Before I began medical school one of my mentors told me, “You do not have to be the smartest to make it. You just have to persevere.”
Lately, I have pondered this quote ad nauseum. At that point in my life, I had everything going on track: a good job, healthy dating life, and a future as a doctor. Sure, perseverance was a well-known concept, brutally beaten into me as a poor rural Arkansan boy who worked for everything he had. Yet, perseverance was a cliché that I had risen above. I had put myself through school, obtained a well-paying job, and then put myself through school again. Although things were tough, my wits were the tool to make my goals come to fruition. It actually felt easy. Perseverance was simply pushing through the discomfort that rears its ugly head.
Medical school orientation finally came and surprisingly I became overcome with conjunctivitis in both eyes. Not the ideal way of making a first impression I assure you. The illness passed and I was seeing clearly again. Things seemed to finally be on the right track. I was even ranked #1 in my class. Then slowly, I began to notice a change in my bowel habits. I began to have daily bouts of diarrhea, abdominal cramping, and fatigue. What started as a once-daily occurrence progressed to multiple times a day with blood accompanying. “This must be a Clostridium difficile infection secondary to the antibiotics used to treat my eyes,” I thought. It would be easy, just push through the discomfort until this is diagnosed and treated.
The insidious progression lasted months until my misfortune made a glorious crescendo. My father abruptly died of a heart attack. The stress tanked my health. I was a prisoner to the bathroom and essentially bedridden with extensive pain, bloody diarrhea, and fatigue. I was lucky enough to quickly see a gastroenterologist and get a colonoscopy which led to a diagnosis of Ulcerative Colitis, a type of inflammatory bowel disease that I would always have. There I was, completely and utterly broken, unable to come to terms with the loss of my health and the man I idolized the most.
“The world breaks everyone and afterward many are strong at the broken places. But those that will not break it kills. It kills the very good and the very gentle and the very brave impartially.”-Ernest Hemingway
These words lingered in my mind and seemed harshly relevant. For the first time in my short life, I wanted to give up, fly the white flag, and surrender. Life looked me in the eye, and I blinked. Born in those moments was the first true test of perseverance. The visage of who I was and the life I was expected to have? Gone. Few have known what it is like to mourn yourself. Now the choice was evident, a path clearly diverged. Do I give up and succumb to my illness or do I keep putting effort into school and a dream I had in a past life? There seemed to be only one true choice.
Steroids helped tame the colitis but not fully. I still had significant symptoms and pain, but I was stronger. I was still proverbially chained to the restroom, but at least it did not feel like death. Like a reactionary counterforce, I became insanely focused and dedicated to what I could do. I pushed through and studied non-stop. If I could not leave my house due to illness and a new contagious virus (covid), so what? Studying would be how I persevere. This newfound tenacity was less a testament to what it meant to push through adversity, and more about simply regaining control. It was also a duty I had to my old man. It was a duty to the friends and family that supported me.
That is what I felt and believed for that next year, and it served me well. I returned to the top of the class, I fell in love with my now fiancée, and I had come to accept my situation. I was graciously granted testing accommodations for Step 1, turning a one-day test into two. The first day of testing went well enough, but as I returned home, life came around for round two. I received a text and call from one of my high school friends, notifying me that my best friend had just perished in a crop-dusting plane crash. His aircraft malfunctioned and crashed into the ground, killing him on impact. His body lay there, burning in the wreckage. Once again, I helplessly watched as a version of myself died.
The next day I went and took the second part of Step 1. I was in utter despair, yet somehow managed to focus on the task at hand. I rushed to my hometown and said goodbye and mourned, and my illness continued to run rampant. That next month I had surgery to have my colon removed, trading suffering for freedom and an ileostomy bag. Throughout the following year, something slowly changed. The overt tenacity to push forward was lost, replaced by a desire to appreciate the here and now. Finally, a deeper understanding of the meaning of perseverance is beginning to emerge.
Everyone suffers and faces obstacles in life, and many have stories that put my humble one to shame. From storming the beaches of Normandy to simply making yourself get up in the morning, every day is riddled with deterrence. To persevere means nothing when you feel as though there is no other choice. When you must keep going because of obligation, duty, the need for control, or just to simply survive. Those honored for their achievements wave off the praise, there was no other option for them. As for me, the world has broken me, and I feel stronger in the broken places. I see that there is always a choice. The meaning of perseverance is to make the choice, no matter how simple, that progresses you towards your ideals in the face of adversity. When fate and circumstance give resistance and the choice to give up, diminishing your character, you scream “NO!” Duty, obligation, control, survival, love, hate, and regret are core tenants of perseverance but only in the sense that they influence the choice to push through the difficult times. Perseverance is a conscious decisionto transform your intangible character into a physical, unstoppable attribute.
So, next time you are faced with an obstacle, be aware that your perseverance means something so much more than you even realize. When all is lost, your perseverance may be all you have left.
Kyle Jackson is a UAMS senior medical student from Lafe (Greene County). He is applying to Diagnostic Radiology for residency with his fiancée who is also a senior medical student. Before coming to medical school, Kyle was a CT/MRI technologist.