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Elmarie Alexander, MD: After the diagnosis, going through my treatment, a lot changed because I had to focus on taking care of myself while just, meeting what I need to do, my requirements to graduate residency.
And more and more when I felt like my body was just not going to be the same. I get dizzy sometimes very quickly.
I get tachycardic sometimes. So I just felt like I don't think I'll be able to be standing, doing procedures that long. I don't want to be a risk to myself or patient. And I decided that I will hold off even, pursuing anything, and probably it might not be what's best for me anymore.
Yes, maybe that's what I wanted. Yes, there's glamour and gold, there's more to life. There's more to life, and that diagnosis just gave me a chance to, or it opened up a way for me to really just look into life and see [00:01:00] What's meaningful to me? It's not just about achieving or going for this, and so I decided to hold off and not apply for the gastroenterology until I had to just find something that will help me to transition into what I wanted to do.
Stephanie Moss, MD: Welcome to life as a patient doctor. I'm your host, Dr. Stephanie Moss, navigating life as a patient and a medical doctor. Walk alongside me as I reflect on the challenges and triumphs and lessons I've learned over the years. Undergoing medical education with invisible disabilities. Join me as I interview other doctors, students, and healthcare workers on their own journeys, listen to their unique stories on how they balance their health while caring for others in the health profession.
Stephanie Moss, MD: Welcome everyone! Today I have a very special guest. I am interviewing Dr. Elmarie Alexander, who was born and raised in St. Lucia, in the Caribbean.
She went to medical school graduated from Washington University of Health Sciences and completed a residency in internal medicine in Brooklyn, New York, completed one year and got her board certification in Jerry Asherk's medicine in NYU, and is currently in a first year of infectious disease fellowship in New York. Interesting to note, she's actually a breast cancer survivor. So she's going to share a little bit on her personal journey of being a patient and a doctor.
Elmarie Alexander, MD: Thank you Stephanie. Thank you so much for having me today. I am so elated to be on this podcast and to dive into my journey. Hopefully I can have a impact and give some hope to anyone who's in the same experience as me.
Stephanie Moss, MD: Yes, I love that. Please tell us a little bit about your journey and your story in medicine.
Elmarie Alexander, MD: Yeah, sure.
Journey Through Medical School
Elmarie Alexander, MD: So I always like to go back and start with a little of what you said. I'm I was born and raised in San Lucia, and that is a very [00:03:00] small island in the Caribbean. And my medical journey was inspired or I was aspiring to be a forensic pathologist, actually. And so I never thought that I would be in like bedside teaching or bedside medicine.
And my journey was inspired by my dad. He was a police officer during that time, and I was really into investigative work. And I figured maybe pathology and forensic pathology was my route.
Being on the Caribbean, there are a lot of offshore medical schools that cater to persons who want to graduate and pursue medicine in the U. S. And so my island did have a few. I applied and I got accepted to one. It was called Atlantic University School of Medicine.
And right after my two years of community college, I was accepted and I started my journey. I did two years of pre med (clinical) and then went into basic sciences and my medical schooling until I was able to pursue my rotations in the States.
However, I did have to transfer towards the end of my medical school because of a few issues that came up but that did not stop my journey. I successfully transferred and It was during my third and fourth year, maybe before that transfer, that I developed that love and yearning for bedside medicine.
I think it was more that instant gratitude of seeing patients who were getting better, feeling well, able to come in sick and live, doing better. That. made me gravitate toward practicing insulin medicine or just, medicine besides pathology. And yeah, that's just a bit of how I will say my journey or my life started in medicine.
Stephanie Moss, MD: I love that. What an interesting look on being from the Caribbean, moving to States. What other challenges and or triumphs, of course, that stood out to you during your medical school or even residency career path?
Dr. Alexander begins her narrative by sharing her dream of becoming a forensic pathologist, inspired by her police officer father. She explains how her journey led her to attend medical school at Atlantic University School of Medicine and later transfer to Washington University of Health Sciences. Despite facing hurdles like transferring schools and adjusting to studying in the U.S., she found a love for bedside medicine.
Dr. Elmarie Alexander, who was born and raised in St. Lucia. Dr. Alexander graduated from Washington University of Health Sciences and completed a residency in internal medicine in New York
Challenges and Triumphs in Residency
Elmarie Alexander, MD: Yeah to answer that question, Stephanie it's crazy because when we, have a goal and we get to that goal, we never, Realize or know what's to come.
Like we always think that after we achieve that goal, it's going to be all roses. And it's just for me and my life, I've had a challenge in every, like step and it's crazy because no journey is, a straight road. We have a lot of hills and it's crazy, but I just want to start by saying.
I would say the fact that I had to transfer was definitely a huge blow during my journey because I never expected it, I was already on that course, trying to finish up my steps and apply for my residency. Until it happened, I would say in the early part of the year of preparing it took a while to, or it took some time to think about , what I would do, try to find another school try to also juggle me being able to do my steps, interviews.
But I was able to apply. I was accepted thankfully to this to a school the year before.
So just for a reference, I got accepted in twenty eighteen, late twenty eighteen, such that I was able to, or I had to repeat a few clinical rotations. And then prepared for my other steps.
Graduated ultimately in September. Finished off my rotations and applied for my residency while preparing for my step three at the same time. And so I did that.
And that was the first hurdle. And then, residency itself and the interviews is definitely challenging to as a foreigner, the currency is not the same.
And so we have to think about our limits to , how many programs we can apply for. And even the flights, accommodation, because during that time, we still had the in person interviews. That was a bit of a hurdle too, but I just tried to, think of the bigger picture and what would be the best in terms of IMG friendly programs to apply to.
And fortunately, I was able, I pre matched in with Brookdale. Which is in Brooklyn, New York.
Impact of COVID-19 and Personal Health Struggles
And so happy and everything was going great, but then COVID hit and was all of us collectively going through the same thing. So it did bring us together.
It was a very tough time. But most of us, in fact, all of us, the residents, the faculty, we were very supportive of each other.
So I wouldn't have asked for any other way. I'm grateful for that experience. But the penalty the ultimate and more shocking of it all was that throughout the pandemic, we sometimes neglect ourselves.
And I did feel. something in my breast earlier in the first part of the pandemic, like 2020. But again, with all what's going on, the confusion, the risk of it all work because we worked a lot of hours. I really couldn't do much about it until after the pandemic where I decided that me just.
Get assessed, do a whole checkup, and after all the tests, we found out that I had breast cancer and just hearing the news, it was, to be honest, I still don't know how I took it in one way, I, it was a hit to me, but on the other hand, I was just so ready to figure out what's next, I guess that was my way of processing it,
But yeah, so I definitely, my journey, I don't think was smooth at all, but looking back, it's just crazy how I was able to maneuver and get over all of these, and I'm still here, so I'm grateful.
Stephanie Moss, MD: Oh my goodness I can't imagine, but I'm sure you're not alone in your experience. So many people couldn't get all their health care. During the pandemic, a lot of people were fearful, there was a lot going on in the entire world.
Elmarie Alexander, MD: Yes. I did see that too. A lot. Sorry.
Stephanie Moss, MD: No, go ahead.
Elmarie Alexander, MD: Okay. I did see that too, a lot, even like from a distance.Doctor standpoint, when we went back into clinics because, clinics, we didn't really have clinics because of the pandemic. Everyone is home shelter in place.
We would see patients coming in, not just the clinics actually, but to the E. R. with emergencies that really didn't need to be. Because they could have been taken care of hypertensive emergencies or like very severe unmanaged COPD or just like TKA (total knee arthroplasty) because, they weren't able to take care of themselves and just many other emergencies , looking back, unfortunately.
Stephanie Moss, MD: Yeah, remind me, when did COVID hit in your residency journey? Were you an intern?
Elmarie Alexander, MD: Yes. I was.
Stephanie Moss, MD: Wow. So you were just fresh on the job.
Elmarie Alexander, MD: Yes. So it was like late 2019. Late 2019, there was like some speculation, but then February, I think between February and March was when it really started like escalating. Yep.
Stephanie Moss, MD: So you went through all it. Is internal medicine three years?
Elmarie Alexander, MD: Three years.
Stephanie Moss, MD: So was it pretty much the entire pandemic, your entire residency time?
Elmarie Alexander, MD: It was really intern year, like I would say half of intern year and half of second year. For the most part yeah, so yeah, but at least one year, you would say because of how the cycle is, July, but at least one year of my residency was pretty much the pandemic. But yeah.
Stephanie Moss, MD: My goodness. Thank you so much for
Like many foreign medical graduates, Dr. Alexander faced numerous challenges, including financial constraints and the stress of applying for residency. Despite these hurdles, she pre-matched in New York and began her residency in internal medicine. However, the COVID-19 pandemic hit hard, affecting her and her fellow residents' training and lives.
During the peak of the pandemic, Dr. Alexander felt something unusual in her breast, which was later diagnosed as breast cancer. Despite the grueling hours and high stress of residency, she navigated her treatment with immense support from her program director, coordinator, and faculty. By strategically planning her work schedule around her treatment cycles, she successfully managed to complete her residency while undergoing chemotherapy and surgery.
Stephanie Moss, MD: Learning on the run, like you were really like jumping in and helping so many people. You mentioned that just that difficulty with trying to care for your own health while also taking care of so many people. How is that balance or that challenge?
Elmarie Alexander, MD: Well it was a challenge. Even many of us felt sick. I didn't, thankfully. Unfortunately, some of us felt sick, especially those who catered to the first few patients that came into the hospital during that time.
We didn't know what was going on. , I can still remember vividly the first person who was positive was actually like someone in the political, field and all of the residents who took, an intern who took care of him felt sick.
But, we were really tired. I would say the biggest thing was tired, but for some reason we pushed through.
We were thankful for our faculty. The community also. We were given food, being fed but yeah, we were tired, I was tired, but for some reason, I don't know, we made it through and I just, it was a dream sometimes you can say just a phase, you don't know, you're just walking through, or you just.
Going through the motions and until you free or it's better.
Stephanie Moss, MD: And you persevered and you got through it together, which is huge. How would, I know you mentioned then your diagnosis. How did that change things in your medical path or did it not? How did it impact, I should say?
Elmarie Alexander, MD: Definitely changed things in my medical path.
During my residency, I battled or thought a lot about what I wanted to pursue in terms of, a specialty. I knew for sure I didn't want to do hospitalist or primary care. I wanted to, specialize, just focus on one thing.
And, I remember one time I even look back to my personal statement, and I had their pulmonary medicine and gastroenterology. I was on the path of thinking of, gastroenterology, but I knew that I didn't have that much research or, scholarly activity. I was hoping to you know, work on it during my second year, third year.
And after the diagnosis, going through my treatment, a lot changed because I had to focus on taking care of myself while just, meeting what I need to do, my requirements to graduate residency. And more and more when I felt like my body was just not going to be the same. I get dizzy sometimes very quickly.
Yes, maybe that's what I wanted. Yes, there's glamour and gold, there's more to life. There's more to life, and that diagnosis just gave me a chance to, or it opened up a way for me to really just look into life and see What's meaningful to me? It's not just about achieving or going for this, and so I decided to hold off and not apply for the gastroenterology until I had to just find something that will help me to transition into what I wanted to do.
And the opportunity came where there was a geriatric position and I figured I can continue practicing medicine it's one year. And I can learn more, managing elderly patients because we see so many of the elderly patients in our cohort or population, in the hospital. So I took it. So it definitely changed my path in terms of, what I was doing. Aspiring for a in my medical journey.
Dr. Alexander details how her diagnosis forced her to reconsider her career aspirations. Initially aiming for a gastroenterology specialty, her health condition made her realize she needed a less physically demanding role. She transitioned into a fellowship in geriatrics, which allowed her to continue practicing medicine while focusing on her own well-being.
Stephanie Moss, MD: That sounds challenging to go through. I'm sure I can't imagine going through that through residency. You mentioned treatment. Were you working at the same time or did you require accommodations or take time off? Do you want to talk about that?
Elmarie Alexander, MD: I don't mind. I can just briefly.
Stephanie Moss, MD: Yes, of course.
Elmarie Alexander, MD: I couldn't have done it all just on my own. My program director, coordinator, the entire faculty. I keep mentioning them because I just enjoyed my residency and the team that I had.
They were very supportive, and we worked together to just carry out a plan as to how I would, manage both staying and completing my residency while getting my treatment. And we took advantage of my vacation, we took advantage of any paid time I could have. I was able to do electives when I'm on chemo such that.
I was already aware of how the cycle would be. So after my treatment, I was all aware that I would not be well for like within 48 hours. And so I won't work this weekend, but the next week I'll be very well. So, it happened such that my chiefs were able to schedule me in a way that I'm able to work , but then I'd have to take those times off.
If I'm on an elective and that's why I would do electives during that period and then following my treatment I definitely had a break before surgery and I would have done all of my other required rotations, like my ICU, all the heavy rotations and then,, I would have had my surgery during my vacation, so that worked out. Then, yeah, I was able to return.
The good thing is, with me, I was very fortunate, a lot of people are not, that I didn't have that many side effects, like CDS side effects to need hospitalization, CDS side effects, to have infections. And had a good healing such that I could have, persevered and continued.
Stephanie Moss, MD: Wow, you are literally a superhero. I don't know, that's amazing. How you were able to conquer that. I can't imagine going through residency while actually going through a treatment that a lot of times needs to take your full attention. I'm so glad that the program was very supportive and was able to work with you.
That is one of the things that I've been wanting to showcase is because especially when talking to other students who are applying to medical school or in residency, there's a conversation of whether or not to disclose their health condition. And a lot of times that fear prevents people from being open.
Did you experience that initially or how did you like break that to ask for help?
Elmarie Alexander, MD: I mean they knew right away because I started with my evaluation within my hospital system. I was on night float when I spoke to the surgeon so I came in early, earlier than I would have to speak to the surgeon and he broke the news to me.
And so I called one of my chiefs. And I explained to her and she was actually pursue going to pursue heme onc, so she knew very well, what it is to learn of such news and how to take it. And so, when I told her she, I told her like, I even remember I told her I can stay.
There's nothing going on with me now. I haven't started, this whole journey. I can at least do my night and all the week, but she was adamant that I leave. They would have gotten coverage from me so I can start, really understanding what was going on with me and trying to prepare and arrange for what's to come. She told me that I needed to leave. And so they knew like pretty quickly or early my diagnosis.
And then I really actually can't recall how I broke it to my program director and everybody else, but it was really just myself, the program coordinator, program director.
It wasn't much of the other residency or my colleagues because we were just trying to understand and figure out how best to work it out at that time.
Stephanie Moss, MD: Yeah, that makes sense.
Lessons Learned as a Patient and Doctor
Stephanie Moss, MD: Now, being on the other side of that experience, how has going through your own health condition impacted how you see interacting with patients?
Was there any experiences that you took away being a patient yourself. Or any lessons that you learned that you want to take into when you're working with patients?
Elmarie Alexander, MD: I would say the first one that I quickly learned was, getting blood draws because as an intern resident moving or carrying on my journey, I never experienced a blood draw before that time.
And I enjoyed doing it, and I even did ABGs, as an intern doctor. And sometimes they're not easy, especially getting the blood draws. So you have to go in different locations, unfortunately, and you want to be mindful of that because the patient is hurting. When I first started getting blood draws, I was really like taken back to reality to this is how it feels.
This is how a patient feels when you're drawing their blood. It's not about the tonic care or anything else. It's just like when that needle, pierces the skin. The first contact and just the tense, the tension of when they have to pull it out. So going through that process and experiencing myself, it definitely allowed me to understand what patients go through.
And even then I was like, so if that's such, if that is so painful, I don't want to feel what an ABG, I don't want to experience an ABG. Like, and so that was one of the experiences or impacts I definitely have now as a patient and, relating to or relating with my patients being a doctor.
And then just in terms of news. Breaking bad news or understanding how a patient internalizes news, especially cancer. Sometimes we on the other side, seeing the patient or the family that, something might be futile, for example. But not understanding what it means to the patient or the family of losing that someone.
So it definitely helped me to understand what it's like in terms of being on the other side, like handling news and facing a fear or death and
Dr. Alexander credits her program director, coordinator, and colleagues for their unwavering support during her treatment. Their understanding and flexibility in managing her schedule were crucial for her to balance both her professional responsibilities and personal health.
Dr. Alexander reflects on how being a patient herself has influenced her approach to medicine. Drawing from her experiences, she emphasizes the importance of empathy—particularly in routine procedures like blood draws. These firsthand experiences shaped her understanding of patient pain and discomfort, enabling her to offer more compassionate care.
Lessons to Other Health Providers
Stephanie Moss, MD: Yeah, those are all really great specific experiences and topics. Is there any wisdom that you can partake to me and other health professionals that are still in training? Any learning experiences that, you would recommend to us in training?
Elmarie Alexander, MD: Let me see. I will say just empathy is definitely a big one. Just imagine, try to imagine, if you're ever going on that tangent of frustration with a patient, for example. Just try to imagine what they might be feeling or what exactly is bothering them the most. In terms of why they're behaving a certain way, or just empathy if they're very hesitant to do something and trying to understand them as much as possible such that you're able to fully assess the situation.
And just, let them know or reassure them that you're trying to do what's best for them and work together with them, and getting them healthy or better.
Stephanie Moss, MD: Yes, empathy. I feel like it is one of the most constant things I hear.
Elmarie Alexander, MD: Yeah.
Stephanie Moss, MD: It seems to be one of the most important aspects of medicine that we sometimes forget. It's being there for the patient seeing them as human.
Promoting Diversity in Medicine
Stephanie Moss, MD: What are your thoughts on breaking stereotypes or promoting diversity, all types of diversity in the medical community?
Elmarie Alexander, MD: Yes, that is actually a very good question. So I feel like it's important to break stereotypes, and it's important to especially promote diversity in the community because we see it all the time: Patients.
A patient is not just one, like one person or you will have 10 patients and they're not the same, there's different races, there's different gender identity. The more you have persons who a patient can relate to, the more you will have a better society and community and better health outcomes.
So I think that it's important to break those stereotypes and promote diversity in order to have better outcomes. For example, we see it all the time.There's so many papers or studies that come out that highlight health disparities and there's also so many studies and papers that come out where.
There might be breakthrough treatments, for example, but then how does it relate to your patient population, or how is it generalizable. Or how does it relate to that population or race when only 15 percent is, part of the study. As much as, we have so many different types of patients, we should have an inclusive and diverse medical community to increase that positive relationship, increase those good health outcomes.
Stephanie Moss, MD: I love that. Thank you so much.
Final Thoughts and Advice
Stephanie Moss, MD: As we finish off our episode, what final pearls of wisdom or advice do you have for other students or health professions, other people, that have disabilities or health conditions?
Elmarie Alexander, MD: I actually just want to first empathize with anyone who is living with a health condition or just a disability. You did not choose it. If you were to choose, you would never choose it, and it's not your fault. It doesn't define you and. We shouldn't allow others to tell us otherwise or dictate what, we want to pursue.
Just wanting to be part of like the medical community shows your love, shows your passion for patients And how much we need you in that field. Additionally, you're not the only one, there are many persons before you , who have done it and continue to persevere.
And so Let it be. Let's continue. Let's join a community. The more we have, the better, to increase that awareness and to also increase that generalizability and relation with our patients too. So just continue to fight, continue to persevere. You will definitely get there. The mind of passion is what you have and what you need and you will get there.
In her closing remarks, Dr. Alexander offers words of encouragement to students and healthcare professionals living with disabilities or health conditions. She emphasizes that these challenges do not define them and encourages them to pursue their dreams and passions in the medical field.
Dr. Alexander also discusses the importance of breaking down stereotypes and promoting diversity in the medical community. She highlights that a diverse medical workforce can lead to better health outcomes, as patients often feel more comfortable and understood by healthcare providers who share similar backgrounds or experiences.
Stephanie Moss, MD: Thank you so much. That was very inspiring, especially, I know for me, as I go on to my residency journey, and I know it will be for many other people. So thank you, Dr. Alexander for being here and sharing your journey all the way from an island in the Caribbean, St.
Lucia. You did medical school down there, and then came up to the States to do your clinicals. Then you did residency in New York, where you went through COVID. Even through COVID, you didn't give up, and you kept being who you are, following your passion, and actually you fell in love with bedside medicine, and found that you can really have an impact on patients.
It was so heartwarming to hear how you kept going through residency and even when health challenges, your own health challenges arose, you didn't give up. You just put it as " I've been through other challenges. This is just another challenge, another hump in the road." you kept going. I loved how you talked about your support of your community, of how important it was to help you get through your diagnosis, your treatment, and then keep going. Now you've graduate residency, did a fellowship in geriatrics and then now you're already in another fellowship.
Like that'shuge and that's so inspiring to all of us that are here either starting our medical careers or in the mix of It. Is so important to hear these stories. I want to thank you so much for being here and sharing your story.
I wanted to also bring it to the audience.
Thank you all for tuning in. If this is your first time, I encourage you to share it with just one other person, someone who you think would appreciate this story, because that's how we can really form that community, as Dr. Alexander said. I really loved just the importance of saying you're not alone in your struggle.
We all feel it at some point in our life, but it's important to remind ourselves that everyone struggles with something at some point in their life, and they're not alone, and they can keep going.
Stephanie Moss, MD: Is there any way that individuals could contact you or you would like them to contact you?
Elmarie Alexander, MD: Yes, of course. I am on Instagram, actually, I was not for a while, but I recently restarted. And you can contact me at @dr.Elmarie_alex. That is my username and also on Threads which is a much newer platform.
But these are the two most common platforms that I use. I also have a YouTube channel. I recently started it, partly because I wanted to eventually share my story, like just the entire journey of my breast cancer. So you can also check it out if you're going through this journey as well and want some insight. I'm open to anyone who's looking for assistance or advice. Thank you.
Stephanie Moss, MD: I love that. What is the name of your YouTube channel?
Elmarie Alexander, MD: It's also my name, Elmarie Alexander.
Stephanie Moss, MD: Perfect. I'll make sure to include your Instagram and YouTube and I'm excited to see your journey continue. , it sounds like you're really working on advocacy and sharing your experience . I look forward to hopefully also collaborating.
if you are also on Instagram, my Instagram is @medpsycmoss, all the other social media are medpsycmoss and you can actually find this podcast.
on YouTube @medpsycmoss, Life as a Patient Doctor, or on Spotify, Apple, and everywhere else you listen to your podcasts. .
Thank you, Dr. Alexander. Thank you so much for joining us today.
Elmarie Alexander, MD: Thank you, Dr. Stephanie Moss. It was a pleasure.
Stephanie Moss, MD: Thank you. Take care.
Elmarie Alexander, MD: Take care.
Dr. Alexander can be reached on Instagram at @dr.Elmarie_alex and on Threads under the same username.
She also has a YouTube channel, "Elmarie Alexander," where she shares her journey and advocacy work.