Determination Beyond Adversity - Dr. E. Chavez
Our family lived in a small town in Mexico with a population of three hundred people where everyone knew each other. In order to get medical care we would have to travel about two hours away. For this reason people in our small town had to rely on a pharmacist for medical care. The pharmacy became my favorite hangout spot as I noticed the pharmacist prescribing medicine for people walking in with simple ailments. This all made sense for a seven-year-old young boy. As I watched him I was intrigued and remember thinking that I wanted to learn more about medicine. However, one particular event at the pharmacy would change my perceptive about what I thought were normal practices at the pharmacy.
A lady walked in with her three year old little girl who looked sick. I could see a worried look in the mother’s face. Her little girl had a high fever and was having seizures. The pharmacist prescribed her a pill and gave it to the little girl. Unexpectedly, she began to choke. I witnessed her mother, the pharmacist, and a few others become frantic and desperate to help, but they didn't know what to do. The three-year-old little girl died in the pharmacy because no one knew the Heimlich maneuver, abdominal thrust or other formal medical procedures that could have helped in such a critical situation. At the time I felt helpless. That moment left a lasting impression that I’ve never forgotten. Knowing what I know now, there is so much that could have been done to save her life.
This event left a lasting impression that allowed me to make important connections later in life. Back then I didn’t know what I wanted to be or that I would be a medical doctor, but I knew I liked science and helping people. I also liked animals because I spent much time with my grandfather caring for his farm animals. I was born in El Salvador and grew up with my grandparents up until I was 6 years old. I migrated to the U.S. illegally and joined my mother who was already established in Los Angeles. I remember adjusting to my new environment when our family had to leave because my dad’s mom got sick in Mexico. This was where the pharmacy and I crossed paths. What was initially a simple visit turned into a six-year stay. I was twelve years old when my parents decided to travel back to Los Angeles from Mexico illegally.
"Back then I didn’t know what I wanted to be or that I would be a medical doctor, but I knew I liked science and helping people".
Whatever my parents established in the U.S. was gone. However, we were very fortunate that the climate for immigration wasn’t as difficult as it is today. The fact that my parents had been here for ten years and had proof that they were productive members of society helped the process.
Assimilating was not easy. I started sixth grade with English being a foreign language to me. My parents were getting me ready to start school but in order to be admitted I needed vaccines. I vividly remember my parents struggling to find a clinic that had Spanish speaking staff that could answer questions, guide the process, and assist us to get the help we needed. I could see my parents overwhelmed and stressed. Rather than the doctor reviewing my medical history or examining me physically, the nurse asked me to take off my shirt to administer the vaccines. My mother looked concerned and asked the nurse whether the doctor would be checking in, but she simply said no.
"I vividly remember my parents struggling to find a clinic that had Spanish speaking staff that could answer questions, guide the process, and assist us to get the help we needed".
Again, knowing what I know now, I would consider that very poor care. Unfortunately, this continued to be my experience throughout junior high and high school. Every doctor visit was a struggle because of the language barrier and because doctor visits often touch upon worrisome heath concerns and sensitive instructions to prescriptions. Such language barriers were common among the Latino community. In addition, there were very few doctors that understood the language and the culture. I thought about how daunting and foreign it was for my parents and other parents to navigate the community clinics. These ongoing circumstances allowed me to make connections that would later lead me to med school and do more for the community. Early on I understood that in order to get far I needed to study. My parents told me stories of how they grew up in a farming community that struggled with poverty. Their limited education contributed to these struggles. Mom finished the first grade and dad finished fourth grade. It was unfortunate that the only jobs that they could get were labor intensive. Both my parents worked in the garment district and got paid cents for every piece that was completed. I often saw them “trimiando” or trimming, which consisted of cutting excessive threads from finished pieces. They were often under piles of material that would later become pants, shirts, or dresses. I remember my parents working long, twelve and sometimes fourteen-hour days. They often brought work home and continued to work until midnight. Even then, we lived in an impoverished neighborhood. Witnessing how hard they worked and struggled to provide us with a better future and the way they encouraged education fueled my dedication in school. I had supportive parents that constantly pushed me to study and succeed. Those values became a part of me. I also had the responsibility of a young brother and sister that looked up to me. I often cared for them because my parents were working at the factory.
I enjoyed school because it was where I could work hard like my parents and because it was the place that stimulated my interests in math and science. English was a foreign language to me when I arrived from Mexico to begin the sixth grade at a Junior High School located near Downtown Los Angeles. Once I had the opportunity to practice all the time, I was able to pick up the language much faster. I was eager to learn, but the high school I attended didn't have the best reputation or the best learning environment. Gangs, fights, and indifferent teachers were common among the culture. I had to adapt to the new environment to stay focused in school. I enjoyed learning, thinking and making connections, which made school interesting. School wasn’t easy and I had to put in a lot of time and effort. While other students were struggling, math and science came natural to me. During the ninth grade I remember getting involved in science. My chemistry and biology teachers encouraged me to consider a career in medicine. Particularly, my science teacher Mr. Heston saw something in me. He was a great teacher and always found a way to connect what we learned in science with medicine. His encouragement led to my participation in science fairs and science projects.
"I enjoyed school because it was where I could work hard like my parents"
I will never forget the day he invited me to a nearby conference at the University of Southern California to listen to Jane Goodall speak. She is a world-renowned expert on chimpanzees and leading researcher on primates. There is a great documentary titled “Jane” that dives deep into her life and contributions to the world. Well, I was fascinated to hear her discuss her work on animal welfare issues. The scientific language resonated with me. Her talk further intrigued my curiously of science and I began to think about what I would do after high school. I began to ask questions about college, but had a difficult time finding someone to guide the process. My guidance counselor was discouraging and suggested I should go to a trade school or community college. Although their standards were low, mine remained high and determined for success. By the eleventh grade I was in a magnet program and taking AP courses. Teachers noticed my determination and potential to do well as an academic. Fortunately, I was recommended to One Voice, which is a nonprofit organization that helps inner city kids go to college and fulfill their dream. They connected me with someone that would help with all the application process and personal statement. I expressed my desire to pursue a career in medicine. As a result they helped me apply to 20 different schools across the country. There guidance led to acceptance from about twelve universities.
The time came to make a decision about which university I would attend. I decided to explore my horizons and flew out to New York to visit Colgate University because they offered the most financial aid, which was a major factor. Thinking about leaving my home wasn't easy because my parents relied on me to care for my brother and sister while they focused on paying the bills. After a difficult conversation about my options mom and dad supported my desire to go. They told me that my education was important and that they would figure out a way to get things done. My parents understood and provided unconditional support. Soon after high school graduation I found myself moving into the dorms at Colgate University. My initial impression of the campus and environment was great as I arrived during the beautiful summer season. However, harsh realities soon set in as I began adjusting to such a new environment.
"I was recommended to One Voice, which is a nonprofit organization that helps inner city kids go to college and fulfill their dream. They connected me with someone that would help with all the application process and personal statement"
I was home sick, one of the few Latino students from a low socioeconomic background and was unable to relate of any of my professors. In addition, I realized that my superior academic track record in high school was considered average performance at this new environment. I quickly went from earning As to earning Cs at best. I found it challenging to find purpose in my daily coursework and struggled to develop effective study habits. I reached out to One Voice for support and guidance. They encouraged me to stay the year and helped me with resources and tools necessary to pull through. I was miserable that entire year, especially because I missed my family and could not fly back for the holidays. While my friends traveled back to spend time with their families, I was having a Thanksgiving meal that came from the vending machine. It was rough and knew that I needed to transfer back to California if I wanted to succeed. Still, I finished the year. Pomona College would be my second chance.
"I realized that my superior academic track record in high school was considered average performance at this new environment. I quickly went from earning As to earning Cs at best".
Although my confidence was shaken, my desire to pursue med school to ultimately serve families in inner city communities never wavered. There were far more resources and support for Latino students at Pomona College. And I would need them because my major was Neuroscience.
Being one year behind meant that I had to initiate a conversation with a guidance counselor to catch up, hustle, and find a way to get back on track. I was learning to study at university level standards. I wasn't the greatest yet, but the determination was there. A chemistry professor, Dr. Beilby, saw my potential and pushed me to excel. Our conversations led to learning and obtaining scholarships, which also helped me progress further. His classes were challenging, but also one step closer to toward med school. Catching up was exhausting, but I needed to improve my GPA as much as possible. By the time senior year came, I felt burnt out. I applied to medical school right after graduating, but I think it was too soon. Unfortunately, I was not admitted into med school. My only option was to wait a year to reapply. I was disappointed, but looking back not being accepted was an outcome that worked out in my favor. I refocused my energy on gaining experience within the medical field.
"Although my confidence was shaken, my desire to pursue med school to ultimately serve families in inner city communities never wavered".
I purposely pursued a position as a health educator for a community health clinic. I was fortunate to land the position. This decision helped me to truly understand and solidify the idea that a career in medicine was for me. Within the year I also got married. After being so involved at Pomona College, I was happy to know that my partner supported my uphill battle. I also felt the need to stimulate my inquisitive mind. I picked up a few books and learned everything I could about computers. For some reason I was interested in technology. Specifically, I was curious about the inner workings of computers. After much reading and tinkering with any computer I could find, I decided to look for a part-time job. After about two months of searching I walked into a computer repair shop and asked if help was needed. The owner pointed to a pile of computers and told me that if I could fix one computer then I could have an opportunity to work. I few minutes later I fixed the issue, turned on the computer, and landed the part-time job. So much happened during that year not knowing all of these life experiences were setting me up for success. I was happily married, worked full-time as a health educator and part-time at the computer repair shop.
The decision to become a health educator served me extremely well. That year I became immersed with the language, expectations, and medical culture. The opportunity to observe doctors, nurses, and other supporting staff was immense. Those experiences gave me something to talk about during the interview as I reapplied for med school. Additionally, during that year I gained more than work experience, I was able to practice and develop new skills, make even deeper connections to my drive, and gain confidence. I was finally accepted into a great medical school at Stanford University. I knew that the next several years would be difficult, but not impossible. It was all about hard work and dedication. This time around I had developed solid note taking skills and study habits. I was fortunate to have my wife by my side that was very supportive and understanding throughout the whole process. I felt bad to see how difficult it was for her to assimilate to the new environment after we moved to Stanford. Yet she did her best to support my dream or what would become our dream.
Med school was demanding, structured and required just about every waking moment. My mornings often began very early and continued on until 1am studying only to repeat the same process the very next day. I remember that labs ended at 6pm. However, mastering information was the standard, which meant quickly connecting with my wife after lab and going back to studying. Being exhausted was something I had to accept, but still had to remain alert during lecture, labs, and as classmates and I discussed medical terminology and concepts well into the night. Each year progressively became harder, but my determination was stronger than my exhaustion. There was no time to slow down or to think about abandoning my chosen path. Once there our professors sought to teach us, guide us, and prepare us for a career that was designed to help people live healthy. After all, preparation was all designed to help me during the residency portion of the program that moved far beyond book knowledge. Residency required shadowing a senior doctor, but also hands on interactions with patients. During the first month of residency we were quickly oriented and by the second month we were sent off to the emergency room to care for patients in serious conditions.
"Med school was demanding, structured and required just about every waking moment. My mornings often began very early and continued on until 1am studying only to repeat the same process the very next day".
To be honest, I was nervous with my first patient. The patient was having a heart attack. I knew that I didn’t know everything, but my training quickly helped me respond to the situation. I went from feeling nervous to becoming very confident with my technical skills and approaches to caring for patients. Completing the residency aspect of med school was well guided, but required a personal initiative to seek ownership to each lesson learned. My goal was to be well prepared to serve the community. While most recent medical grad students were eager to sign the dotted to begin their careers at a typically large hospital, I knew I would be taking another route. I purposely decided to steer away from working at a large hospital because the plan all along was to open my own family practice in an inner city community. My wife and I moved back to Los Angeles to pursue our goal once med school and all of its requirements were achieved.
An opportunity emerged to build my own practice near Downtown Los Angeles. Once again, my wife supported this venture in numerous ways. In fact, I couldn't have done it with out her. I was on my way; I was making reality what were only dreams for many years. I was pleased to care for patients, serve the community, and slowly build a support staff. I had it all figured out, except for one key aspect - the business side of running a clinic. Aside from seeing patients, I had to learn about payroll, policies, how equipment functioned, and long lists of city regulations. In addition, I needed to train and direct staff. The administrative aspects of these responsibilities became overwhelming. I often did charity work and provided free services to those with severe needs. However, the clinic began to struggle to bring in sufficient funds to keep it operating smoothly. After three years of hard work and dedication I began to contemplate shutting down the clinic. I began negotiations with potential buyers. The clinic was evaluated only to be offered severely less than what the clinic was worth. The offer was insulting. Even worse, they asked me to stay and work for them. I didn't respond. Without hesitation I simply stood up from the table and walked away from the meeting and the offer. I couldn’t do it. I hated the idea of possibly closing down when I knew families still needed our services. I preferred to slowly dissolve or give the clinic away for free to other clinics in need than to sell under those circumstances. I didn't know what I would do.
"I purposely decided to steer away from working at a large hospital because the plan all along was to open my own family practice in an inner city community".
At the time One Voice was still in the picture. I was collaborating with the organization by doing free physical screenings for the kids that were part of their program. From time to time, Kathy Momii, CFO of One Voice called to see how everything was going. She happened to call a few days after I rejected the offer to sell. She asked how I was doing and sensed that something was wrong by my response. She urged for us to meet. During our meeting, I informed her about the situation. She presented me with a brilliant idea to convert the clinic into a nonprofit. It made perfect sense to transition the clinic especially since the overall goal was to serve the community. One major obstacle stood before the proposition. Unfortunately, there was debt attached to the clinic, which meant that seeking further loans was not an option. To resolve this issue Kathy and One Voice offered to help raise the funds needed to convert the clinic into a nonprofit. I was and will always be grateful and privileged to have such tremendous support. Their guidance began many years back to support my dream to become a medical doctor and continued on to revive a clinic meant to serve the community. More then ever, I understood the value of building relationships and collaborating with remarkable people that are passionate about improving the quality of people’s lives.
My initial interest that led to becoming a doctor may have come from unique or personal experiences, but those initial interests were complimented with important building blocks. There are few key considerations that have been instrumental to my success along the way. First, mentors played a central role that provided advice and encouragement. It’s important to take the initiative to find answers to questions from those that have experienced the paths we seek. I think that aspiring academics may get stuck along the way because they lack proper guidance. A good mentor can make a great difference toward the path of success. I was fortunate to come across amazing mentors at critical stages of my academic and professional career. I can attribute my success to others believing in me and providing me with the tools necessary for growth. Secondly, having the desire to be a medical doctor should not be fueled by money. Monetary gain alone will not be a strong enough motivator once its time to persist through all that is necessary to pursue and achieve a career in medicine. Instead, the desire to a career in medicine should be giving rather than taking. Giving back for me meant being able to serve and relate to English and Spanish speaking families in low-income communities that seek medical care. These communities have been and still are underserved. Being able to relate to these families is key to being a good leader and doctor.
"mentors played a central role that provided advice and encouragement. It’s important to take the initiative to find answers to questions from those that have experienced the paths we seek"
I am currently severing the community as CEO of Universal Community Health Center in Downtown Los Angeles. It has been a long and hard journey to get to where I am today, but I’m glad I persisted. Turning the clinic into a nonprofit was a great idea that has allowed us to thrive. In fact, our successes have amounted to opening up a second clinic that is also empowering communities towards wellness. I credit my family, wife, friends, teachers, mentors, and outreach programs like One Voice that recognized my potential and never let me give up. I’ve come along way from the small-town pharmacy that marked my mindset and determination. I found my passion in science and medicine, but the overarching goal was to serve underrepresented communities and promote healthy living. Despite the many adversities I was confronted with along the way, this passion and commitment to serve patients as a family physician never ceased to exist. Being a medical doctor is rewarding, which is why I would absolutely do it all over again.