Braver Than Before

As I am writing this, my right eye is wide open for the first time since 2016. Just one month ago, I was very matter-of-factly explaining to Anthony that they weren’t sure my eye would ever be fully open, when I suddenly began to cry. This was as much a surprise to myself as it was to him, but the weight of what I was saying came down in full force. I brought this concern to my eye doctor, and we have been working together to find the optimal balance between keeping my eye healthy and making me more confident.

I currently wear a little detachable eyelid weight to help me blink that looks like a little piece of tape (and is a massive pain in my ass to put on in the mornings), and I am going to try wearing a large, rigid contact lens that can act as a shield for the surface of my eye. I am having a custom lens 3D printed (!) for my very scarred, irregular eyeball, and they needed to take an impression for the mold. This is just like a dental impression, but they have to pull my eyelids apart a little bit to fit the mold to the whole surface. To do this, they needed to un-do the stitch in the corner of my eye so that they could get an impression of the entire surface, and they are letting me keep it open at LEAST until the lens comes in about 3 weeks.

Of course, the first thing that I did was take a selfie to send to my mom after. The lighting was good and my hair was on point, and I was struck by how much I looked like my old self. But even more surprising to me was how little that mattered to me. In contrast to the massive progress I have made in my life recently, it’s disconcerting to observe my appearance moving backwards (but in the best way). My gradual return to the way I looked before my accident almost feels like cheating- how can I possibly have gone through all this shit and still be able to look like my old self? I am so incredibly different from that girl.

I’m thinking a lot about just how much I have changed since I last had two eyes fully open. I am certainly sassier than before. I am tougher than before. Braver than before. I expect more of myself than before; but just because I have struggled doesn’t mean I have to wear those battles on my face. The victories that I’ve won don’t go away as the scars fade; I can love myself and still want to improve myself.

I shared the photo on Instagram this morning and am, as always, humbled by the love and support from everyone. My friends and family have fought with me, laughed with me, cried with me, and this victory is theirs as well.

Game Face.

Having a ‘game face’ looks different to different people. For some, it’s putting on a smile and listening to a customer’s ridiculous complaint. For others, it’s making it to a social event despite overwhelming anxiety. It’s doing the hard stuff that you didn’t really want to do. For me, my game face is shown in the attached image; marked up and ready to be cut open.

This picture shows my surgeon’s ‘map’ that he drew immediately before my last (!) facial reanimation surgery at NYU. This one has been in the works for a very long time; it is the second phase of the reconstruction began last summer.  Last summer, they took a nerve from my foot, connected it to my working facial nerve, and hoped that it would grow across my face over to my paralyzed side. That part was perhaps the most important and hardest progress to monitor, but this second surgery was no cakewalk either.

During the ten hours that I was in surgery on 7/16, Dr. Rodriguez took a piece of my gracilis muscle (in my inner thigh) and all of the attached blood vessels/nerve supply, and then grafted it into my face. He attached it to the corner of my mouth and my temple, much like a working face muscle would be oriented, then attached the product of last summer’s nerve graft to this new muscle. The most delicate part, however, was connecting blood vessels from my neck to those that attached to the muscle when it was in my thigh.

This part was so important because, without adequate blood supply, the transplanted muscle would die and render the last year of preparation useless. It’s a delicate process in any patient, but previous trauma to my neck (the actual accident, past missteps by lesser surgeons) made this part extra difficult. Dr. Rodriguez, of course, was able to find and connect vessels necessary to feed the muscle, but unlike other patients, I did not have any viable back-up vessels to use in the case that something went awry during recovery.

I won’t say the recovery was the easiest thing ever, but I can also say that I have experienced much, much worse. Luckily, it was uneventful, and I am back to my normal routine. I am still a little swollen and quite bruised, but it’s nothing that a little makeup can’t fix. Now, I wait 3-9 months for the connected nerve and muscle to start talking to each other, and that is when everything will start moving.

My game face is walking myself into the operating room with a smile. My game face is cracking jokes about spaceships as I stare up at the massive surgical lamps above me. My game face is saying ‘please’ and ‘thank you’ to the nurse sticking me with my fifth IV needle of my stay. My game face is walking myself out of the hospital, with yet another body part rearranged where it doesn’t naturally belong.

Relaxed and Ambitious

I have never, ever, been ruled by my own self doubt- even when I’m not confident, I move past the worry. As I begin this medical school application process, there’s much to be insecure about- my crappy grades, my test scores, my uncertainty about the people reading my application. I know that my case is unique, but everyone is unique. When it’s my future career that hangs in the balance,  I can’t just not listen to this voice of doubt in my head. I know that it’s spewing completely irrational things, but the stakes are much too high here. My defense against the worst-case-scenario has always been to prepare. The only way to ‘prepare’ in this situation is to acknowledge the possibility that EVERYTHING goes wrong.

For example, I got my score back from the MCAT I took in March. I scored almost exactly average. When I first saw my score, I was angry and confused- I had talked myself into feeling ‘pretty good’ about a test that I honestly had mixed feelings about. On the day I took it, I walked out of that test having NO clue whether or not I did well. I figured that if I didn’t feel defeated, it couldn’t have been THAT bad right? I mean, it’s the fucking MCAT, I’m pretty sure it’s not meant to ever feel like you aced it. My test-taking instincts are almost always right, but in this case, I had been lying to myself.

I took the exam again in May, having regrouped and focused on the areas that I knew I was weakest in. I immediately felt overwhelmingly more positive about this attempt; there was much more that I KNEW that I knew, if that makes sense. But now, a day before I get my score back, it’s my doubtful voice’s cue to chime in. Yeah I felt good about it, but my score will only improve if I did at LEAST as well as last time. Since I wasn’t in a full-time class this time, how could I possibly have held onto my training? I’m having a really hard time not buying into the panic, but my fate has been decided and won’t change regardless of how much I worry.

If this were literally any other test score, I would be quick to let it go. It is what it is, and it’s not what it’s not. But this is so much more important to me. If it is what it is and it’s not great, I can’t just accept that and be passive in my pursuit of the rest of my life. Being okay with a less-than-stellar test score at this stage is equivalent to being okay with my application getting passed over. And that is most certainly not okay. At the root of this dilemma is just that it’s very difficult to be relaxed AND ambitious at the same time.

Being nicer to myself.

Over the weekend at a restaurant, I overheard a conversation happening at table of friends catching up over a meal. Somehow, the conversation had drifted to one friend’s recent nose job. I heard them rationalizing the surgery to their attentive and supportive friends, and didn’t think much of it other than it seemed a bit shallow. However, when I was talking about it to my boyfriend later that day, I dissolved into tears.

Let me make one thing clear: I do not give two shits about any alterations anyone does or does not make to their face. So why had this conversation made me cry, hours after hearing it? It made me mad. Not because it was a nose job, I don’t care about that. I was envious because they were the ones that got to decide that they wanted a new nose. It was a TRULY elective surgery, they got to decide to improve the face they were born with.

In 2018, I had five surgeries on my face, all of which were performed by plastic surgeons.  Those weren’t plastic surgeries, though. Those were reconstructive surgeries. My accident, my facial paralysis, stripped me of the right to just change my natural face because I don’t like it. I don’t get to do anything to my face for improvement, everything I do is a step back to my normal. I don’t like my face. I don’t like it because it’s a lingering reminder of a terrible point in my life. I don’t like it because it doesn’t really work all the time. I don’t like it because I miss how it used to be.

When I am getting botox injections, it will not be to prevent wrinkles. It will be to partially paralyze my working side, so that my face looks more symmetrical. I know this is an odd point, but wishing you could change your face is a privilege- take a minute to revel in it. Maybe your nose is too big or too crooked or too round, but it’s yours, and you are in total control of how it (or your attitude) changes. In general, I avoid thinking about the things I don’t like about my face. Most of the time, it’s because I choose not to dwell on the things I don’t have. Sometimes, though, it’s because I’m afraid to know how long the list really is.

Reading through this, I’m unsure of whether or not to share it- it’s not exactly light hearted. That said, it’s a good reminder to myself and everyone else to be nicer to ourselves. I still don’t like my face but I will stop picking on her for tonight, she got seriously hurt and she’s doing the best she can to recover. I will be kinder to myself if you do too, deal?

Makeup.

Today, I had my 6 month post-op with Dr. Fung, my corneal surgeon. It’s not like this was anything formal- I have probably seen him roughly 6 times since the surgery. Today was important, though, because this is officially 6 months post-op. At 6 months post-procedure, things should be happening if everything went well. I did the same stuff as usual- they checked my eye pressure, checked my vision in both eyes, looked at the surface in the microscope. One fun thing that happens is when they poke my eye with different-length sticks to check my sensation.

All of the above looked good- my sensation is at about 80%, and the surface of my eye looks about as good as it possibly could. I could care less about the sensation, but the health of my cornea means that the surgery has been successful in the critical areas. I didn’t realize how worried I had been about it until I felt the relief- positive surgical experiences have been pretty hit or miss for me, so this is a huge win.

I had come to the appointment straight from work, and only one eye was made up, as is usual for my makeup routine. We were talking about the next steps over the coming months, when Dr. Fung said something that nearly made me cry. He looked me in the eye(s) and told me that I should wear makeup on my right eye. Not because I needed to, but because I shouldn’t be feeling like my right eye doesn’t get to participate in the rest of my face. It was certainly observant, but I would expect that attention to detail from a world-class eye surgeon. The empathy is what blew me away- all I needed to be was another successful case, another pat on the back for himself. But he sees me, the young woman trying to navigate my self-esteem and droopy face and find a sense of normalcy.

This empathy, this humanity- this is what my own experiences will allow me to give to my patients, and the impact it had on me being on the receiving end is something that will stick with me as I move further towards becoming a physician. I think that I can say with confidence that I have been cared for by some of the most talented doctors and surgeons that exist today, but the things that I remember are not how they treated me but how they treated me. Talent is unquestionably half the battle, but the difference between a phenomenal surgeon and a phenomenal caregiver is the ability to remember that the scans, test results, charts, numbers that one is examining belong to a human being.

Girl Stuff.

The morning that I arrived at the testing center to take the MCAT, I was amazed at the rigidity of the security rules. I had to temporarily part with my mom’s gold signing ring, which is a constant symbol of what can be done by a determined, strong woman. They made me leave my lucky scrunchy (yes, scrunchy) in my purse, which was locked away. The people working at the center didn’t seem to have any patience or understanding for anyone who wasn’t aware of the ‘rules.’ Anyone reporting to take the MCAT is probably experiencing the most stress they have experienced in their recent lifetime, is it really necessary to refuse to empathize when we aren’t aware of the rules?

Luckily, my anxiety-ridden self had only read the rules about 17 times before reporting for the test. When I arrived, I discreetly asked the very stern woman if I would be able to access my purse to get a tampon on my break; I was on my period and didn’t want any distracting ~accidents~ to take place at any point during the test. When I asked, she softened a bit and explained that yes, I could access my bag on the break. She kind of smiled and shook her head and said “sometimes it sucks to be a girl.” I shrugged and said “yeah, but anything they can do, WE can do bleeding.” She softened a bit once I said that, and the exam proceeded without consequence and ~accident~ free.

This exchange kind of broke the ice for the day I think. The day I took the MCAT was a brutal and stressful day, and I was not in any mood to be treated like I didn’t deserve to be there. The stress probably made me more sensitive than normal, but then this small moment of uncomfortable humanity reminded the both of us that there’s no reason we can’t exist as allies rather than enemies. She’s just an uptight test lady and I’m just super duper nervous and BLESSED by mother nature on this day. I’m just trying to make the rest of my life possible, here. The MCAT was insanely scary and difficult and has kept me up at night for the last several months, but then mother nature swooped in to remind me that, the next time she visits, this will be over.

I was fully drinking the cool-aid, twisted in knots over the 5 questions I had been completely stumped on in the practice exam. Then this awkward, but COMPLETELY PREDICTABLE obstacle that every female faces brought me back down to earth. The MCAT is important, but it’s not a force of nature. I am. The things that make me, me, are completely unrelated to how the MCAT went or will go. All of these things associated with my upcoming med school applications are important for my future, but none of this will affect who I am.

I am the girl who can make friends with a brick wall, who can win over the coldest of hearts. Not because I care about this happening, but because my candor and sincerity is something that everyone can appreciate and relate to. Everyone has said (or thought) some of the shit that’s actually PHYSICALLY left my mouth before. When people get over the surprise at whatever I said, sometimes they find that they can relate.

I am the girl that has survived things most people would consider their worst nightmare. I am the girl that has carried on in spite of this horrible accident, and has in fact done better with her life than she would have without it.

Those are the things that are important to the grand scheme of my life. The MCAT too, but significantly less so. A few years ago, getting my ~period~ would have sent me into a tailspin on such an important day, but not this day. Because that’s not the biggest disaster I can think of.

I’m doing it.

I am a morning person. I always have been, and I am physically incapable of doing much of anything late at night. When I was little, I would inform my mom when it was time for me to go to bed. Nobody else gets to work until at least 10, but I wake up at 6AM to arrive by 8:45. My early-morning productivity, however, comes with a hard 10:30 bedtime.

These days, the type of ‘person’ I am is irrelevant. I have to be an all-day person- wake up at 5:45 (allow myself 5 minutes to hide under my blankets), get dressed and out the door to the gym by 6:15. Work out, shower, get ready for work in the locker room, then head to MCAT prep class by 7:45. Sit in my car and review my notes until 8:45. Take notes and listen intently to instructors from 9-12. Head immediately to work. Eat lunch at desk, sifting through the last 24 hours of emails and creating my daily to-do list. Spend the hours between 1pm and 8pm working, doing MCAT studying during periods of down-time which vary day-to-day. Caffeinate as often as possible, but only until 4pm otherwise I won’t get any sleep that night. If necessary, work remotely from 8-9pm at home while also making dinner, packing lunch for the following day, and doing homework/pre-work/reading for class.

9-10pm varies. Sometimes I say ‘fuck everything’ and go to bed, because the day needs to be over ASAP. Sometimes I will do a bit of yoga to wind down. Most of the time, I take the path of least resistance and have a tall glass of wine. I re-watch early episodes of Grey’s Anatomy for inspiration sometimes, imagining myself as a brilliant and competitive intern (before they all died, of course). I know that some of you may think that if i can’t stay up later that I just don’t ‘want it’ badly enough. Or that I should skip the gym in favor of sleeping in a bit. But the truth of the matter is, I had a severe brain injury. Cognitively, I can’t afford to just sacrifice some sleep or endorphins in favor of doing more.

When I start to regret my insanely early alarm (usually the moment it goes off), I remind myself that pre-rounds will start at 5:30. I’m already running late for the rest of my life. I like to think waking up will be easier when I’m excited about the thing I’m getting out of bed for. This is who I am now, and it’s going to mean that I wake up insanely early and go to bed insanely early, and I cannot falter for a second in between. I have stopped caring about how I appear to others long before I had to buy a fancy carrying case for all of my colored pens, long before I started carrying a lunchbox. I don’t think that I cared much about how I looked to my peers before March 13 of 2016, but now I dare someone to try and belittle me for having 17 colored pens. I am going to color-code my way to victory, I’ll worry about being dorky all day over worrying about being alive, or walking again, or breathing on my own.

This is not about how hard my life is, I don’t need anyone telling me how tough I’m being. No, this is not fun, but I am pleasantly surprised by the general balance I have been able to maintain. When I am stressed, without fail, my emotions are all over the place. I have found myself being ‘sassier’ than normal to my loved ones- especially my parents, best friends, and saint of a boyfriend. I have the self-awareness to apologize and think about why I’m so volatile, but I don’t always like the answer. Right now, studying for this big huge life-altering exam makes me worry about not being enough, but this self-doubt spills over to all aspects of my life.

I worry that I’m not ‘committed’ enough to my MCAT studying- should I be pulling all-nighters? I worry that I’m not a ‘dedicated’ employee- does my boss think less of me now that I don’t work 50 hours in a week? I worry that I’m not returning the favor for my loved ones- they have given me the love and support I need to get through this in one piece, and I can’t possibly imagine how I can be doing that for them. I know that these are pretty irrational and I do my best on a daily basis to remind myself of that. This is one of the side-effects of doing something really fucking hard.

But that’s just it- I’m doing it. I am not sleep deprived, I am not constantly sick, I have my mental health (reasonably) in-check. I’m doing it.