Releasing the Restraints

When I finally awoke from this white dream and the outlines became clear pictures, the vision turned blue and silver—to wires and machines. My fifth birthday had been spent in a coma as I recovered from a serious horse-riding accident. Two people stood beside the bed—my mother and one who quickly introduced himself as my doctor. With delicate grace and humor, my orthopedic surgeon explained my placement in the ICU and gained my trust by releasing the restraints across my body. From this first impression, I embarked on the exploration of a career in medicine—at five, this meant learning the word orthopedic and memorizing most of the major bones in the body. Yet, in formulating my plans, I was unprepared for the challenge which surfaced later in my adolescence. The inner anguish from my coming out process in a conservative religion and culture shaped the way I would accomplish and appreciate my goals. My observations indicate two likely extremes in coping for a "closeted" young person. That is, the individual can give in to a sense of defeat and underachieve, or desperately overachieve in an attempt at self-acceptance while never quite valuing the accomplishments. I happened to land in the agonizingly self-critical latter pathway. In retrospect of my undergraduate years at Stanford, I have a heartfelt concern for my brothers and sisters who face the rigors of medicine while enduring the initial process of coming out as a lesbian, gay, bisexual, or transgendered person. When applying to medical school, the decision of whether to be out on my application required careful consideration. At the time, I lived within the idealistic cloud of Stanford where I had never had a discriminatory experience, my individualism was encouraged, and I learned to speak openly about my sexual orientation publicly in the "protected" environment. On the other hand, I talked with several practicing physicians in the gay community, who criticized me for possibly jeopardizing my acceptance. It's so competitive Tun, why would you want to risk it. Does it really matter? According to one surgeon, as ignorance continues to permeate the ranks of those with a daily understanding of universal precaution, his colleague might read my application and consider me a risk in transmitting HIV to patients—a liability for simply being gay. The thought of this possibility poured salt into my healing wounds of coming out. Understand that I struggled with my sexual orientation during a time I term the 'second generation of HIV—in which coming out as a gay man implied HIV infection. The fears and serious health implications which would delay coming out would also further unhealthy mental attitudes, and perhaps risky sexual practices, among my age group. Unfortunately, due to the transmission rates of HIV in the gay male community during the early 1990s, I fear a rise in AIDS cases by the time I practice medicine— my friends, my created families, having felt invincible to a virus which only infected the older among us and which society had deemed obligatory anyway, right? Slowly my inner voice became clearer and resonant. It mattered. One day during the interview phase of applying, I sat paralyzed—Novocain and a mouth full of gauze— in my dentist's chair listening to him create macho small talk. The only thing women really care about is clean teeth and fresh breath. Aside from the misogynistic nature of the statement, I became quite offended by his assumptions. At the time, I could have spit out the gauze and started militantly yelling at him, spoken unconvincingly quietly and awkwardly, or taken it like a punch in my stomach as with the many other de1Second-year medical student, University of California at Los Angeles, Los Angeles, California. 2Correspondence should be directed to Timothy Cruz, c/o Student Affairs #266, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, California 90095.