Facing fears and looking to the future

Scarlett Kass

Critical reflective writing holds a prominent place in the Medical Humanities curriculum at Rocky Vista University College of Osteopathic Medicine. Beginning in the first semester of Medical Ethics, students engage in critical reflection to explore their own assumptions and biases and how their values impact their practice. This submission is selected and edited by Nicole Michels, PhD, chair of the Department of Medical Humanities, and Alexis Horst, MA, writing center instructor.

Scarlett Kass is a third-year medical student at Rocky Vista University School of Osteopathic Medicine in Colorado. She grew up in Aiken, S.C., and later got her B.S in exercise science at the University of South Carolina. Prior to medical school, she attended Rocky Vista for her M.S. in biomedical science. She is interested in pursuing a career as an emergency medicine and sports medicine physician.

There is nothing more daunting than sitting in an MRI machine with a cage around your head at one of the top medical facilities in the world with your mind racing about what could be going on –the unknown. Those 45 minutes were the most trapped I have felt in my entire life. I had no option but to sit there as still as possible with the loud machine whirring in my ears thinking about my inevitable fate. Why me? Why now?

In March 2020, I, like so many others, contracted COVID-19. I was in the middle of my master’s program, so I refused to be taken down by a viral illness. I had a moderate case of the virus, but my recovery took a little longer and also had some unexpected turns.

At that time there was no diagnostic test or treatment for COVID-19. I was treated using supportive care that managed my symptoms at the time. No one knew what to expect during or afterwards. What was normal? What was abnormal? What are red flags that I need to be aware of and looking out for?

I remember my first episode of neurologic symptoms. I got the worst headache of my life and then proceeded to have leftside motor and sensory weakness with changes in vision, nausea and slurred speech. My first thought was that I was having a stroke, but I didn’t know what to do because I could not move. I felt alone, helpless and terrified in that moment. Is this how I go? Who is going to find me? I eventually lost consciousness in what I had accepted could be the end for me. I woke up hours later, my dog whining next to me, with resolution of symptoms.

Over the next few months, I had repeat episodes. I saw my primary care physician and she suspected I had multiple sclerosis (MS), so she ordered the full workup. The brain scan showed “nonspecific brain inflammation,” and I didn’t know what that meant, so I called my father, who is an internal medicine physician, and told him what was going on.

He advised me to see a neurologist as soon as possible. I called every office in Denver, and because of COVID-19, I couldn’t get in anywhere for six to nine months. In that moment, I felt unheard and unseen, like no one was listening to me or could help me. I never want patients to feel like I did when I called begging to be seen.

I have never been more scared in my life – paranoid of getting an attack and wondering how long it would last, how much pain I would be in, the lasting side effects, and if it could be potentially fatal. I wanted to know what was wrong with me so that it could be treated because I wanted to get back to my life. On the other hand, I was frozen with fear with what that diagnosis was and what it entailed.

My father had a connection at Mayo Clinic Florida, and I was scheduled to see the head of neurology within a month. Once at Mayo Clinic, the workup began. There was an eerie feeling in the waiting room. It was full of people from all across the world with severe or rare medical conditions, but I could see the hope in their eyes because they were at Mayo Clinic seeing the best of the best – if they had a chance, it was here.

After the MRI results came back, I was diagnosed with hemiplegic migraines, a rare disorder in which individuals experience a migraine headache along with weakness on one side of the body.

What does that mean? How is this going to affect my quality of life? Can my body and mind still handle medical school? There was no cure, no definitive treatment, and no real consistent data on how it affects people. There were some off-label medications that I could try, but there was no guarantee because every case was different.

This continues to be a part of my everyday life, and I have reflected a lot over the past few years. I have learned so many things both personally and professionally that I choose to use to shape me to be a better human and a better health care provider in the future.

I have learned the value of trusting your patient whether that be their story, symptoms or especially their instinct because it is usually right. They know their body best; listen to them, and we may be surprised at how integral patients can be to their diagnosis and care. Nothing compares to not feeling heard, and I never want my patients to feel the way I did.

Something I didn’t anticipate was the level of personal growth that this diagnosis would bring me. I have learned far more than I can write in this reflection and continue to learn and grow each day as life gives me new challenges. I have gained a new level of resilience. It took some creativity, adjustment and flexibility but I am doing it.

Being flexible has been a major adjustment. I have to really listen to my body, and there are many factors that I have to consider when choosing how to spend my time and energy. I also can’t anticipate when I will feel sick or have a bad day, and I have to adjust to that in real time, which has forced me to practice healthy life balance. I have no other choice other than to make sure that I am well taken care of mentally, emotionally, spiritually, physically and academically if I am going to make it. I check in with myself throughout the day, really tune in to what my body needs, and then do that.

Finally, I have learned and better appreciate that life is short. I know it is cliché but it’s true. We never know what is going to happen, and life is chaotic and so out of our control. But we can choose to control our response. I choose to still pursue my personal and professional aspirations and embrace all the good and the bad in the hopes that it will continue to shape me into a better human as well as a more well-rounded health care provider. ■

Mary Jo Heins is a former medical practice manager and past president of Colo MGMA As an independent Medicare insurance agent, she now helps people with all facets of Medicare – objectively and fee free.

“Over the years I watched my patients struggle with what type of Medicare plans to select for their particular needs. As I approached going on Medicare, I did not relish wading through the choices. My burden was lifted when I started working with Mary Jo Heins.

Working with Mary Jo has been the most pleasant experience I have ever had in selecting an insurance program for me or my practice group. I trust her knowledge and advice so much that I have referred my patients, colleagues, friends and neighbors to her. My office manager was right –she is ‘the best.’”

– Michele A. Velkoff,

MD

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