and jokingly questioned out loud what missteps we had taken to end up between the humidors under the moonlight while most of our friends from college would be out celebrating the beginning of a weekend. Together we find a sense of comfort in knowing we are still flourishing, learning, and bonding, in so many ways unbeknownst to most.  

Song Kim is a first-year medical student at the Medical College of Wisconsin-Milwaukee. She is an M1 Liaison for the Student Surgical Society and LGBTQ+ People in Medicine. 

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Matters of the Heart: Love, Actually

Welcome - Himanshu Agrawal, MBBS, DF-APA

Student voices

The Moment I Knew Our Stars Aligned - Wentrell Bing 

The Journey of Love as a Medical Student - Alec Hafferman

How We Know We Have Hearts - Meg Mercy 

Departure  - Ndidi Ojiako   

The Small Wonders - Jennifer Nehls 

The Perseverance of Love - Gabriella Swistara 

Two Poems - Michael Kofi Esson

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Welcome to Matters of the Heart: Love, Actually

Himanshu Agrawal, MBBS, DF-APA 

 As a psychoanalyst-in-training, I have been asked to offer my perspective on this collection of essays and poems – about how love has come to be associated with the heart, instead of the brain, to which we naturally assign all other emotions.  

 

I have been pondering on this thought-provoking query with the seriousness it requires, and here’s what I have come up with so far: 

As you breathe in and breathe out Wentrell’s essay – where, in your body, do you feel the longing it evokes? 

Now, take yourself on the journey Alec describes – navigating the demands of medical school as a loving spouse about to become a new father, unexpectedly hit with worries of pregnancy complications and a premature birth – what part of your body starts pounding with anxiety and fear? 

Allow Meg’s musings to settle in as a lump in your throat – in which direction do you find it settling, as it slides down? 

As the tears well up from witnessing Ndidi’s account, notice – they are welling up from somewhere below, not dripping down from a bony cage above. 

As Jennifer’s Cranberries mixtape brings alive her buzz within you, where do you feel that buzz? 

Gabriella takes you through a corridor of facts and figures and chooses to end with this: ‘I believe there will always be things about love that cannot be explained.’  

Thrill, once again, to Michael's poetry, this time in praise of his beloved. 

Where does that note hit, within you? Is it the brain? 

It’s somewhere in your thorax, isn’t it. Maybe it’s the thymus, or perhaps a referred sensation from a parathyroid gland? 

Is there not something about settling on the heart that just feels… right? 

I’m not certain how my cardiologist wife might feel about these ramblings. I do wish I could write poetry for her with Michael’s swoon-worthy talent!  

I hope you revel in this labor of love with all your heart. 

Himanshu Agrawal, MBBS, DF-APA, is an Associate Professor in the Department of Psychiatry and Behavioral Health at MCW and co-director of the psychiatry clerkship. 

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The Moment I Knew Our Stars Aligned 

Wentrell Bing 

Close your eyes. Take a deep breath. Think of your favorite person and how much they mean to you. Now, exhale…  

Did you smell that? The aromatic fragrance of love in the air. The calmness of security and happiness that swept you away as you focused on how good it felt to be in the moment with that person. Did it make you feel good or bring back any amazing memories and the hope for more? Ah, what a relief… What if every day could feel like that? The hustle and bustle of living in the mega society of medicine minimized at the presence of the one who makes you focus on the finer things of life. 

For much of life, I thought love was a fairy tale. Like seriously, what are the chances that you’ll find someone to make you happy enough that you forget to finish your manuscript? Let’s be serious here. The only real happiness comes from within. Then, out of nowhere, I met you and life as I knew it changed. My perspective of what it meant to be happy shifted from my studies to spending every minute with you. I wanted to give you the finest things in life. Well, there aren’t many other things in life finer than you. 

Gracious, I have this crazy gut feeling that I just cannot shake. Do I love you, this soon? How can you infiltrate my mind and cause a shift so drastic? What happened to me? YOU.  

Love isn’t a fairy tale. Love has no time limit or timeline. Love comes and goes as it pleases. One may even utter that it is like the seasons — it grows and decays like the leaves. Love brings a harmonious balance to our lives and challenges us to conquer our fears and be our best versions. It inspires generations and transcends cultures. Love does not have boundaries and creeps into our hearts when we least expect it. I once heard someone say, “when you thought it’ll never happen, is when love really happens.” That’s what happened when I saw you. You made my life seem like a movie, guy meets girl, and every day afterwards is like Brandy on Friday evening — it just feels right. 

But wait, wait, what if I’m not ready for that? What if I feel like love will never come my way? I can’t fall in love that fast. I need time. 

Ah ha, the pessimistic optimist. I was waiting for you. Were you always ready when things happened in your life? Surely, there are times when you didn’t think things would work out for you. How did you handle those things when they did? I challenge you to challenge yourself to look at love and life as two mutually inclusive threads of your being. Whether it’s the love you have for your friend or the love you have for that favorite, too small night shirt you should’ve thrown away years ago, you are capable of love and love has been with you since the moment you were born. Tragedy and heartbreak might have come, but you overcame it because you loved yourself enough to face the amazing new journeys of tomorrow. Then, each day, miraculously got easier and you healed and grew stronger. So don’t be discouraged by the lack of freedom in your schedule or absence of parental affection, love will come and make the changes feel like they should’ve always been there. We are human and we deserve grace. As life progresses, we learn how to love and be better at it.  

Now take another deep breath. Think back to last Christmas or last Valentine’s Day when you saw all those nice couple’s photo shoots. Don’t exhale just yet, listen to that small voice in your mind that says this would be nice someday. Let them come forward. That’s your reality. One day you will meet someone who sings your song and you guys seamlessly move to the beat of the same drum. May every day get better and better, and you become overwhelmed with peace in their presence. The hard times become a breeze and the smiles never fade. Oh, and the days, you’ll lose count because it will feel like you’ve known them forever. You are ready, you have made it this far. Trust yourself and allow love to guide you. 

You see the stars in the sky, they were made for you and me. May they soon align and radiate across the moonlight sky. 

Now, exhale. Quickly, I can’t have you passing out. I’m only 1/8th of a doctor. 

 

Wentrell Bing is a first-year medical student at Medical College of Wisconsin-Milwaukee. Born in Columbia, South Carolina, he earned his bachelor’s degree in biology as a pre-med student at North Carolina A&T State University. His motto: “Believe in yourself when no one else does because success is not measured by position, but rather by the obstacles you’ve had to overcome.” 

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The Journey of Love as a Medical Student

Alec Hafferman

Balancing medical school and a family is a journey. A second-year medical student shares how love and strong communication helped he and his wife through complications of pregnancy and premature birth...

I have heard from many that relationships and love can be tested as a medical student. My wife and I married right before medical school started and our relationship has strengthened me through the rigors of medical school. We have had a different journey than most and I hope to share some wisdom that can benefit other medical students in a loving relationship.

It was a calm, autumn day as I was transitioning to my second year of medical school. I had just finished summer clinicals and was heading into my second year of didactic learning. During a campus meeting to discuss how clinicals went for the class, my wife called. She was 22 weeks pregnant at the time, and I was looking forward to hearing how her day was at work but had to text her that I was in a meeting and would call as soon as it ended. She immediately called back, informing me she had been admitted to the hospital for high blood pressure, which was concerning for her and our baby. I had so many emotions in that moment: feeling overwhelmed with school, fear of the unknown, but, more than anything, I wanted to make sure my wife was safe. Little did I know this phone call would be just the beginning of a new chapter for our relationship. The continuous balancing act and routine I built as a loving partner for my wife and as a medical student was unexpectedly flipped upside down.

Thankfully, I was able to work with the faculty at Medical College of Wisconsin–Central Wisconsin and reschedule my commitments for a later date so I could go to the hospital. My wife and our unborn baby were doing well. She was discharged two days later and advised to be on bed rest. While she was on bed rest, I did as much as I could to help her through this difficult time both mentally and physically. After 10 days of bed rest, she had an appointment with her doctor and was abruptly admitted again. This time, she was admitted “indefinitely.” At this point in my medical school career, we were doing clinical and academic courses simultaneously. My wife and I were also enjoying the journey as a newly married couple, expecting our first child.

Our new home became her hospital room, and my new bed was the beloved “dad couch.” After a month of sleeping on the “dad couch,” I feel qualified to give it a 3 out of 10 for comfort. I struggled to see my wife go through the mental and physical pain she endured day after day, while I felt overwhelmed with didactic lectures mixed with STEP studying, volunteering as a football coach, and interspaced clinical rotations. I allowed these feelings to build because I didn’t want to burden her any more than she already was. As the weeks went by, I noticed I was worn down and not communicating well with her. My wife and I learned through this journey how important strong communication is to love and a successful relationship. We made it a point to be upfront with our feelings and set aside dedicated time to discuss our days. This created a deeper connection during one of the most difficult times we both have encountered.

At 30 weeks and 2 days gestation, our baby boy was born. It was a wild ride. During the delivery, I had a growing curiosity as a medical student, watching the process, along with an intense amount of adrenaline coursing through my circulation system. But I knew I needed to be a husband first. It was an eye-opening experience being on the patient side, as I have seen multiple deliveries as a student. After experiencing labor, I realized I had not previously understood or given the respect needed for the roller coaster of emotions that labor brings. Interestingly, right before our son was born, the hospital team had hoped my wife could carry our baby until he was 34 weeks. His placenta had decided otherwise. At this point, our lives felt like we were floating in the ocean just trying to overcome the waves that kept coming as the rigor of medical school continued.

Throughout this journey, I grew close to many faculty members and students at my Medical College of Wisconsin - Central Wisconsin campus who gave my family incredible support. I am someone who does not like to burden others for help but have learned “it takes a village.” Please do not feel you are burdening those around you when you need help!

I remember the night before a musculoskeletal exam, my wife was rushed to a delivery room because it looked as if our son would be born soon. I frantically emailed the coordinators, afraid of how they would respond. I was extremely thankful they understood my situation. My wife and I were blessed to have our family nearby and are so thankful for everything they did for us during this journey. As traumatic as the journey was, we grew closer, surrounded by supportive family and friends. Our son was in the NICU for 56 days, which was another trial for us, but we knew how to face each “high and low” as a team.

Now, our boy is healthy, growing so fast, and it is spectacular to see him learn something new every week. My wife and I overcame and learned so much about ourselves and each other through the last year; some may say too much at this point in our lives. All jokes aside, we have strengthened our relationship because we understand each other more deeply through improved communication and emotional intelligence. Our thoughts have such an impact on our overall wellbeing and ability to be there for others. This has allowed us to take every challenge life brings with grace, knowing we can overcome any obstacle in our new family’s way.


Alec Hafferman is a second-year medical student at Medical College of Wisconsin-Central Wisconsin in Wausau. He was raised in Edgar, in rural, Central Wisconsin. He has been enjoying taking walks outside in the spring with his family as well as watching basketball.

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How We Know We Have Hearts 

Meg Mercy 

The pain we are collectively experiencing by living through current events, while damaging, also ties us to the reality of being human – of experiencing the ironically ubiquitous “unnatural” pain of humanity – which is itself the natural domain of health workers… 

We are holding tight to a strange, bucking beast – clinging by our fingertips to the survival of medical school – memorizations of drug classes and genotype mutations, believing we are in the business of saving and improving lives, all while seeing from a distance the massive loss of life and unimaginable suffering occurring in Gaza since October of 2023 (just three months after M1s began their medical education).  

Psychic Trauma 

Psychic Trauma is felt most potently in today’s world through the influence of social media as purveyor of constant, up-to-date news. Photos and videos of loss of life and limb and loved ones are transmitted haphazardly between our searches for recipes, black tie gala outfits, and explanations of cardiac valvular dysfunction. We are regularly inundated – without warning – by stories of atrocities we can do nothing to alleviate. Each glimpse into the tragic and the unfixable impacts us in ways not immediately apparent or resolvable.  

Signs of Goodness 

The fact remains, however, that if we were to witness such great degrees of trauma and loss of life without being impacted – without it hindering our homework efforts and without questioning our usefulness and place on this earth – we would not be well-suited to the weighty role of “doctor.”  

As physicians, we should care as much as – if not more than – other people do about the preservation and quality of life for others. When considered through that lens, the amount of suffering, helplessness, anger, and grief that we feel is in direct correlation to how much we wish to protect and improve the well-being of others’ lives. 

Our Normal is Really Not 

The truth is that what we have been living through is not normal, nor should it be normalized. What we have witnessed – again and again in recent years – though it is beginning to feel common, should not be accepted as business-as-usual. If we are to help people – which can only be genuinely done by those who view all others as deserving of life, dignity, and safety – we must feel the pain of those who are hurting, who are without access to an empathetic physician, a willing pharmacist, a skilled surgeon, and a hospital under no threat of imminent attack.  

While we clearly are not suffering anywhere near as much as those at risk of family and community eradication, we – as humans – are suffering with them. And this is not metaphorical. It is the deep, psychic pain of humans who wish so badly to help, protect, and heal, simultaneously facing their inability to do so.  

 

When Suffering is Good 

So, are we doing okay? Probably not. Would it be better if we weren’t suffering? Probably not. This suffering means that we are human. We are part of the human collective – unseparated by city, country, state, or oceans of distance.  

We understand the value of life, and that is what will make us excellent physicians. That determination to not accept the intolerable, to fix that which seems unfixable, and to reach those who are currently unreachable. The anger, rage, grief, and helplessness we feel is the same force that will drive us to help the suffering we meet in our own communities and through our future outreach initiatives.  

 

To Be or Not to Be Okay 

So no, you shouldn’t be “feeling okay” – at least not always. While we may have times when we forget the trauma – diverted by fun or focus – we shouldn’t be feeling fine and unconflicted in the midst of the horrors our fellow humans are experiencing. Does it make it hard to devote ourselves to our work and confusing when we feel happy? Yes. Does our inability to help the suffering people and impact these events leave us feeling helpless and impotent? It does and should. 

But if we ever questioned it before, now we know that we have hearts – hearts for others and hearts for the world – because they’re breaking.  

 

Meg Mercy is a first-year medical student at Medical College of Wisconsin-Milwaukee. She is an anti-trauma advocate and educator, and an awardee of the Richard Ralph Winter Phoenix Rising Humanitarian Award. 

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Departure   

Ndidi Ojiako   

In this essay, Ndidi reflects on the nature of palliative care through the lens of her family and an unexpected death during a trip to Nigeria…   

 

As I disembarked the plane at the bustling Port Harcourt International airport on December 24, 2018, the smell of smoke and dust inundated my lungs. It was a sweltering day, and I, my five siblings under the age of 16, and parents had just completed an almost 24-hour trip to Nigeria. We were jet-lagged, hungry, and had gotten on each other’s last nerves as most families do during traveling.   

During the long drive from the airport to the village, my siblings were sound asleep, their bodies still in the early morning hours of Illinois. I was determined to beat the jet lag that left me scattered and confused on previous trips, so I stared out the window, bleary-eyed, taking in the familiar and yet unfamiliar scenes of my father’s village in Imo State.   

Once we finally got to the village, we stopped at my paternal grandfather’s house. After a long battle with cancer, including being flown back and forth between the states and Nigeria for expert healthcare, my grandmother had passed away in 2017, and my grandfather’s health had subsequently deteriorated. My dad had had heated conversations with his caretaker’s back home over the past year, making sure he was getting the best care he deserved, so we were all worried about his fragile health and what we would discover upon seeing him for the first time in years.    

He was lying on the warm, damp floor of the living room when we walked into his house. The moment she saw him, my mother, a board-certified Palliative care physician, immediately changed her demeanor. With no stethoscope, she gingerly placed her head on his chest to auscultate his fluid-filled lungs. Looking straight at my father, she told him in a calm tone that my grandfather would likely die within the next 24 hours. The only thing we could do was to make him feel comfortable.   

This was not the bubbly, vivacious mother I know, delivering those flat, methodical words. As she shared the prognosis with my father, the tone of her voice was one I had never heard before. It was a tone reserved for outside the house; a tone reserved for patients. It was not a tone for talking about her own father-in-law, whom she had known for over 20 years. I knew that my mother was a doctor, but never fully understood what her work entailed until that day – the way she could recognize death almost immediately was jarring to me.   

As they continued to examine him, my father tried to get him out of his sleepy-like state by speaking to him. My grandfather finally recognized his voice and spoke to him in Igbo with a gargled voice. They were both relieved to hear him speak, assuring him that they were here now and would take care of him.    

We took a very careful drive back to my father’s home village and laid my grandfather on a bed by the living room. It was my first time seeing my cousins in several years and this was how we were reunited: knees chafed from kneeling on hard tile, surrounding the guest bed of my sick grandfather, who laid in the bed almost serenely. My father brought in a priest to pray over my grandfather. As the priest prayed, we all avoided looking at each other, our hands clasped together, and eyes closed in silence.    

My grandfather died a few hours after we prayed over him. When my father told my mother, she immediately started wailing and screaming his name out loud, with such deep emotion as is custom in Nigerian culture. This was the mother I knew, not the one I saw in my grandfather’s house with those emotions tucked into a corner of her brain while speaking in an almost robotic voice.    

Years later, I now understand that with her physician’s voice came a soft understanding that – though it was hard to deal with – death would come knocking on our doors one day, and all we could do was try to go out with dignity. This was the way my mother showed her love: through honesty, through finality, through understanding. Her love was shown both in the finality of her prognosis and intensity of her wailing when my grandfather passed away.    

Ndidiamaka “Ndidi” Ojiako is a second-year medical student at Medical College of Wisconsin-Milwaukee. She graduated with a bachelor’s degree in integrative biology and a minor in creative writing from the University of Illinois at Urbana-Champaign. In her free time, she enjoys biking, knitting, and trying out new restaurants. 

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The Small Wonders 

 

Jennifer Nehls 

 

In the dead winter, a light they stole  

from a neon pizza sign filled me with a buzz, 

The music was their laughter,  

I tried to find lyrics to keep  

the song playing, 

Micro fires spurt in my chest as  

they held onto me, 

Captivating my straw house. 

Time leapt,  

skipped the little moments, 

the quiet moments 

My life burnt on vitality. 

Save the Cranberries mixtape 

The case blackened of ash, 

I examined my buckled house 

Tiptoed on my skin, the frost returned 

This is no time bound,  

it crawls on its knees, lingering. 

I met you on a forested hill in a valley, we strode through a river  

Tracy Chapman sang to us until my fast car died;  

I had a feeling that I belonged 

We lace together, I branch to you, from you, and you to me, from me. 

These are the moments of small wonder 

The caress of an orchestra’s strings amusing our ears 

Who composed this piece, can we add our notes, 

The trees bending around our swaying bodies 

Is the breeze too strong, might we dance the whole way home 

The catch of colorful light through the glass, illuminating our space 

Should we unearth others at a thrift store? Absolutely 

The peaceful silence between quiet breaths, 

Could we hold hands while we walk, always. 

Time moves graciously now. 

  

Jennifer Nehls is a first-year medical student at Medical College of Wisconsin-Green Bay. She grew up in Green Bay and earned her bachelor's and master's degrees in biology from Eastern Illinois University. Her interests include writing, film photography, and cycling; she hopes to write a novel and bike pack the Continental Divide one day.  

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The Perseverance of Love: An Exploration of the Oldest Human Emotion 

Gabriella Swistara 

What is love? It’s a simple question. Yet it brings with it a multitude of propositions. What makes us feel loved? Is love something which can be quantified? Does it serve a purpose? People have tried to understand the concept of love for a long time, and different cultures have varying beliefs on the subject.  

In Greek mythology, for example, the story goes that we are each only one half of a whole, but Zeus separated us out of jealousy and fear so that we are to spend our lives searching for our other half. In other words, it’s the origin of soulmates. In Arabic literature, the story of Layla and Majnun is one of heartbreak, longing, and passion – said to have potentially influenced Romeo and Juliet years later. Time and again, across region and religion writers return to partnership and love.  

Love is all around us – a study on the psychology of music found that 67% of musical lyrics since the 1960s have been about love. “Love” evokes different images for different people. I, for example, think first of my significant other and the exact spot we were when I first told him I loved him, wrapped in his arms late one night and watching the Dark Knight. I also think of my wonderful family and friends, my long-haired cat spread out on my yellow couch, and the place that I call home.  

One fact of love is that it has palpable consequences: sex, marriage, and childbearing. Under this lens, does love function solely as an evolutionary means to an end? Some chemicals in the brain to serve a purpose and help get us to an end result?   

When looking at the statistics of when Americans first fell in love (34.8% of women report falling in love before the age of 18), it made me think back on my own teenage relationship, which at the time I would have considered love. Looking back, I don’t think it was. It had none of the true hallmarks of love: care, trust, loyalty, closeness, or affection. But if you had asked 17-year-old-me if I was in love with my high school boyfriend, there would have been no doubt in my mind that the answer was yes. This raises the question: when do we ever really know that we are in love?  

I think that maybe there’s a problem with the way we have all evolved to use the term. That this feeling we have towards others – this undeniable, overwhelming affection and care – is true, but we’re not always able to label it correctly. And that sometimes, even when that overwhelming feeling is not there, we’re so eager to label it as “love” nonetheless.   

A study conducted in 2017 showed that, when asked to assess what made people feel the most loved, behavioral actions and gestures counted more than verbal affirmations. Perhaps the age-old saying is true: actions do speak louder than words. I am grateful every day for my partner and the small acts of kindness he gives me: making dinner while I study, taking out the trash, making me laugh over text, or giving me a back rub.  

I’m not sure that love could ever be quantified, or fully understood for that matter. I believe that it’s subjective. And although people might generally agree on what makes them feel loved (being held, hearing “I love you,” receiving gifts), the degree to which we allow the emotions of love to penetrate us vary from person to person and the meaning of the word differs.  

I believe there will always be things about love that cannot be explained. But there is no doubt in my mind that it is love which brings me comfort when I lay my head on my partner's chest, brings me excitement when his name flashes on my phone, and brings me joy when I see him smile. 

 

Gabriella Swistara is a first-year medical student at Medical College of Wisconsin-Milwaukee. She earned a bachelor’s degree in writing seminars and psychology, with a minor in visual arts, at Johns Hopkins University. She is a member of MCW's writing group, the Moving Pens.  

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Two Poems 

Michael Kofi Esson

Alliza

By Michael Kofi Esson 

“Hi, I’m Michael,” not one for stargazing— 
She pulls me close, whispers in my ear, “Alliza,” a spell, 
 Leaving me lost in a daze. 

A goddess enthroned, lightning and thunder bow— 
Angels ascend at the mere mention of her name, 
Descending from a kingdom by the sea, in her starry eyes there is no escape, 
 Claiming my mortal soul, she forever reigns. 

Angels high above, and demons down below conspire, 
A symphony of envy, echoing in a celestial choir, 
Mortal men fall at her feet—a battle ground for the soul of the irresistible Alliza, 
Time ticks and tocks, narrating tales of the mysterious Alliza, 
Morning fades into midnight, bringing me dreams of the beautiful Alliza. 
 
Whispers of wind sneaks through my window,  
Carrying secrets from the enchanting Alliza, 
Thoughts float like a gentle breeze over a field of dandelions—  
Captivated by the mesmerizing Alliza. 
 
Then, in the hush of midnight, a touch; a shower of emotions pours, 
My heart’s desire—to love and be loved by the breathtaking Alliza, 
In the electricity of our shared kiss, 
Dreams unfold like petals, a wish granted by my love—the mystical, 
Alliza. 

- - - - - - - - - - - - - - - -

Whispers of Midnight 

By Michael Kofi Esson 

 
I’d rather whisper your name as full moon looms, my darling, yet, a secret covered in mist, 

I’d rather taste the nectar of your lips, the sweetest verse in the poems off my lips, as if dipped in honey—your kiss, 

I’d rather be next to you, our heart whispers of secrets true: intertwined like two paper planes on a string, soaring higher and higher, a howl on a full moon, 

I’d rather be looking into your eyes, deep—beauty beyond bounds of heavens high and oceans orange, warm—a whisper of midnight’s bloom, 

 
I’d rather be holding you in a lovers embrace, under the covers of twinkling stars where God whispers of midnight’s breeze, 

I’d rather be thinking of you, your words—delivered on the wings of butterflies to my ears, Cupid’s arrow pierces, whispers that echo in midnight’s atmosphere, 

 
 
I’d rather be dreaming of you, a tapestry of colors woven with intricate desires—of a soul on fire, 

I’d rather whisper in your ears, like coins in a wishing well, “I love you, forever,” while angels sing in choir, 

 
I’d rather call you mine—the queen of my heart—serenaded by rising highs of violons ‘til the end of time,  

But when it comes to you: 

My love, 

My muse,  

My secret,  

My dream, 

My queen, 

My midnight,  

I’d rather love you for one more forever— 

Michael Kofi Esson is a third-year medical student at MCW- Milwaukee. He was born and raised in Ghana, and migrated to the U.S at the age of 13. Although he once pleaded with his parents to keep him out of school due to his initial struggles with the English language, he now proudly thanks his parents for rightfully ignoring his pleas. As a psychology and biology major, Michael was presented with an opportunity to study literature in D.C while earning his degree. He never looked back. 

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