My journey to emergency medicine

I grew up in Los Angeles, the child of undocumented immigrant parents. Neither of my parents had the equivalent of a middle school education, with my mother fully illiterate even in her native Spanish. For medical care, we relied on free clinics in our neighborhood, and we always knew that if things got bad, the emergency room would be there. I grew up understanding the importance of that safety net.

Today, my parents are full U.S. citizens, and I’m in my third year of medical school at UW School of Medicine.

Beverley ‘Bev’ Heins (R) and her daughter Lisa Koch (L) were always best friends.

I’ve been in emergency medicine for half my life. I was always interested in medicine, but for a long time it was a dream. Becoming an EMT was more attainable, and it was also immediate — I could start treating the community right away. I spent 10 years as an EMT in L.A., Texas and Washington.

After moving to Washington, I started talking to my colleagues about going to medical school. A lot of them were also thinking about it, and it was encouraging to talk to other people. That’s when I started working toward my bachelor’s degree, first going to community college and then transferring to UW Bothell — I’m a proud double Husky! My goal in going back to school was to become a doctor.

I ended up as a patient care technician (PCT) at UW Medical Center – Montlake’s emergency department after my friend Casey, a recent graduate of UW School of Medicine, convinced me to go to a career fair. I met UW Medical Center’s chief nursing officer and told her I wanted to work in the emergency department. I worked there from the time I graduated with my bachelor’s to a week before starting medical school.

A PCT handles logistics — our job is to always be two steps ahead and to know where everything is when things get critical. And since I started in December 2019, things were about to get critical.

During the early days of the COVID-19 pandemic, I worked closely with the doctors and nurses to ensure patients who were isolated in their rooms had everything they needed. I helped make sure we had enough personal protective equipment (PPE), like masks and gloves, and that the doctors and nurses could get their PPE on and off quickly. I ended up as one of the few patient care technicians who was allowed to work directly with COVID patients, and I was named Employee of the Quarter eight quarters in a row.

A unique medical school experience

When it came time to apply for medical school, I only applied to one school: UW School of Medicine. I don’t recommend that to anyone else, but it was the right choice for me. Having worked in the emergency department here and seeing what it meant for the community, I couldn’t imagine being anywhere else.

I was also attracted by UW Medicine’s commitment to underserved populations. There’s a lot of focus on rural medicine here, but we also take the time to focus on urban underserved populations. I’m proud to be a CUSP (Community-focused Urban Scholars Program) scholar. Through CUSP, I’m working to serve areas similar to where I grew up.

As someone in my 30s who had a whole career before starting medical school, my experience is different from my classmates’. It’s really helped me understand the systems aspect of medicine — I have a holistic understanding of how someone gets from their home to the emergency department to the operating room.

Being an EMT and a patient care technician has also helped me learn to take care of myself while also taking care of my patients. I’ve had a lot of great patient interactions, but I’ve also had a few that weren’t so great. And through those, I’ve learned empathy and patience.

A patient once started seizing immediately after throwing a bedpan at me. I didn’t have time to be upset in the moment — I had to focus on stabilizing him. You have to put the patient first, because they’re right in front of you and they need your help.

Putting my skills to work in the real world

My real-world experience was helpful when, earlier this year, my friend L.C. had a seizure during a small-group Zoom discussion.

A group of four of us were on a Zoom meeting when I saw L.C. reach backwards. At first, I thought they were petting their cat, but then they were out of frame for too long, and I started to hear noises, first grunting and then gurgling. After a few moments, it clicked that they were having a seizure.

I’d never had to get medical help for a close friend before, but I knew what to do. I knew where L.C.’s building was but not the apartment number, so I called 911 immediately and gave them the building number while the three of us on the call started contacting friends to get the apartment number. I knew the most important thing was that the ambulance was on the way — I could call back later to give them the apartment number, which I did.

I was still on the Zoom call when the EMTs arrived. L.C. was conscious at that point, so I was able to talk to them and the EMTs. Then, when L.C. arrived at the hospital, I spoke to the doctors and filled in some of the details.

It was scary to be in that situation with one of my close friends, but it was also a reminder of the importance of emergency medicine and maintaining composure in a crisis.

Scholarships will help me serve my community

I’m 100% going into emergency medicine when I graduate. My mentors encourage me to keep an open mind, but another specialty would really have to knock me off my feet to get me to change my mind.

Emergency medicine is what I always pictured when I imagined community-facing medicine. As a leader of the Emergency Medicine Interest Group, I know a lot of people are there because they’re interested in treating trauma. I try to get them to look beyond the trauma, to get them excited about other aspects of emergency medicine.

There are so many people who fall through the cracks of the medical system, and the emergency department is at the bottom of those cracks. In emergency medicine, I can be there for the community.

Emergency medicine is my calling, but it isn’t the highest-paying specialty. That’s why I’m so grateful for scholarships. We all know how expensive medical school is, and scholarships take pressure off students — especially those who, like me, come from non-traditional backgrounds.

The Dr. D. Paul and Tamara A. Matsenbaugh Scholarship keeps financial considerations from determining what specialty I choose. I can become an emergency medicine doctor without having to worry as much about how to pay back my loans. And it’s so important to lessen those financial concerns as a factor when people are choosing where to serve.

Growing up, my parents instilled a sense of service in my brother and me. Even as we were relying on food banks and government assistance, my brother and I were volunteering at local community organizations and working to bridge access gaps. It was important to my family that we gave back as much as we could.

Emergency medicine is the way I’ve continued, and will continue, to serve my community. The UW School of Medicine and the scholarships that support me in medical school have been instrumental in ensuring I can continue that service.

Written by Alex Israel