Up at the crack of dawn

Today wasn’t the first nor the last day that I woke up before the sun came out. Between my sophomore and junior year of high school, I woke up at four in the morning to be out the door by no later than 4:45am. I would then walk two miles to the nearest bus stop. I lived in the “lower valley” in El Paso, Texas, at a time when it might as well have been a far-off town in a third world country. Over 90% of us had well water and the closest thing to a hospital were clinics and medical practices sponsored by the county hospital. If I wanted to get some experience in laboratory technology, I would have to make this trip on my own.

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There’s a bus that can take me all the way downtown now. Times have changed.

My mother used to be a secretary at the medical school in Juarez, Mexico, when she was pregnant with me. In fact, it was the medical director of the school who first knew that I was on the way. Mom was worried that she was pregnant, so she asked him if he could do a pregnancy test. Dr. Ricardo Ortiz Piñeru had his own medical laboratory where he did routine laboratory tests. It was right downtown in Juarez, less than a mile from the international bridge. He requested a urine sample from mom and gave her the good news later that day.

About 15 years went by, and I was a sophomore in high school. I was interested in the medical field, so mom thought it would be a good idea for me to meet Dr. Ortiz and his assistant Daniel Chavez Licón. When I met them, I was in awe of all the equipment they had in the lab. They were old analyzers, microscopes, and all sorts of flasks and other instruments to process biological samples.

The lab would see a couple of dozen people early in the morning. Daniel would draw their blood or collect their specimens. He would then process the specimens throughout the day. Dr. Ortiz’s wife would hand out the results some time in the afternoon. And Dr. Ortiz? Well, by the time I met him, he was in his 90s. He would come in late in the morning, check his own urine for sugar, and then sit at an old word processor and work on a book he was writing. It was a book on genetics. (It might as well have been written in Chinese to me.)

The waiting area of the lab had a big painting that Dr. Ortiz made after he graduated medical school. It was an Aztec sacrifice scene. His face was painted onto the high priest excising the heart from a man. The warriors, priests, and other Aztecs looking onto the scene had his classmates’ faces painted onto them. And the man being sacrificed? Legend has it that it was one of their professors from medical school. It was a really detailed painting. I wish I would have taken a picture of it to keep.

For the whole summer, I would get up at four, get ready and get out the door to go to the lab. I’d do this 3 or 4 days out of the week. As soon as I came into the lab, I had a task assigned by Daniel. At first, I had nothing to do but make blood slides. Some were “as thick as sandwiches,” as Dr. Ortiz would say. Other’s were “as thin as crepes.” The sweet spot was somewhere in the middle. By the end of the first week, I mastered that art.

The second week was all about drawing blood. I’d see Daniel drawing blood and practice on a pillow. The first person I ever drew blood from was my maternal grandmother. I think she still had the bruise when she passed away almost two years ago. She took it in stride, though, congratulating me on getting it done even though I was shaking with nervousness.

As the weeks went by, I learned the ins and outs of all the tests that Daniel performed in that lab. I learned to process specimens the old way, via mouth pipetting. (You had to be very careful not to swallow a milliliter or two of other people’s serum, which I did not.) I learned about spectrophotometers and how changes in the color of the specimen when a reactive substance was added indicated the presence or absence of a substance and even its concentration. I learned about Beer’s Law and how different concentrations of substances absorb light of different wavelengths at different intensities. And I learned about all the different cells present in the blood through looking at them in the microscope.

The world would never be the same after I did that. While I had played around with microscopes when I was in grade school, middle school, and high school, I was very impacted by looking at a slide that I had prepared (not too thick, not too thin). And the Gram stains? That opened up a whole universe of stuff. Not only were the microbes everywhere in the environment — which I knew already — but they were of different shapes, sizes, and Gram staining properties.

All of that summer and some of the next one came together when I applied for college a year later and got into the medical technology program in the second half of my college years. By the time I was learning about medical technology at the university, I already knew about making slides, staining them, and the principles behind a lot of the tests that we would be performing as “med techs” once we graduated. While it would be other aspects of my life that would distract me from getting straight A’s, those months of getting up at the crack of dawn and making that trip to the lab taught me so much more than just laboratory medicine.

As I was walking across the parking lot to the school of public health today, an hour before sunrise, a woman was walking down the sidewalk as she pulled a piece of luggage along. She was yelling something incomprehensible. It was more like loud mumbling, really. Then there was a group of people waiting for a bus. Half of them were smoking. On my drive in, I heard about an oil spill which has contaminated the water of a small town in Montana with benzene, a cancer-causing chemical. All the while, I huffed and puffed as I had made my way down several flights of stairs at a brisk pace because it was cold.

For a couple of seconds, the weight of the world and all of its public health problems — from mental health to what hurts us at the genetic level, to the high number of us who are overweight or obese — seemed a little too big for me. Then I remembered that I’ve been doing this for a while now. All of this school stuff and learning and taking on the problems thrown at me by the world around me is nothing new. That little bit of panic went away and was replaced by the familiar feeling that getting up at that ungodly hour to travel into Baltimore was but a tiny sliver of what so many people have to go through just to stay alive… Not to make a living, but to actually stay alive.

I’ve been lucky in my life to be able to get up that early, walk on my own two legs, breathe the cold air of a dark and stormy winter morning, and get on with learning more things and putting them to practice for the benefit of myself and others. I hope you have been that lucky too.

I'm a doctoral candidate in the Doctor of Public Health program at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen