This Year’s Annie Li Yang Student Essay Contest Winners
April 20, 2026
Three students were named winners of the 2026 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 Kristina Simon, second place winner Katherine Bekker and third place winner Farid Alsabeh.
Read their essays below.
- First Place | "Where Disease Meets Reality" by Kristina Simon
By Kristina Simon
Where Disease Meets Reality
In the classroom, disease is organized and internally consistent. Diabetes is defined by insulin resistance and progressive microvascular injury. Wound healing proceeds through predictable inflammatory and proliferative phases. Social determinants of health appear on lecture slides as modifiers of risk. Within that framework, pathology feels structured and controllable. It was through my work with Spartan Street Medicine and at the free clinic that I began to understand how incomplete that framework was.
Through Spartan Street Medicine (SSM), I met patients whose illnesses unfolded not only through biology but through instability. During outreach, we encountered individuals managing diabetes without refrigeration for insulin, attempting wound care without clean water, and rationing medications because refills required documentation or insurance they did not have. I remember speaking with a patient who could clearly explain her A1c trends and insulin dosing strategy. She understood the physiology of her disease. What she could not control was the loss of insurance coverage that made her regimen unaffordable. In lecture, we studied the biochemical pathways leading to neuropathy and nephropathy. Through SSM, I saw how gaps in coverage and cost barriers accelerate those complications more reliably than any molecular cascade. Disease progression was not simply physiologic; it was structural.
Working in both outreach and clinic settings forced me to reconsider what “noncompliance” truly represents. In the classroom, treatment plans assume access: stable housing, reliable transportation, financial flexibility, and consistent nutrition. Yet food insecurity repeatedly complicated the chronic disease management strategies we discussed in endocrinology. We are taught to counsel patients on carbohydrate moderation and balanced meals. Through community engagement, I met patients who relied on shelters, food pantries, or inexpensive packaged foods to survive. Dietary modification was not a matter of motivation; it was constrained by affordability and availability. I began to recognize that clinical recommendations detached from context risk becoming unrealistic expectations.
Housing instability presented similar challenges. In pathology lectures, wound healing is a biologic sequence of hemostasis, inflammation, proliferation, and remodeling. In practice, wound care depends on conditions that many patients lack: clean environments, supplies, and the ability to return for follow-up. During street outreach, we encountered patients with chronic lower extremity wounds attempting self-care with limited materials. Advising daily dressing changes carries a different meaning when someone does not have a secure place to sleep. A treatment plan may be biologically sound yet practically impossible. These experiences reshaped my understanding of what makes medical care effective. Accuracy alone is insufficient; feasibility determines impact.
My perspective has also been shaped by my own experience navigating healthcare as an immigrant without stable insurance. I recognize the quiet calculations patients make before answering questions: whether disclosing medication nonadherence will invite judgment, whether asking about cost will appear ungrateful, whether scheduling follow-up will create financial strain. In lectures, access to care is presented as a determinant that influences outcomes. In exam rooms and on sidewalks, it is a lived reality that shapes every decision. I began to see that clinical reasoning must account not only for pathophysiology but also for structural vulnerability.
Importantly, these experiences have not diminished the value of biomedical knowledge; they have reframed it. Understanding mechanisms remains essential. Knowing how hyperglycemia damages endothelial cells or how inflammation impairs wound repair allows me to recognize risk and anticipate complications. However, I am learning that effective physicianhood requires integrating that knowledge with structural awareness. When a patient’s A1c remains elevated, the question is not solely whether insulin dosing is correct, but whether storage, cost, literacy, and food access make adherence possible. When a wound fails to heal, the inquiry extends beyond infection or vascular insufficiency to include housing stability and supply access.
This integration has reshaped my identity as a physician-in-training. I entered medical school focused on mastering mechanisms, believing competence meant recalling pathways and treatment algorithms. Through Spartan Street Medicine, clinic rotations, and classroom synthesis, I am beginning to understand that competence also involves designing care within constraint. It requires asking different questions, listening for unspoken barriers, and resisting simplistic interpretations of complex circumstances. It demands humility in recognizing that health outcomes often reflect structural conditions beyond individual control.
I do not yet have solutions to fragmented insurance systems, food deserts, or housing insecurity. What I do have is a growing awareness that these forces shape disease as powerfully as biology does. As I continue my training, I hope to practice medicine that acknowledges both; care that is scientifically rigorous and structurally informed. Bridging classroom learning with community experience has taught me that becoming a physician is not solely about diagnosing and treating disease. It is about recognizing the systems in which disease unfolds and adapting care accordingly. That understanding; that medicine lives at the intersection of biology and structure, is central to the physician I am becoming.
Return to Top - Second Place | "Ten Thirty-eight" by Katherine Bekker
Ten Thirty-eightby Katherine Bekker
The first time of death pronouncement I heard was 10:38. I don’t know how long it will be before I forget that time. The pronouncement was so final, an audible indication that the code was over, and any hope of resuscitation was gone. The patient was a child, and I don’t know if I will ever forget the desperate cries from their family members, the mother collapsing to the cold linoleum floor, steadied by a social worker and friend. The moment did not feel like a lesson or milestone. It was an abrupt confrontation on the limitations in medicine.
It’s easy to remember the hard things, especially the hard firsts. It’s easy remember the names and faces of patients who died, the ones who did not get the results they wanted, the patients who were abused, or the times you couldn’t find the answers. The mind holds to these experiences with a particular stubbornness, perhaps because they expose the fragility of the systems we trust and the limits of our own knowledge. Yet, if medicine were only defined by its hardest moments, it would be unbearable. What has sustained me is the steady presence of its beauty. Amid the hard things in medicine, there are many beautiful firsts: the first delivery you watch, the first thank you, the first moment you realize you helped someone in a tangible way. These moments are often quieter, less dramatic, but no less meaningful.
I remember the first toddler I saw discharged home after spending her whole life in the hospital. She was going home with a trach and a g-tube, but she had overcome so much, and she was finally going somewhere truly permanent and safe. The air was light, the family was giddy, and the patient, though not totally sure of what was going on, playing on a mat. They didn’t think she would survive her first week, and here she was, playing with toys, her parents discussing the follow-up appointments with the goal of full oral feeds and decreased trach dependency. I also remember the first family member I saw burst into tears after learning their loved one would be moved out of the ICU to a step-down unit. The profound humanity in medicine is best illustrated in the clinical setting, and despite the early wakeups, fractured studying schedule, and countless preceptor assessments, the clinic is a vital step in our early medical education.
In class, the cases are centered around us, the medical students. Medical school classes are designed with the students’ learning needs at the center of the curriculum. The cases are carefully written to reflect what we need to learn and how we best internalize the new information. In the clinic, however, medicine is no longer about us. The clinics are not designed to fit our needs and conveniences and come with limited predictability. They contextualize and humanize the pathophysiology we learn in the classroom, but the patients do not present in neatly packaged narratives and outcomes are not guaranteed to align with expectations. The fictional patients in class are reified through real-life experiences and people with complex needs and families.
Because reality is not only higher stakes, but also deeply emotional, those first-time experiences stick, imprinting themselves in ways that lectures cannot. We will all dwell on the patients whose courses do not go the way we hoped. We will feel the immense sadness that comes with loss. We will feel anger when a patient is denied treatment from insurance, or when a child comes into the ED with visible signs of abuse. We will feel outrage when political and social dogmas exacerbate misinformation that directly harms our patients. We’ll feel fear when a patient unexpectedly decompensates, when a situation escalates beyond what we feel prepared to handle. We will feel deeply inadequate many, many times while trying to find answers. I have said phrases like, “those feelings are valid” now to dozens, or maybe hundreds of patients when they also express feelings of sadness, anger, and fear. Likewise, this same acknowledgement must extend inward. The feelings of grief, anger, fear, and inadequacy are not signs of weakness. They are evidence of the engagement in our work, the humanity of the work.
And yet, there is tension in how we remember our experiences. Positive emotions like joy and satisfaction may feel more transient and don’t seem to outweigh the negative emotions, even when they occur more frequently. For the one pediatric death I saw as a medical student, I saw dozens and dozens of patients who went home with optimistic outcomes. And yet, the time 10:38 still lingers. This imbalance reveals something important about memory and meaning. Painful moments demand to be processed, requiring more from us, emotionally and intellectually, resistant to being quietly filed away. There is a book I read to my toddler called “In My Heart” that discusses feelings, some more complex than others. The book illustrate that all feelings are valid, and that they can coexist, even when they seem contradictory.
The lesson is simple, but its application to medicine is profound. Medicine asks us to carry the memory of 10:38 while still showing up for the next patient with presence and compassion. It asks us to acknowledge loss without becoming defined by it and to celebrate small victories without dismissing the weight of harder outcomes. The work is not about choosing which experiences matter more, but about learning how to live with all of them. Meaning in medicine is not found in isolated moments, but in the accumulation of them, a quiet stitching of grief, hope, doubt, perseverance, and hundreds of other emotions, some of which we cannot express adequately with words. Perhaps, over time, the goal is not to forget 10:38, but to understand where it fits alongside the many other moments, both painful and beautiful, in developing the emotional architecture that expands our understanding of what it means to care.
Return to Top - Third Place | "Presence and Paracentesis" by Farid Alsabeh
By Farid Alsabeh
Presence and Paracentesis
“It’ll be nice to get down there.”
The patient was fully reclined as she spoke. I smiled and nodded, but my eyes were still fixed on the tube that snaked across her abdomen.
“How’s it looking?” the doctor asked.
There was fluid in the tube, but it wasn’t moving. The doctor advanced the catheter that was plunged into the patient’s abdomen. I adjusted the tube’s position slightly, carefully pulling it away from a peripheral IV line. Suddenly, the straw-colored liquid began flowing again, down toward the floor and into a container.
“I fly out there every winter.”
I sat down, and the doctor leaned back in his seat. With the fluid moving freely again, we turned our attention back to the patient.
“There’s nothing more important than family,” I said.
This wasn’t the patient’s first paracentesis. Her chronic liver disease required her to undergo one every few weeks. But today, she had been unable to make an appointment with her GI specialist in time. And so she found herself here instead, making conversation with us during my EM rotation.
Five liters: that was the number on everyone’s mind. The doctor had explained that if we went over that number, she would need to remain in the emergency department for a few extra hours, long enough to receive an infusion of albumin.
But the patient was eager to leave. In just over a week, she would be moving to Arizona to live with her daughter. It was a big decision, and one that she had been considering for years. Now, having made it, her thoughts were occupied with the logistics.
That, and the number five.
I replaced the second container with the third.
***
Passing the time, she shared more details about her life. Her daughter had become a mother herself, and she was anxious to help her raise her child. Her husband had passed away several years ago, and most of her memories of him were in Michigan. Would leaving the state mean leaving those memories behind?
She got these concerns off her chest; meanwhile, the liquid kept draining through the tube.
I replaced the fourth container with the fifth. The patient looked down, and seeing that her abdomen was still distended, registered that more than five liters would be necessary.
“Looks like you’ll be stuck with me for a little longer,” she joked.
Perhaps because the issue was settled, she relaxed, and there was a corresponding shift in her tone. She expressed her excitement about moving to a new state. She recalled with vivid detail the first time that she saw her grandson, and how she saw her husband’s face in his. How he lived on in his smile.
Sitting there with the patient, it occurred to me that this exact experience synthesized much of what the Shared Discovery Curriculum was designed for. Before my clinical placement that day, I had only ever read about paracenteses in a textbook, as well as the indications for an albumin infusion. Now, I had a memory to anchor these facts to, a human reference that would help me appreciate and understand them more.
But this experience had been valuable for different reasons, too. By giving me this time to spend with a patient, without the high demands and pressures inherent to the clerkship years of medical school, I was able to practice my skills connecting with patients as whole people. And if the ‘Human’ in ‘College of Human Medicine’ means anything at all, it means exactly that: the practice of medicine that honors the whole person.
That day I found myself doing a small version of that, of all places, in an emergency department. And the measure of our time wasn’t grains of sand in an hourglass, but milliliters of a liquid, which continued to pour out.
***
We ended up draining 8 liters that day. As I loaded up the containers onto a cart, a nurse prepared to administer albumin through the peripheral IV. We could now leave the patient alone for a while, so we returned to the hustle and bustle of the emergency department.
An hour later, I checked back on her. What she had lost from her abdomen, she seemed to have gained in her face: there was a fullness to her expression, which beamed with energy. She thanked us for our help, and I thanked her for sharing her story. We parted ways.
As future physicians, we face many challenges when it comes to honoring the human dimension of medicine. First, we have the objectification that is inherent to dealing with the body: of relating to the patient as an It, rather than a Thou. There are also the demands of time constraints, which can make meaningful connections with patients difficult. Finally, we will contend with incentive structures that reward the complexity of diseases, but not necessarily the complexity of people and personal identities.
My interaction with that patient, and many others during my second-year clinical placements, helped me to feel more confident navigating those challenges. Not only had I gained real-life experiences related to important medical information, but I also had the opportunity to develop important skills related to patient care, and particularly in balancing clinical care with the human touch.
I’m proud to be part of a medical school whose commitment to training humanistic physicians runs deeper than words, but is reflected in the very structure of its curriculum. And during my clerkship years, I will wear the ‘College of Human Medicine’ badge proudly, seeking to fully embody the meaning behind its second letter.
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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.”