The Resilience Of A Self-Starting, Latinx Woman MD

My name is Racquel Carranza-Chahal and I was born in Tucson, Arizona as a first generation Mexican-American. Like many other Latinx, education and hard work were big themes in my childhood. My father, orphaned at five, always dreamed of an education and encouraged my sisters and I to pursue our learning to the highest level. My mother echoed that sentiment and taught us how to work from a young age. We spent weekends and time off from school playing in and helping her clean beautiful houses. Each time, she reminded us that she worked with her body, showing us her worn hands, and that our job was to go to school so that we could work with our minds. I think that was extremely powerful as a kid. During the summer, we stayed connected to our roots by spending time in Mazatlan, Sinaloa. This exposure was formative in that I was acutely aware of the dichotomy of my identity and my otherness in either country.

There’s a story of me whacking my abuelito with a toy reflex hammer when I was four years old. Basically, I always knew I wanted to be a doctor. This meant that as the first person in my family to go to college and like many other Latinx students, I would have to navigate educational bureaucracy on my own. I remember being ten years old and asking my mom to drop me off at a charter school so that I could fill out the forms myself, sign them, and get back in the car to let her know that I would be going to a different middle school that fall. That moment is pretty telling about the kind of person I’ve always been, decisive and looking towards the next step. 

As high school approached, I knew that I needed more than what my school district offered so I registered in the wealthiest area, where we had cleaned beautiful houses growing up. I was accepted as a student under the out-of-district quota, which in retrospect, was my first introduction to diversity quotas. Nevertheless, I’m grateful I made that bold move because being in an environment where higher education was the norm made opportunities available to me. I became aware of the educational disparities that someone like me was faced with: the years of educational resources that my peers benefited from were the same ones I was just beginning to discover. Things like ACT or PSAT tutoring, or even considering college out of state were so foreign to me, and obviously prohibitively expensive. The same would later be true for MCAT prep. Again, I was intimately aware of my otherness, this time in the predominantly white space of “academic success.” College was a big goal for my family so I worked hard in high school and built my CV by volunteering at the children’s hospital holding babies starting at age 16 (it was the best and I was so sure I would be a pediatrician).

I was happy to stay in Tucson and attend the University of Arizona close to family and at an institution that I had grown up with. I sought out opportunities aggressively to better prepare myself, specifically the New Start program (which is still around), and where I got six weeks of classes before the fall with other first generation students, almost all of which were Latinx. It was an incredibly powerful opportunity; one where I met students that were like me and equally motivated to succeed. 

I started college and I thought, this is where the playing field will be level. As naive as that was, it’s that very mentality that allowed me to navigate higher education in all its bureaucratic glory and gross disparities for students of color. I started as a Physiology major and quickly added a Religious Studies major, briefly a Spanish & Portugues major (that later became a minor), as well as a minor in Arabic language. I figured I get to do college once on a scholarship and that I would learn everything I wanted to learn about before being in medicine forever. I found support in the Honors College, passion for Latinx higher education by starting my own chapter of the Hispanic Scholarship Fund, and all the love and encouragement I needed at home and with my now husband. I continued to build my pre-med CV by doing bench research, continuing to volunteer holding babies, and working as a medical assistant, nanny, and tutor through college. Looking back I admire the hustle of those days, but also recognize the extremely draining nature of doing all of those things with 20-24 credit semesters. 

In the background of that scrappy chaos is the story of me as a patient, diagnosed with disseminated coccidioidomycosis (Valley Fever) right out of high school. The patient that coughed up handfuls of blood until Christmas of sophomore year when I finally had a lobectomy (excision of the lobe of my right lower lung) for a large granuloma. The patient who lost hair and nails because of high doses of antifungals. The same one who was told she could never get pregnant because re-dissemination would kill her. In all of that, I learned about the fleeting, finite nature of this life. I also learned that I didn’t want to be just any doctor. I was certain I would never be like the doctors I had seen that didn’t hear me or wrote me off. I started studying for the MCAT after my surgery and it was a tough six months until test day. Ultimately I performed about average (28 on the 2012 MCAT) and I was so disappointed in myself. The regret of not finding a way to pay thousands of dollars for prep courses, studying different or harder, using used prep books eventually faded and I applied confidently to medical school knowing who I was, where I had been, and that I belonged. I only applied to three medical schools, which sounds absurd now but I truly didn’t know any better. When I got accepted to the University of Arizona College of Medicine in Tucson I jumped in my living room. It was finally happening. 

I was fortunate to have a really positive experience in medical school where non-traditional students were the norm and there were an above average number of Latinx students. I pursued research in Valley Fever, which is such a niche disease that the research community is incredibly small. I wholeheartedly believe in pursuing research or endeavors that really serve you versus solely adding a line on your CV without any deeper personal or spiritual gain. For me, Valley Fever research not only allowed me to get authorship and experience, but also helped me advocate for myself as a patient. I was able to talk to my doctors and research team to devise a plan that would allow me to taper off my antifungals, monitor my cocci titers (the only, albeit unreliable, measurement of infection), and ultimately get pregnant. In early 2015, I was undetectable, off of medications, and became pregnant later that year, with my now three year old. 

During my preclinical years I was so sure I would be a dermatologist (remember I thought I wanted to do peds?), because of my years as a derm medical assistant. But that dream quickly faded in the self-doubt that things like becoming AOA and class rank bring upon medical students. I try not to live with regret, but I wish I hadn’t let that dream go so easily. There is so much pressure on medical students to choose a specialty without real exposure to the realities of residency and practice are. It’s an incredible disservice and perpetuates dissatisfaction, abuse, and infantilization even at an early stage like medical school. Eventually I decided to consider ObGyn and peds equally and had two applications ready to submit for residency. My son was just two weeks old when I submitted my ERAS application for ObGyn and the next chapter of our life began. We travelled on over 40 flights before my baby was even 4 months old, interviewing across the country. Thinking back, my husband and I are grateful for the naive bliss that we entered that experience with because it was an incredibly challenging and expensive time. On the interview trail, I never met one other Latinx applicant and currently do not work with any. This was a huge moment in realizing the importance of increasing our visibility in medicine in spite of the fact that recruitment of our people lags miserably behind. I am so incredibly grateful for the perspective and language abilities that being Latinx give me as a physician. I look forward to practicing in an area where I can care for more Latina women after residency. 

I’m now in my third year of residency. My time in training has been anything but easy as a mother and a person who deeply values other aspects of my life beyond the all-consuming work of a resident physician. The turning point in my experience as a resident physician and the sentinel moment for the work I need to do in this world occurred as an intern, when I was told I should divorce my husband and lose custody of my son if I wanted to get into fellowship. Since that moment I have been fighting for all mothers / women who desire motherhood in medicine. I decided to found the Mothers in Medicine Institute (awaiting non-profit approval), to elevate the status of mothers in medicine through advocacy and oversight initiatives, leadership, education, and community. Our goal is to demand just, equitable working, and learning conditions while dismantling the structures that perpetuate gender-based discrimination and harassment with emphasis on motherhood, reproductive choices, and caregiver status. I once read that if you want to make change in the hardest way possible that starting a non-profit was the answer. To me, forcing institutions to change does not occur out of the kindness of any hearts - it only changes secondary to financial and/or legal risk. My goal is to empower all moms across the spectrum of medicine to fight for their rights and be able to navigate it. I never want another mom to feel helpless and alone when something like what happened to me happens to her, or worse. 

Everything I do is with the knowledge that, yo soy Latina, soy madre, and I belong in every single space I exist in. It is why I added back my maiden name, why I’ll teach my children Spanish, and continue to be proud of where I come from. And I’ll be damned if someone doesn’t know where I stand.