Finding Worthiness in Being Different

Editor’s Note: This piece was awarded an honorable mention in the Pulse writing contest, “On Being Different.”

“What do you want to be when you grow up?”

The first time I was asked this question, it didn’t occur to me that my answer might not be matched by a corresponding opportunity. In the years since, I’ve learned that the question should have been “What will you be allowed to be?”

As children, we’re taught that we can do anything we set our minds to, and that we’re worthy of boundless opportunity and success. Our society fosters this belief by telling children to reach for the stars and granting them greater autonomy as they mature. But this implicit assumption of worth and possibility is deceptive. What we don’t tell children is that, for some, being deemed worthy will ultimately become a privilege, not a right.

In society’s eyes, I lost my worth and my right to opportunity when I was six years old—but it took me another twelve years to discover this.

I was a high-school senior, filling out the Free Application for Federal Student Aid (FAFSA), used to determine students’ eligibility for financial assistance for college. Scanning the form’s section on immigration status, I saw that there was no option stating: “Yes, I am an undocumented immigrant—but I didn’t realize that when my family came here from El Salvador. I was only six, and we were just trying to escape gang violence and an abusive home. I’ve been here since first grade, and I already have my college acceptance letters, and my parents pay their taxes, so can I please just have a loan for college?”

I learned this lesson several more times, feeling progressively more outraged each time I confronted the reality that my academic achievements and merit, my professional potential and my personal worth meant nothing in a world that had labeled me “illegal”—as if my very existence were a crime. Despite what I individually might have to offer the world, my opportunities would stay stalled unless the green card said go.

I realized that I couldn’t be who I wanted to be as long as I was viewed only as where I’d been born.

Even if I tell them who I am, I thought, what will they allow me to be?

I was faced with a choice: acquiescence or nonconformity. Despite feeling hurt and rejected, I held onto the truth that I was just as worthy of opportunity as anyone else. I knew that my mother had left an entire life behind to travel to a foreign country, not knowing the language, solely to give me and my brother a chance. I felt determined that her sacrifice would not be in vain.

My wish became not to prove that I was the same as everyone else but to emphasize (loudly and proudly) that I was different, and that my difference was valuable. The challenge lay in balancing my desire to be loud and proud against the fear that my legal status would become known in the wrong circles, leading to deportation and/or imprisonment for my family and me. That fear didn’t stop my college-application efforts, but it did silence me.

It would take several years before I could secure my green card. In the meantime, I overcame financial and legal obstacles by attending community college, where I obtained non-federal grants with no questions asked about my legal status. My college experience itself was nontraditional: It meant working forty hours per work before classes, drowning in immigration lawyers’ fees and fighting for a voice, for visibility, for a chance. In hindsight, it was a beautiful nod to the power of perseverance—of finding possibility where once only impossibility lived.

Throughout that time, the question of self-realization stayed with me. As I navigated the challenges of getting an undergraduate education, I was fighting most of all for the power to shape the narrative around my identity and my value.

All of my life, I’ve been seen as “other.” Too Americanized to be Salvadoran, too Salvadoran to be American. Too light-skinned to be Latina, too Latina to be white. Too foreign, too illegal, too poor, too different.

Yet through all of that, what I’ve also been is defiant.

My journey could have stopped the moment I accepted  “illegal” as my descriptor. Now, writing this, I know I’m one of the lucky ones: I was raised by a woman who stopped at nothing to achieve her dreams, in a community that taught me to believe in my worth. I grew up seeing immigrants build lives from the ground up. I grew up believing that I could do anything I set my mind to—and though it may have been naive, that belief was the key.

Ironically, once I entered medical training, I found myself given a new label: “nontraditional.” Amid a sea of students whom I’d assumed were like me, I still felt like an outsider.

True, I am a Latina, immigrant, nontraditional. I am different. And this time, it was a label that I wore proudly, cherishing the power and tenacity it represented. Even more importantly, I understood that I could be part of a wave of change that will help to save lives.

In preclinical lectures, medical students are taught the ins, outs and in-betweens of human physiology. We’re taught how to take a patient history and derive a differential diagnosis. We’re taught to think in rigidly standardized ways. But I believe that being “other” gives me the ability to offer patients something more.

It is my difference that allows some patients to confide to me their fear of U.S. Immigration and Customs Enforcement (ICE). My difference helps me to recognize the cultural undercurrents shaping a family’s resistance to a treatment plan. My difference allows me to listen attentively to someone else’s experience with otherness, without assuming that I know best.

Because I too am other, I can be an ally and advocate. I have been “othered” so much that I now seek out “others.” I relate to them, I seek wisdom from them, and I feel fulfilled by our encounters. For me, this translates directly into a commitment to care for underserved minorities.

Despite ongoing efforts to remedy inequities, medical education and training still reflect outdated beliefs and practices—from kidney-function guidelines that suggest racial differences where none exist, to a scarcity of references about dermatological conditions in people of color.

My peers and I belong to a generation of clinicians-in-training who are challenging these structures. I feel fortunate to be part of this, but I need to remind myself to make space for humility—to recognize that I’m still learning.

I am learning, for instance, that to be corrected and educated by a patient is not a personal attack but a gift. I feel humbled when a parent, tagged with “poor medication adherence,” explains that their doctors have never used their native language when giving them medical advice. Such corrections are a favor, coming from someone who believes that I can understand how medical professionals have failed in the past and believes that I can do better.

I hope that my patients will find me worthy of trust. I hope that they’ll feel that, through the lens of my otherness, I can see them clearly. As a clinician, I know that I’ll be making decisions that affect other human beings’ lives for better or for worse. To do that well, I need to be a lifelong learner, gaining knowledge and wisdom both through medical advances and through my patient encounters. The only way to be better is to make room for it.

And so the next time I ask a young person about their wishes for the future, I won’t say “What do you want to be?”

Instead, I’ll say: “Who will you show them you are?”