This Year’s Annie Li Yang Student Essay Contest Winners

March 7, 2024

Three students were named winners of the 2024 Annie Li Yang Student Essay Contest. Students were asked to reflect on the connections between their clinic and classroom experiences and share how it has impacted their growth as future physicians. Congratulations to first place winner Jake Haver, second place winner Andrew Harris, and third place winner Eliza Burr.

Read their essays below.

• First Place | "Speaking with Silk" by Jake Haver

  Speaking with Silk

  By Jake Haver
  
  Behind me, Lucy swings open the oven door, inviting the aroma of chocolate chip cookies to unfurl across the kitchen, and into the living room. She fashions the cookies on a porcelain heirloom platter, saved for special occasions, and places them on the coffee table in front of me. With a tender smile, and a nod, she insists that I take one. I politely bite into one, as I sit in Ted’s recliner. The lazy boy was tarnished with Ted’s silhouette, as decades of Sunday football and Channel 4 News had tattered and frayed the leather into the shape of him.
  
  “Broken-in!” Ted would call it.
  
  “An eyesore” In Lucy’s opinion.
  
  As I indulge in the fresh baked cookie, I attune myself to the home’s details. It whispers hints of what makes a house a home. I notice the heartwarming impressions of Ted and Lucy’s adorned bygone days - windows I imagine were once decorated with faint fingerprints of kiddos peeking outside hoping for a snow day, a cookbook with a page cornered to Ted’s favorite pot roast recipe, and the numbers to Lucy’s soap opera channel worn off of the remote control.
  
  “You’d better be careful sitting in Ted’s recliner, he’ll give you an earful!” said Lucy.
  
  I gave her a winced smile and a head nod, as I exhaled audibly out of my nose. We sat in silence, and took the moment in.
  
  “It is nice being home again. No beeps, no interruptions, no hospital food!”
  
  “Yeah” I murmured with a lighthearted scoff, and a playful eye roll.
  
  Ted lays next to us, unresponsive, swaddled like a newborn, with morphine coursing through his veins. I only know he is breathing by the slightest rustle in the silk sheet atop his chest. His skin is so ghostly that the veins traversing his temples match the blue of his eyes. His mouth hangs slightly open, void of the strength to close it. His frame is now half the size of the silhouette on his recliner. For all the strength that persisted in Ted poured into rustling that silk sheet, like it was the weight of the world. I sat there, with Lucy, waiting for it to stop.
  
  I don’t know Ted, and I don’t know Lucy either. I met them fifteen minutes ago.
  
  Ted was placed on hospice care just weeks prior, when his surgeon stopped a scheduled procedure after opening him up and finding cancer assailing nearly every organ in his abdomen. At that moment, Ted nearly felt fine, though cancer affords little grace. Just days later he would take to bed a final time, where healthcare providers visited periodically to help him pass as comfortably as the emperor of all maladies would allow.
  
  The picture frames upon the walls, and the subtle idiosyncrasies engraved into his home, are all I know about Ted. Now, Ted sits with me, his wife, and the home nurse I am shadowing on my medical school hospice rotation. I think to myself “Who am I” to be sharing his final moment alive with him. According to my syllabus, I am a medical student learning about the signs and management of imminent death. So, I guess that’s who. Still, I have a hard time palating the thought that we leave this world the same way we entered it a lifetime ago - swaddled, and in the hands of nurses and doctors we don’t know, and will never know again.
  
  I picked another cookie off the platter to sanitize the realization that one day I might also lay ill in a bed as a preceptor explains to a tremulous medical student that my shallow and erratic breathing means I am down to my last few. I wondered what Ted was thinking. With the last of his strength Ted slowly inched his eyes from the ceiling, down the wall, and into my eyes.
  
  For some reason, as the blue of his locked with the brown of mine, I felt the overwhelming sensation of him welcoming me there. Almost as if Ted knew he would henceforth, and forevermore, be a part of my story, and thus in a butterfly effect kind of way, be a distant part of every patient’s story I ever would care for as a physician. Almost like he was showing me death, to impart the true essence of living.
  
  As we step outside to give Lucy privacy, the silk stops, and Ted supernovas; a synaptic symphony of neurotransmitters floods the corridors of his consciousness, and his sweetest memories dawn and set a final time. With the physical transcendence of four people, to three, I felt no such change in who was in that house. Ted was still there, almost more so than he was a minute ago. It was at this moment that I realized that we leave behind more than a turned cookbook corner, or our outline on a tattered leather chair, or the flesh and bones that was our home. We leave behind our soul, our impact, our story, and it will never cease. I realized that one day when I pass away, and use the last of my lifeforce to look into the eyes of the medical student learning the signs and management of my imminent death, he will realize why he is becoming a doctor.
  
  Ted spoke no words to me that day, but as the rustle of silk atop his chest decrescendoed, he shared a story. It was a story in which the last chapter of his, and the first chapter of mine as a physician, were scribed in the same ink. Ted lived his whole life not knowing he would find this purpose on his very last day. When he was a boy he never knew this day would happen. He had no way of knowing that someone he’d never meet would be his storyteller. Life is beautiful in that way; for you never know how the most transient of moments might send a ripple throughout a complete stranger’s life. And for that ripple, Ted means a lot to me - I wish I had the chance to introduce myself, before I said goodbye.
• Second Place | "Not as Strangers" by Andrew Harris

  Not as Strangers

  by Andrew Harris
  
  Most aspiring medical students seem to dream of their white coat ceremony. It’s one of those days that shouts “your life is changing” and serves as a lookout or rest stop on the steep ascent to becoming a physician. My outlook was a little different. I was not dreaming of my white coat ceremony. Rather, I was dreading it. Perhaps it was white coat syndrome amplified, as I walked onto the stage and announced my name to the crowd, my smiling face masking a deep, visceral ache. My core throbbed, a tight and unrelenting constriction from a fear that lurked inside me that whispered “I do not belong.” As I walked across the stage, I saw those around me as insiders. It was as though everyone else glided to shake the Dean’s hand and smile for the camera, meanwhile I felt like I tracked mud across the floors. It was a day to celebrate finding my path, yet I felt out of place and hesitant of the future.

  The semester began, and the ache continued. They say that learning medicine is like learning a foreign language. In my opinion, it’s more like being thrown out of a plane and parachuting into an unfamiliar culture. My mind rattled with the cacophony of jargon and unfamiliar diagnoses, set against a new rhythm of process and formality. I’d nod and feign understanding while racing to look up seemingly basic topics like “what is a CBC.” I felt like I was a wandering microorganism, somehow having breached the defenses of my host via a lucky form of molecular mimicry. Out of place, but undetectable. From my past career in business, I was familiar with this style: fake it till you make it. But in medicine, I wasn’t so sure we wanted anyone faking anything.

  I felt like a stranger, but thankfully the ache of feeling out of place began to crack and erode. This mindset change was mostly thanks to the people around me. Time spent with caring faculty and incredible students enabled me to chip away my fears and access my underlying confidence.

  And then I started my clinic rotation, and I realized that many patients face similar feelings of outsider-ness. The ways that the body functions, both correctly and incorrectly, and the complex organization of delivering care are behemoths that many patients find foreign and hard to understand. In the clinic, I watched an elderly patient drip with anxiety as they discussed their profound concern over a recent note in their chart. A few months prior, they had an ultrasound which incidentally showed a cyst on their left kidney. They went through a follow up investigation and came to the clinic confused and afraid. Pulsing with fear from the implications of a disease, they explained how they had read the imaging report in their chart and had no idea what it meant. The physician declared that the cyst was not a cause for concern, and the patient erupted with tears of relief. Offering a hug, the physician remained in the room for a long time. As the patient asked more questions and listened, their fear evaporated and their confusion turned into curiosity.

  I met another patient, a professional musician, who came to the clinic terrified about recent pain in their arms. They described how the pain forced them to stop performing in the middle of their set, and they admitted their fear that this condition would prevent them from playing. “I feel lost in my own body,” they said, as the provider asked how they were coping. During the visit, the provider explained, with no hint of jargon, how the body responds to pain and carries out movement. The patient leaned in as the provider drew a rough sketch of a nerve pathway, and while the provider could not yet point to the cause of the pain, the patient expressed their satisfaction in understanding more about the situation.

  In those moments when I met fearful and lost patients and watched caring physicians offer support, I better understood my feelings of outsider-ness. Somehow, I had the conception that in training to become a doctor, I would have to discard my humanity. I realized I’m not training to be some sterile, robotic, pseudo-machine. I’m immersing myself in medicine so that I can be a guide to those who come to me feeling scared and uncertain. To many, like me, medicine is a foreign world, and I’m training to be a bridge into that world, to be adept in the complexities and technicalities so as to make it understandable and personal for my patients. I’m training to care for those who feel like strangers, and in the process to see them not as others, but as full human beings, with hopes and dreams and stresses just like me.

  I realize that encouraging strangers to feel known and providing a foothold to those who feel lost are lofty tasks. Some people think consideration and empathy are finite resources. Some see kindness and concern like pitchers of water that we must ration as we pour ourselves into others, afraid our springs will run dry. Certainly, when we are fatigued from hard work and tackling our own stressors, it is hard to muster the energy that is required to mask our feelings and focus on patients. Certainly, there are times when the feelings poke through, and even in our best efforts, there are patients who do not feel satisfied. But my challenge to myself, at least, is that as I venture deeper into the world of medicine, I never forget my feelings of being an outsider. My challenge is for me to remember the radiating ache that I felt during my white coat ceremony, and for me to remember that many patients experience similar, if not more magnified feelings. My challenge is to remember that I’m not an automaton or some prestigious purveyor of science: I’m simply a human, learning medicine, in order to help other humans

   

• Third Place | "Myco-Medicine" by Eliza Burr
  

  Myco-Medicine

  By Eliza Burr
  
  

  When I arrived in Michigan, I had been foraging mushrooms for a few years. I first became interested in mycology, the study of fungi, at college in upstate New York. The environment was luscious, the kind of environment that encourages mycorrhizal structures lying beneath our feet to fruit, and it is the fruit that catches our attention. There’s amanita muscaria, also known as the “Mario mushroom,” not to be eaten; puffball mushrooms pallid like softballs; laetiporus, lovingly referred to as the “chicken of the woods.” And beneath our feet, the networks of rhizomes, the real organisms, stretch out for miles. They commune with the roots of trees, providing necessary nutrients. They respond to subtle shifts in temperature, moisture, and light. Fungal networks have been referred to as the “wood wide web,” transmitting information throughout the giant organism of our ecosystems.
  
  When I began medical school at Michigan State University College of Human Medicine, I was already looking for mycorrhizal networks everywhere. It was not difficult to see the underlying web of interconnected needs in health care as a mycorrhizal network itself. My medical training has been preoccupied with the investigation of where one entity ends, and another begins. This dissolution of the individual is visible on the molecular level, where systems blend into each other to interact and influence the operation of the body as a whole. It is evident on the level of the healthcare system, in which patient care is only as effective as our communication with everyone involved. But as someone who went into medicine for the human interactions, I am most interested in the community that is built between those of us who provide care and the patients who receive it.
  
  If I imagine this generative space, I begin to fill it up with all the ways in which we are connected to our patients. There is the physical connection, the foundation of medicine, in a clinical examination of another person. Touch is the most tangible form of connection. The link between my ears and their heartbeat is a message murmured between S1 and S2. Then there is the emotional connection between us, the empathy that we are taught to carry to each room on our rounds. The subtle cues in a patient’s glance or tone tell us about their fear, or their sorrow, or their impatience. Even before we exchange words, a connection is formed based on the way we enter their room and the way they greet us. Then, the conversation, the history; we are taught its importance even before we learn physical cues. Human society is built on the backs of words as they string together one discrete body to another. The History of the Present Illness, or HPI, is much more than the story of a symptom. Rather, it is a door into the patient’s experience. In trusting us to care for their health, patients trust that we will not abuse the bridge they are building between their needs and our solutions. They are inviting us in with the hope that we will take them along. The HPI is an experience in duality, a building of community.
  
  Admittedly, this framework has not been supported by the power of fungi alone. CHM has reaffirmed the framework of community-building on every level. In lecture halls we are taught to understand discrete biological systems by building “mental bridges” from one concept to another. This is a virtue of the C3 curriculum that encourages thinking outside the traditional medical structure of learning one bodily system at a time. In simulation sessions we were encouraged to pay attention to stories and nonverbal cues alike from our standardized patients. I will never forget the session during the second year Structural Competencies rotation in which we were able to sit down with the people who had been our standardized patients all year to get to know them as themselves. One of those sessions ended with both me and the patient in tears, grateful to have been able to find community in each other’s stories. These experiences allowed me to feel the power of mutualism when it is practiced in healthcare settings.
  
  Understanding the universality of mycorrhizal networks has helped me access the invisible threads that tie me to the patients I see. One of the valuable lessons I have gained in medicine is the ability to let go of ego and lean into the community that surrounds us. Finding that community with a patient helps us help each other, making the collective experience of seeking care and providing it run more smoothly. Finding community within our healthcare systems allows us to feel less isolated in a field that is often full of grief. I remember during my first rotation of third year, I walked into the Hurley Medical Center student lounge to find a circle of peers decompressing from the exhausting and often frustrating experiences of their clerkship rotations. In that moment, I felt recharged by the mutual support I was witnessing. This kind of community-building allows us to accomplish the shared goal of providing high quality patient care without sacrificing our mental health and wellbeing.
  
  In my clerkship rotations in Flint, I have used the lessons of community-building gleaned from MSU and mycorrhizal networks every day. When I see patients, I feel the network stretching between me and them, them and their community, their community and my community, and my community and me, all wrapped up in the time I take gathering their history. When I talk to a patient’s nurse or try to coordinate care between two specialists, I see us all as nodes in the healthcare network, each one of us providing nutrients and information to the other. From the patient to the physician to the administrator, we’re all part of a system with collective goals. My hope as I move forward in medicine is to hold fast to this network to foster community that stretches for miles, perhaps invisible, nourishing us all.

IN MEMORY

The contest is named in honor of Annie Li Yang (1995-2019), one of the inaugural essay winners. Annie was a first-year medical student at the Michigan State University College of Human Medicine. She held a BA from Princeton and would have received her MD in 2022.

In her winning 2019 Inaugural Student Essay Contest entry titled “Patiently Gazing into Patients’ Lives,” Annie candidly delved into her fear of and journey to overcome reductive thinking, stressing the importance of always keeping sight of the individuality of patients and their lives outside of the hospital or clinic. In her words, “what it truly means to become a physician [is] to see the patient as someone much like myself, a member of a wider community and family.”

View previous essay winners