Tribute to a Mentor

“A teacher affects eternity; she can never

tell where her influence stops.”

– Henry Adams

It was our first week in Med School. One hundred scared young kids who did not know each other were escorted from one place to the other in what administrators called “Orientation Week.” We had physical exams; dental checkups; lectures on how to work hard; conferences on how not to study too much; psychologists who told us not to worry; crusty professors who urged us to be concerned. By Thursday we were befuddled and far from being “oriented.” We were eager just to get it all started.

The last event of the week was the CPC, or Clinicopathologic conference. In those days this type of conference revolved around a mystery case, usually someone who had died without a clear diagnosis having been made. The professor in charge went over the physical findings, lab tests, X rays, and response to hospital treatment. The turning point of the hour came when the professor had to come up with her/his diagnosis. In most cases an autopsy had been performed. After the professor spoke, the pathologist assumed center stage to confirm the clinician´s diagnosis, or to reveal a surprise diagnosis.

We spent most of the hour glued to our seats. None of us had any idea what these people were saying, but it was obvious that everyone took this exercise very seriously. When the time came for the pathologist to lead the conference we heard a murmur of anticipation rise from the audience.

This was a case that involved the brain. The neuropathologist was a tall woman in her 50’s. She wore a wrinkled white gown that had its share of stains here and there. She had gray unkempt hair, alert, penetrating blue eyes, thin lips that to me appeared to be gentle and soft, and a very determined expression. In a firm, clear voice she proceeded to explain the correct diagnosis (meningitis) and then went on to skewer the house staff that had taken care of the patient.

Even to this ignorant student it was clear that she was upset and disturbed.  She spent five minutes describing how things should have been done differently. Not a sound from the audience: nobody coughed, maybe nobody breathed during this spell. After she was done everyone filed out as if they were in a hurry to get back to whatever needed to be done. We had nowhere to go, so we fled to the hospital cafeteria for a bite to eat.

A small group of us congregated at a table. We tried to make sense of what we had seen and heard. We agreed that a mistake had been made. We wondered if we had chosen the right career: being corrected in front of 250 of your peers ranked as a dismal experience. We noticed that a couple of the senior students sat down a few seats from us at our table. One of my classmates decided to ask them their interpretation of what had transpired.

“Yeah, a mistake was made,” one of them said. “It happens.”

We asked what it felt like to be embarrassed by the professor.

“Oh, that’s just Dr. Stryker,” he said. “Too bad you had to start your career being exposed to her. She’s one castrating bitch.”

For a Puerto Rican boy who had been raised by a nurturing mother and her loving cousin, and was surrounded by four sisters who worshiped the ground he walked on, these were harsh and unwelcome words. But for the next three days anyone we asked about Dr. Stryker used the same term to describe her. When the time came for our first microanatomy lab session I felt like she would be standing at the entrance to the room with a scalpel, ready to mutilate anyone who did not know the material as well as she expected.

I was huddled over my microscope, in the middle of trying to see everything that I was supposed to see (it was a piece of skin, I remember clearly), when I heard a gentle female voice ask me:

“Everything all right?”

I looked up and almost fell off my lab stool. The castrating bitch herself was standing over me, towering about ten feet over my head, smiling at who was sure to be her next victim.

I almost screamed that everything was fine. I prayed, hard, that God would make her move on as quickly as possible.

“Did you see the horny layer?”

I had.

“Did you notice the dermis stains a bit differently?”

No, I had missed that. Will try harder next time, I promise.

“Here, let me show you.”

She bent her lean frame over my microscope. I wanted her to leave; I wanted to leave the room myself. My belly began to cramp.

“You don’t have a pointer in this scope,” she said.

No, I didn’t know you could get one.

“I can make one for you,” she said.

I said no need, please don’t bother yourself on my account. She smiled and patted me on the back. To my surprise, it did not hurt.

“You can make one from an eyelash. It will be curved, but it will serve the purpose.”

Before I could protest further she removed one of her eyelashes, went to get some form of invisible glue, and in five minutes my microscope had a pointer.

But she did not leave. She sat down and made sure that I was an expert on everything that had to do with skin. The next day it was gut, and the next lymph glands, and every day after that Dr. Stryker made it a point to make sure that I knew everything.

The few friends that I had made asked me what was up. I assured them that I had no idea. True, she tried to help everyone, but it was clear that she spent a large amount of time at my place. Not that they were jealous: no one wanted her even close to their work station, so they were delighted that I was deflecting her attention.

I saw her name often. Every time that I opened the neuroanatomy textbook, in fact. She was one of the editors. Every few pages there was a photo of a nerve cell that she had taken. During lectures other professors referred to her work on an almost daily basis. It was clear to me that our “castrating bitch” was a world-famous authority on nerves. I began to feel proud of the fact that I knew her.

For six weeks she came by every day, always with a smile, always with a pat on the back, always reassuring me that I was doing well. After our first test she made it a point to come by to congratulate me on my score. This went on until our course was over. My by now more plentiful friends were delighted that they were rid of this woman, at least until the next year in neuropathology. I began to wish that I knew more about her.

That did not take long. We developed a habit of raiding the hospital cafeteria whenever we were up late studying. I often saw her sitting by herself late at night. One night she followed us right into the dorm. It was then that I realized that she lived in our building. The way one of the seniors explained it to me, she had to kill some of her lab rats at 2 in the morning, and it was much easier for her to live next to the medical school grounds. She was single; had never married; had no children. As far as we could tell she had no family. She never seemed to take off on vacation.  Every once in a while she would leave to attend a medical congress. It looked like medicine was her only love.

When the second semester started I began to develop my own habits. We no longer walked about in bunches, like children who did not want to get lost.  We found many places that we could eat at other than the cafeteria. We discovered how to move about the city. We were growing up, at our own pace. Learning to be comfortable in the isolated, maybe elitist environment that medicine has cultivated for centuries.

This is when Dr. Stryker miraculously began to appear whenever I ate by myself at the cafeteria. She sat in front of me and grilled me on how classes were going. It was not a matter of checking on my performance. It was more like she wanted to make sure that I was happy. My classmates were puzzled. What had I done that the “castrating bitch” wanted to talk to me?  When I insisted that she was sweet, kind, and caring, they would say “Yeah, sure” and move on.

One day she told me that she would be attending a neuropathology seminar in Puerto Rico, at El Convento Hotel. My face lit up.

You have to meet my father.

She blushed. She told me that she did not want to be a bother.

You have to meet my family. You will not get a full idea of what my country is if you do not meet the locals.

I gave her my family’s phone number and insisted that she call my parents. She was a bit surprised. I saw her blush intensified.

I began to understand that this world-famous supposedly intimidating woman was a bit shy. Maybe more than a bit. I made her promise that she would make that call.

Two weeks later we had lunch at the cafeteria. She had met my parents, and several members of the science faculty. They had given her the royal all- inclusive tour of the island. It seemed to me that she must not have spent much time at the congress at all. She saw everything, ate and drank everything, and loved it. She also shared many facts about the island that she had learned. I guessed that my overenthusiastic father had spent many hours tutoring her.

My first year passed. I settled into a comfortable sophomore year routine.  Dr. Stryker’s cafeteria visits became less frequent. I felt more confident on my ability to handle the workload. I began to socialize, and asked for a few dates.

I was shocked when a particularly beautiful nursing student agreed to date me. She was funny, and fun, and she seemed to love to be around me. We had great times together flying kites in the park, going to dances, and even studying together.

One day that we were having lunch at the cafeteria I saw Dr. Stryker approach us. A big part of me felt apprehensive, because I cared for this girl, yet I did not want Dr. Stryker to see that I was not devoting all of my time to study. Maybe I was also anxious that this woman who had basically adopted me would not approve of my choice.

I need not have worried. Dr. Stryker was gracious and polite to my friend.  She checked on my progress as usual. She asked me my opinion on something, I don’t remember what.

I haven’t heard it from the horse’s mouth, but…

She didn’t let me finish my sentence. She smiled from ear to ear. She was literally beaming. She interrupted me.

“Look at you! You’re using our idiomatic expressions. You’re dating a beautiful girl. You’re doing well in school. You look happy and healthy.”

She paused for a moment.

“You don’t need me any more.”

With that she picked up her tray, excused herself from my friend, and moved to another table. I never saw her again.

Two weeks later Dr. Stryker announced to the dean that she would be moving to another medical school. Her mentor, the man who had gotten her interested in neuropathology and had nurtured her at every turn in her career, was the dean at this school. This gentleman had been a department chairman at our school. When he moved away (this happened as I started my freshman year) everyone wondered why she had not followed him.  Now, almost two years later, she did leave.

I wrote to my father to give him the news. He wrote back that it was time to tell me the real story.

When Dr. Stryker visited Puerto Rico she confided on my father. When I applied to Med School I was quite immature and self-possessed. I refused to fly to St. Louis for an interview, and I made no effort to have many college faculty members send letters of recommendation for me. I had always been at the top of the heap. I figured that the medical schools should beg me to join them.

Maybe because of this, maybe because I was Puerto Rican, maybe because I was so young, for whatever reason the chairman of the Admissions Committee had refused to consider my application. In those days one “No” vote was enough to derail an application. There were plenty of qualified students that were interested in getting into the elite medical school. There was no need to take a chance on a “borderline” applicant.

Dr. Stryker had insisted that the time had come to take a chance. All of my classmates were white; many of them were sons and daughters of physicians. A large percentage could easily afford the tuition and other costs.

From what my father heard this battle went on for many rounds, until the crusty old chairman was no longer willing to fight it. Dr. Stryker went to bat for me and won. In a sense, she was protecting her investment when she mentored me.

In my deeply held opinion, however, she really wanted to do the right thing because that is the kind of person she was. Her demand for nothing less than the best effort from all I now find to be perfectly appropriate. And I have learned, after many years of dealing with male doctors, that what they think of as a “castrating bitch” is nothing more than a smart woman with a firm, clear, well-defended opinion.

Dr. Stryker left St. Louis quietly. She did not say good-bye. A year later, my father sent me a half page article from The New York Times. Dr. Stryker had died in her sleep. They printed a long list of her accomplishments. Many famous physicians were quoted as saying that her parting was a tremendous loss for all.

The New York Times failed to ask a once shy, once intimidated young Puerto Rican boy for his comments. He would have said that this woman who had never borne a child had been more than a mother to him. That she had gone far, far out of her way to make sure that his life was kept on the right track. That she had placed her own life on “hold” for almost two years so that he could have a chance to make it in her world. That he never had the opportunity to pay her back. That ever since she died he tries extremely hard, every day, to emulate her and help those who feel alone and scared. That to the end, she did everything she could to do the right thing.