There are so many different ways to speak with others and understand one another, and it is important for us as medical professionals to be attuned not only to spoken words, but also to everything that falls in between.
Alexandra Cohen is a 23-year-old Montreal native who recently graduated from the MDCM program. She will be starting her pediatric residency in July at the Children’s Hospital of Eastern Ontario in Ottawa.
Describe yourself in one sentence.
Impossible! But seriously, I would say that I am a very driven, enthusiastic and optimistic person with a passion for both medicine and musical theatre.
Tell us about your journey to medical/dental school.
I fell in love with medicine when I was eight years old. At that time, I was diagnosed with Crohn’s Disease and was hospitalized for several months. It was a very painful and difficult time in my life, but throughout all of that, I found myself very inspired by my doctor. She really represented the principles of whole person care and empowered me to take an active role in my own healthcare, even when I was just a little girl. So during that hospitalization, I told my parents that I wanted to become a pediatric physician and that I wanted to help children who are chronically ill and guide them through their journeys in the medical system, like my doctor did for me. From that point onward, I was very dedicated to medicine; I never really considered another career path. During my growing-up years, I interacted with a lot of physicians and I just tried to take as much as I could from each of those experiences and learn from both the positive and negative ones. I think I carry a lot of those with me now as a medical student / incoming physician.
I think it really helps to keep you human, you know? In the medical environment. When you start to depersonalize [your patients] because you’re feeling burnt out or tired, you kind of have to take yourself back to what it was like being the patient. That always brings me back into the present.
Did you want to know about my concrete journey as well? Concretely, I went to Marianopolis College and was [then] accepted into the Med-P program.
What has been your most impactful or memorable experience since starting medical/dental school?
All of my most memorable moments involve patient encounters for sure! When I rotated through community pediatrics, there was this little boy in the clinic who was around four years old. He was nonverbal, I could hear him crying literally from down the hallway where the nurse was trying to get his height and weight. I think it honestly took her around 10 minutes before she came to find me and said, “I’m sorry, it’s just not happening today.”
When he came into the room, I knew right away that examining him was going to be a problem. And of course when the time came, he hid behind the mother’s legs and wouldn’t let me anywhere near him. But for me, one of the things I really love about pediatrics is the challenge, and also the need for creativity. I think I probably crawled around on the floor with him for eight minutes or so in order to gain his trust. Since we couldn’t communicate using words, I would point to things in the room, I would point at the cars out the window and just try to engage in the things that he seemed interested in. Finally, he let me examine him. After that, I went to review the case with my supervisor and we came back together. I sat down at the desk and he immediately just came over to me and crawled onto my lap. He started kissing my mask and holding my hand, and he stayed on my lap for the rest of the appointment. He was the absolute cutest! His mom was like “I think you should come home with him!”
For me that was really memorable because I got to see that kid completely transform throughout the appointment. So I sort of hold onto that memory, just to remind me of how important it is to focus on the child’s individual needs, to be patient with them, and to always foster creativity in the clinical environment.
In your opinion, what has been the most impactful discovery in medical/dentistry?
I will preface this by saying that my answer is very basic! But I do need to be honest about what I actually think is the most impactful discovery, even if it's a boring answer. It has to be the first vaccine for me – smallpox. I think that this discovery opened up a whole new field of medicine where we are able to eradicate infectious diseases. It also shifted the way that we approach medicine as physicians. We have moved away from this reactive approach to medicine towards a more proactive and preventative approach to disease. And I think that transformation has its roots in the discovery of vaccines.
What is something little known about you?
I think very few people probably know how much I love creative writing. I started writing fictional novels when I was around 12. It’s something that I still do when I have the time to sit down and dedicate myself to my words. I’ve written a lot of books, but none of them are published!
I also write songs. I taught myself to produce backing tracks on GarageBand during the pandemic more recently, but I am definitely more of a lyricist than a composer. I just find that it is a great way to channel my emotions into something positive when I’m having a bad day.
What is one experience that you have had that you feel others can learn from? One story you would like to comment on?
I think I’ll pull another story from my early days in the clinical environment. I was doing a pediatric elective, and in clinic, I was given a consult for a little boy who was described as nonverbal. So during the interaction, I really focused the interview on his mother. I took the history from her and really only spoke with her.
When it came time to do the physical exam, I turned to the little boy and started speaking to him - “Can I take a look in your ear? Can you open up your mouth?” - and I was surprised by how engaged he was in the exam. He listened very attentively, he did exactly as he was told, and very clearly understood what I was saying.
When I finally left the room to go speak with my staff, I felt very ashamed of myself to be honest. Having been a patient myself, I take pride in my ability to always engage with a child first no matter how young they are. Even if they are too young to really understand what I’m saying! I always try to start the appointment with them, so they feel like they’re a part of it.
When I went back into the room with my staff, he sat down at the desk and started speaking with the mother. But this time, I really kept myself next to the boy and focused my attention on him. I feel like he kind of felt the shift in me when I came back into the room. Because he felt more seen, I think he developed more trust in me, and he actually pulled up the leg of his pants and pointed to some lesions on his skin. They had nothing to do with the reason why he was in the clinic - it was an ENT rotation - but I asked him some questions. I asked whether it itched, whether there were any more… he pulled up his sleeve to show me more on his arm. At the end of the day, we referred him to dermatology, so I’ll never know how the story ended, but I walked away feeling like maybe I had been able to uncover something because I really took the time to focus on the child.
I think people can learn about the importance of nonverbal communication from this story. There are so many different ways to speak with others and understand one another, and it is important for us as medical professionals to be attuned not only to spoken words, but also to everything that falls in between.
What is something you wish you knew before entering medical/dental school?
I think that in my early days as a medical student, I was really shocked to learn more about the CaRMS process. I realized that it wasn’t going to be as easy as I expected to pursue my dream career! At the time, I spoke with as many people as possible who I thought could advise me on the best path forward. And while I always do recommend that people seek out advice from those who have more experience, at the same time I wish I better understood that there is no recipe to ending up in a certain program or a certain profession. Everyone wants to know about those magic ingredients that will get you where it is that you want to go, but at the end of the day, there are so many paths that will lead you to the same destination. People told me this from time to time, but I don’t think it really landed on me until more recently.
Do you have any advice you would like to give to future cohorts of medical/dental students?
I have a few thoughts! I would say first of all, as hard as this is to do: try to avoid comparing yourself to others. Like I said before, we all have our own unique journeys. Instead of replicating someone else’s, I would advise you to try to find your own personal niche and dedicate yourself to that. I found out early on that I love medical education, so that became something that I involved myself in very heavily throughout medical school. But that was my thing, and everyone will have their own. You shouldn’t compare yourself to what other people are doing, because everyone has a different way of getting where it is that they want to go.
I think that finding great mentors is very important. Mentors can take on many different shapes: they can be medical students, residents, staff... really anybody who you trust. You can also have several different people who you turn to for different things. A lot of people put pressure on themselves to pick a career path early on, but at the end of the day, your mentor doesn’t have to be in your chosen specialty. It’s actually really nice to have [a mentor] who isn’t, because you can really speak with them candidly about your struggles and not worry about it impacting your career trajectory.
I would also try to be confident in your role as a medical student. A lot of people will say, “I’m just the medical student”, but at the end of the day, we have a lot of value. We have value in the clinical environment and even in the research world, and it’s important to own that. That shows a certain level of maturity that gets noticed. [For example,] when you are having an initial research meeting, see it as a meeting, not as an interview. It is really a two-way street, [so] if something doesn’t feel right to you, you can say no, [such as] if your interests or expectations don’t align with [theirs].
Finally, I would say to hold onto the things that you love outside of medicine. Maintaining your hobbies is so important for wellness. As an added bonus, it’s also helpful for CaRMS. I think I was asked about non-medical hobbies in almost every interview during my [CaRMS] tour. Now, several Program Directors are well-acquainted with my favourite Broadway musicals, but that’s just part of the process! Hold on to those things as they are so important.
Would you like to expand on how you were able to balance your personal interests and hobbies with medical school?
Oh gosh, balancing all of my interests was very difficult for sure. I think at the end of the day, it’s about time management and advanced planning. Also, it’s about not taking on more than you can handle and leaving some room in your schedule for the unexpected. Because sometimes opportunities [that are very exciting] will come your way, but if you have committed to too many things upfront, you may not be able to accept those opportunities when they come along.
For me it was about hand-picking the things that I was most passionate about and really dedicating myself to them. But also by staying on task and by working ahead of schedule, I was able to carve out time for the things that I love. I think you have to work to find realistic ways to keep the things that you love in your life while balancing all of your commitments in a way that is personally satisfying.
I think it’s also important to know when to say “no”. Be willing to say “no” to things that don’t excite you in the way that they should, even if you think they might look good on your CV. At the end of the day, that lack of passion will come through [during interviews], and it’s just not worth wasting your time on it.
What are you most looking forward to in your upcoming residency? If you are comfortable sharing, what are you most worried about?
I’m very excited to embrace my role as a resident and to develop my emerging independence. I look forward to learning a lot more about the practice of pediatrics and being able to focus single-mindedly on the pediatric population —finally. I’m excited to meet lots of new people, find new mentors, continue to develop my professional identity, and have new learning experiences, all while exploring a new city!
I think it’s always scary at first to take on more autonomy and be responsible for patients’ lives more directly than we were as medical students. Writing those first prescriptions might be a little scary, just because I want to make sure that I’m doing it all right. Even though I’ve [already] been writing them as a medical student and having them co-signed by the resident, it kind of feels different to have that final word on a situation. Thankfully, that’s why we have senior residents around!
I’m also nervous about going through the process of specific career exploration, in terms of trying to figure out what subspecialty path I want to follow, but I’m grateful to have four years of residency to explore different options and figure that out!
If you had a superpower, what would it be?
I feel like personally I never have enough hours in a day to accomplish everything that I want to do. So if I could harness the power of the Time Turner in Harry Potter, then I think that I would probably get a lot more done in my life. I would vote for that. Then I would have time to be in a musical while in medical school!
If you had a magic wand with one wish to change this world, what would you wish for?
It probably sounds silly, but I would instill in everyone a little bit more empathy. I think that those who have treated me with more empathy during difficult times in my life have really impacted me. So when I’ve been in contact with other people who are struggling, I’ve been able to give them the same thing, while hopefully having positively impacted their lives. I think a lot of the world's problems really boil down to people being unable to or unwilling to really try to understand each other. I think if we try to put ourselves in other people's shoes more often, the world would probably be a much better place.
What is the most "useless" talent you have?
I could lie and say that any talent is useful if you think about it long enough. But probably the least useful of my abilities is my ability to speak really quickly. If I get excited about something, I tend to start talking really fast, and I have to tell myself to slow down so people can understand what I’m saying. On the other hand, this is where the whole utility thing comes in: if there was an urgent situation going on, I could communicate it very quickly!
What is the funniest way that you’ve been injured?
When I was in elementary school, I was doing a dance recital. When the song ended, we all ran off stage, and I was super excited because I thought that I had done a good job, and I literally just ran into a wall backstage. There was a loud crash and the whole audience just gasped. Afterwards my mom said “I knew it was you because you're such a klutz”. My eyebrow was bleeding but luckily I didn’t need any stitches!
Note: The above is a direct transcript from a live interview with Alexandra Cohen conducted by the Resonance Humans team.