How Pathology chose me

I was lying in my bed, hugging my favorite stuffed animal that I can not seem to name at the moment, when a doctor entered my room. He was a friend of my mom's; his name was Eduardo. I was sick, and he came to examine me. He smiled at me, played with me, gave me some medicine, and left. I was around 4 or 5 years old. Ever since that memory, I've wanted to be a doctor. That is the earliest part of me I can remember, but it has never meant the same thing at different stages of my life. At six years old, being a doctor meant making people feel better so they could play as much as they wanted. No one in my family had ever worked in healthcare, so I didn't have much to relate to, but I knew Eduardo, and I remembered that the next day after seeing him, I was running around in the fields outside my house again, exploring and having fun.

As I got older, I started to understand that Medicine is much more than just making people feel better. I understood that people's struggles vary and that their health isn't something you can switch from bad to good with a cherry-flavored syrup. I also came to understand that there were many paths I could take to pursue my desire to make this world a better place, connect with people, and help them. Around that time, I also lost my grandmother to Lung Cancer, and I started to feel disenchanted by medicine altogether. I was hurt, but I was still naïve.

In high school, I found Chemistry, and I fell in love with it. The art behind atoms’ interactions drew me specifically to Organic Chemistry: that virtuosity captivated me. When you “do” chemistry, you are naturally thinking and seeing the world differently. There is nothing I enjoy more than looking at the world from a different perspective. I remember reading that John Newlands suggested the elements were just notes on a piano; Li being Na, but an octave higher. It blew my mind that I could intertwine my interests to help me better understand the world around me. I studied Organic Chemistry at Harvard Summer School in 2018 and later earned the Silver Medal in the Advanced Category of the Costa Rica Chemistry Olympiad. All of these experiences taught me that my curiosity had no bounds, that I was privileged enough to grow up in a family that allowed me to learn and explore however much I wanted. I remember that even through all-nighters, I felt free. I had a great time, truly, but something was missing; I felt like there always was.

In Costa Rica, you pick your career early on, even Law or Medicine, you start at 17-18 years old, and when my time came, I chose Medicine. I don't know if it was destiny, luck, or something else I can't explain. While everyone expected me to go into Chemistry (even myself), I pulled a 180º and marked Medicine as my first choice after completing my University's Entrance Exam. I got in, I couldn't believe it. I remember feeling scared. I wasn't sure if this was the right choice for me, but I knew it felt right. I remembered 4-year-old Maria and her drive for making people feel better, and it became clear – this was the right choice.

My first day was what you might imagine; I felt so many feelings that I don't think I can list coherently right now. During the first year, you take "core" classes such as Biology, Chemistry, Physics, and Philosophy with people from other majors. But there I was, a medical student at last, just like I once dreamed. Then came COVID, and well, we all know the story.

When I started more "medical school" courses like anatomy and physiology, I just felt at home. It was just fascinating to understand how our bodies are so complex and organized at the same time. The more I learned, the smaller I felt in the sea of vastness that is medical knowledge.

Then, I became sick. It was like nothing I had ever experienced before. Not only did I have to leave my courses behind, but my whole sense of self was also overthrown in a matter of days. I remember being stubborn and going to class, thinking the pain was going to pass. It felt like my brain stopped working, not understanding a single word I was being told; it felt like I had quantum jumped into a dimension where no one spoke my language anymore. It was scary and devastating to think I wouldn't be able to continue studying what I loved. I thought about quitting medicine altogether, but I couldn't bear to accept that, so I just focused on getting better, on seeking help, and getting to a point where I could at least keep going to classes. Looking back, that whole year changed my life forever. I became more aware of how hard these types of diagnoses are for patients, how everything can change in a second, and how hard it is to accept it before even thinking about seeking help. I am sure that, as hard as it was, it will make me a better, more empathetic physician. It taught me to push through my doubts and believe in myself more than anyone. It shook me to my bones, but I gained the fuel that lights me to this day.

As I got better, the brain fog seemed impossible to get rid of. But alas, I enrolled again. I felt lonely in my vocation. I remember crying to my mom and partner about how badly I wanted to be a doctor, but I couldn't click with any future career path in medicine. I felt like I was missing something once again. What if this were Chemistry all over again? What if this wasn't my path? Then, I enrolled in histology.

I remember it being my favorite class; it was easy to connect to it. I could see a slide, and everything made sense. During those lab classes, my brain fog seemed to be gone. It was the most peaceful I had ever felt in months, and while everyone hated histology because everything seemed like a bowl of cell soup, I saw microscopic pieces of artwork, and I loved it. I remembered how my past passions made me feel, but this one felt like home. I didn't know it was a path I could follow.

I never felt lonely with my slides; I would often go after hours to glance at them, and I found patterns among them. Medicine became fun again. Every class I took, that being Anatomy, Embryology, Histology, Physiology, or Pathophysiology, the Pathology side of it always captivated me the most. I loved understanding the body, how its cells work together to create the ensemble of human life, and how a single error could lead to devastating consequences.

People often believe Pathologists only do autopsies or that all pathologists are Forensic Pathologists, and I, as embarrassing as it is to admit, was one of them. Pathology Outlines has a joke vignette that highlights this. I truly didn't know what Pathology is.

My third year came around, and we finally started our rotations. One of the first classes we take while on our "clinical years" is Pathology. It was like a course designed for me, with everything I loved, neatly packed into 2 4-hour weekly classes for a whole year.

One Thursday, I got back my own biopsy report, and I remembered it had pictures of MY cells, right next to the report. I was mesmerized. I saw these little colorful cells that looked like art, as the pathologists did, in a way I couldn't yet understand. The morphological changes my cells showed gave her information about the pathophysiology of my condition at the time. She put together the pieces of my own puzzle thanks to my cells telling the story (with a little help from my clinician). I was in awe. "What an honor it would be to do this", I remember thinking this was the coolest career someone could ever have. All of this was briefly after starting my third year. That was when everything clicked for me.

Ever since, I've been in love with the field. The more I learned, the more I loved it. Nothing is missing from my journey anymore; I finally see my future clearly. Pathology allows me to be creative, to fully embrace my curiosity, and to let my autistic brain find a little peace in an environment that isn't overwhelmingly stimulating. I can spend hours studying slides, finding patterns, contribute to the care of many patients each day, collaborate with clinicians to improve people's lives, and teach others about the wonders of the human body, how diseases develop, and how cells leave behind subtle clues that, when carefully interpreted, lead to accurate diagnoses and better treatment.

I switch the tears of desperation to my mom and partner, and now I get excited and nerdy about over-explaining pathology slides/quizzes that pop up on Twitter (sorry, X).

Medicine found me in my early years, but Pathology chose me when I needed it most.

One of my first Histology Labs back in 2023.