Nine years ago
Somebody shoot me now. Lisa fumbled blindly for her pager on the small table by the bed she lay on as it went off for the thousandth time it seemed. Weary did not begin to describe how she felt. She finally grabbed the pager and shut off the annoying beeping. She rubbed her eyes. Her 24-hour shift in the emergency room at Boston General Hospital had finally ended half an hour ago. She had come to the on-call resident’s room to catch a brief nap before driving home. Her eyes stung as she peered at the message displayed on the tiny screen. She had to blink a few times before she could make out the summons to the office of her residency program director. She groaned and got up. She stuffed her scrub top into her pants, slipped into her long white coat, and walked towards the elevator that would take her from the basement where the residents’ rooms were to the beautiful and modern fifth floor administrative offices.
“Come in, Lisa, take a seat.”
Lisa plopped into the chair across from Dr. Lehman, the emergency medicine residency program director. She heard him begin to speak but it was hard to make out his words through the fog of fatigue and the headache that had begun with her sixteenth hour of work. She wondered how he might react if she put her swollen feet up on his handsome executive desk. She giggled internally at the thought.
“I know you’re at the end of your shift so I won’t keep you.” Dr. Lehman leaned his forearms on his desk and interlocked his fingers. He wore a burgundy bowtie and light blue shirt under his pristine long white coat which had his name embroidered above the left breast pocket. Lisa thought this was unnecessary; everyone knew who Dr. Lehman was. He had pioneered a revolutionary treatment protocol for multi-drug-resistant tuberculosis and was frequently invited to share his expertise at hospitals all over the world. He looked at Lisa through kind eyes behind wire-rimmed glasses.
“As you know, halfway through the third year of residency is when we select a resident to stay on an extra year as chief resident.” He paused. “We’d like you to be next year’s chief resident.”
A myriad of thoughts went through Lisa’s mind but she was too tired to move her facial muscles to express or voice them.
Dr. Lehman continued. “The program faculty, myself included, selected you because you’ve demonstrated exceptional clinical and leadership skills. As chief, you would work closely with the program faculty as well as the residents to help us accomplish our program goals. This invariably leads to a faculty appointment after you graduate and is the start of a prestigious academic career.”
Still Lisa remained silent.
“Again, I apologize for having this discussion when you’re finishing your shift but I’ll be away all week presenting in South Africa and I wanted to give you the news so you can think about it, discuss it with family, and let me know your answer next week.”
Lisa finally found her voice. “Thank you Dr. Lehman, I’m honored.”
“You deserve it. It was a unanimous decision among the faculty members.” He stood. “I won’t keep you any longer. You go home and rest and let me know your decision next week.” He showed her out.
Twenty minutes later, Lisa was home and in bed again, fully dressed. After a six-hour nap and some food, she began to feel human again. She went back to her conversation with Dr. Lehman. These shifts could be so brutal. Did she really want to sign up for another year of this? The answer was an unwavering yes. She’d spent four years in college, four years in medical school, two and a half years thus far in residency. What was one more year to set herself up for a brilliant academic career? Wait till she told her parents. They would be over the moon. Brian, though... She looked at the clock. He’d be home from work in about twenty minutes. She went to the small laundry room in the apartment she’d shared with her boyfriend for the past year and began folding clothes just to have something to do to keep her nerves steady until he got home.
A few minutes later, she heard the front door lock turn and came out to meet her boyfriend.
“Hi, hon.” Brian kissed her. “How was your day?”
“Exhausting. Come in and sit down. I’ve got news.”
Brian took off his jacket and threw it in on a chair then sat on the couch next to her. They’d been dating since her final year of medical school. They met during her rotation at a mental health hospital where he was doing his training as a psychology student. She was immediately drawn to the handsome black man who displayed all the confidence she lacked in the intimidating environment that was the Harvard world. He helped her through her incredibly difficult first year of residency and had stood by her since, crazy work hours and all. She knew he was planning to ask her to marry him and looked forward to saying yes. She also knew he was ready for her to be done with residency and wasn’t sure how he would take the news that she wanted to extend it. She gathered her courage and spoke.
“Dr. Lehman offered me the position of chief resident.”
Brian was silent for a moment. “What did you tell him?”
“I didn’t give him an answer. He told me to take a week to think about it.”
“What is there to think about? We’ve been waiting for you to finish residency and get a job with better pay and more reasonable hours so we can move into a bigger apartment and begin to think about starting a family.”
“About that.” Lisa took a deep breath. “When I didn’t get my period last month, I assumed it was because I was stressed from working so much and then I forgot all about it until yesterday morning. I felt sick and threw up.”
“Oh God! Are you...?”
“Oh my God, Lisa, that’s amazing!” Brian hugged her and pulled her into his lap. “It’s sooner than we had talked about but that’s fine. In five months you’ll be finished with residency. Then you can get a job with better hours, take maternity leave and get back to work without missing a beat.”
Lisa moved off his lap. “I want to be chief resident.”
Brian’s smile quickly turned into a scowl. “Why?”
“Because it’s an incredible opportunity. It says a lot that they’ve offered me the position. This will open doors for me for the rest of my career.”
“Isn’t it enough that you’re a doctor? Black girl from Akron, Ohio; your teachers couldn’t have predicted it. But look at what you’ve accomplished. You’ll make a good income and we’ll live a good life. Why do you want more titles? Do you enjoy the crazy hours and the stress?”
“You know why I want this, Brian. It’s important to me to be successful professionally. To prove to myself and to others that I’m smart enough, good enough. To show my parents that I appreciate what they sacrificed to get me a good education.”
“Isn’t it enough that you went to Harvard Medical School?”
“No, it isn’t. Half the time people think I got in because of affirmative action. The other half, I think that’s why I got in. I live in fear of people discovering that I’m an impostor, that I’m not smart enough to be here and taking my medical degree away from me. This opportunity for chief is my validation. Confirmation that I am good enough.”
Brian took her by the shoulders. “When is it going to end, Lisa? When is this pursuit for greatness going to end so we can start living our lives?”
“It doesn’t have to end. Being the best doctor I can be doesn’t mean I can’t have a fulfilling life with the man I love.”
“Yes, it does. At least not a life with me.”
A rock settled in Lisa’s stomach. “What are you saying, Brian?”
“I’m tired of seeing my girlfriend, whom I live with, every other day. When I do see you, you’re too tired to do anything. You’re going to have to choose, Lisa. Me or being chief resident.”
“Me or being chief.”
“What about the baby?”
“Me or being chief.”
Lisa began to cry. After a few moments, Brian said, “I guess you’ve made your choice.” He grabbed his coat and walked out, slamming the door. Lisa dropped to the floor and sobbed great big heaving sobs. She didn’t know how long she lay there. Her pain was so great it seemed to split her abdomen in two. And still she cried. She finally quieted, utterly spent. Empty. Broken.
The room darkened as she lay on the rug she and Brian had bought together. Eventually she stood up and went to the bathroom. She splashed cold water on her face and stared in the mirror, desolate. She patted her face dry and turned to walk out of the bathroom. She suddenly noticed the bloody footprints leading to the bathroom. She looked down at her pants, and for the first time in her life, fainted at the sight of blood.