“I tell people: It’s just like a marriage. You can’t just expect your spouse or your significant other to be always nice. They’re going to have bad days; there’s going to be things you don’t like about them. This is my job. So if you don’t love it like that, you’re going to hate your job eventually… if you don’t love your job like that, it’s not a job you’re going to be with for a long time. You’re not going to be able to accept the ups and downs.”
- Dr. Warnsby
Perseverance is defined as a “continued effort to do or achieve something despite difficulties, failure, or opposition” according to Merriam-Webster dictionary. In the field of medicine, perseverance is necessary. No matter who you are, the trials and tribulations that accompany the “M.D.” title requires a determined person willing to combat all adversaries. However, perseverance for some future-physicians is more than just battling stubborn attending’s and harsh graders. For people of color, women, and other underrepresented groups, perseverance in the medical field often means combatting rude comments and people who won’t help you.
It sometimes means pushing through some of the most rigid stereotypes and having to perpetually justify why you deserve to be in medical school. For Dr. Caron Warnsby, it meant all of the above.
Just over two months ago, I had the pleasure of listening to Dr. Caron Warnsby’s story of perseverance. Dr. Warnsby, a beautiful person with a contagious laugh, is a black woman and a general surgeon. Just recently, Dr. Warnsby moved to work at Nash UNC Hospital in Rocky Mount, North Carolina. When I interviewed her, she had just finished her move from Michigan to North Carolina.
Dr. Warnsby’s medical journey began as early as her childhood. In fact, Dr. Warnsby knew from day one that she wanted to be a doctor. This is because she spent most of her childhood in and out of hospitals because her brother had an injury that required a lot of surgeries. “In my mind, the hospital was a fun place… there were always toys, the doctors were always nice, everybody was nice,” she smiled. Dr. Warnsby explained how she would always get toys, particularly Barbies. Because of this, the hospital seemed like a fun place to work. Even as Dr. Warnsby grew older and began questioning why she wanted to be a doctor, she said, “I was like, ‘It's always been a fun place.’” To this day, Dr. Warnsby feels the hospital is a fun place to work, even though she has to deal with the stressful parts of being a healthcare worker (and doesn’t get to play with Barbie dolls).
However, becoming a black, female physician wasn’t going to be an easy path. In fact, black, female physicians were practically unheard of in the 20th century. Because of this, Dr. Warnsby received opposition to her becoming a doctor as early as high school. Dr. Warnsby went to a predominantly white school in Chicago and was 1/50 black people in a class of 380 in her high school.
Dr. Warnsby first attended Lincoln University in Pennsylvania for a year but ended up transferring to Tuskegee University because she felt Lincoln University was too small. At Tuskegee University, Dr. Warnsby earned a degree in Biology.she went to speak to a school counselor. “She [the school counselor] was like, ‘Oh, your grades aren’t good enough to go to Illinois.’ And I’m like, ‘Well, I mean, I made at least the ‘B’ Deans List all the time, how can I not…? Why is my B not as good as their B or C?’” Instead, the school counselor recommended Dr. Warnsby go to community college, which was looked down upon where she came from. In fact, to even apply to college, Dr. Warnsby had to send her white friends into the counselors' office to acquire paper applications for her, as the counselor wouldn’t give her the paper applications without fussing. Dr. Warnsby applied anyways and was accepted into at least five colleges, including the University of Illinois.
Dr. Warnsby first attended Lincoln University in Pennsylvania for a year, but ended up transferring to Tuskegee University because she felt Lincoln University was too small. At Tuskegee University, Dr. Warnsby earned a degree in Biology.
Dr. Warnsby wasn’t sure if she wanted to go to medical school right after she completed her undergraduate schooling. For Dr. Warnsby, the MCAT and medical school applications (since they were all on paper) were very overwhelming. So instead, Dr. Warnsby did a post-baccalaureate program through Scholl’s Podiatry School. Through that program, she did half a year in New Orleans and half a year in Chicago. However, Dr. Warnsby didn’t want to take care of peoples' feet. So, she persevered through her stresses with the MCAT and the applications and applied. “When applying for med school, I would get questions like: ‘What makes you think you can be a doctor?’ And I’m like, ‘Never thought I couldn’t be a doctor. What’s that question about?’” Dr. Warnsby was met with a variety of questions like this when she decided to apply to medical school. She was later accepted into the University of Illinois’s medical school.
At the time, the University of Illinois’s medical school had four parts to their program. The first part of her schooling was done in Urbana-Champaign. Later, she was split up and graduated from University of Illinois’s Peoria campus, which is now University of Illinois’s medical school.
In Dr. Warnsby’s medical school experience, there was a program named “Urban Health”. Urban Health was a program created for minority recruiting. Essentially, medical schools wanted doctors of color to go back to work in the communities they came from. Dr. Warnsby later explained this was related to Affirmative Action. Because of this, students would say, “‘Oh you didn’t really get in [to medical school] because you were smart, you got in because [of]… Affirmative Action.” Dr. Warnsby later found out that there was another program named “Rural Health” that accepted students from rural communities to go back and work in the areas they came from. This caused a lot of confusion. “So why is my special program to keep minorities in their communities… why’s that a worse program than your Rural Health program?” Things like this became draining. Dr. Warnsby constantly had to combat comments from students, some of which had also been admitted through a special program, in order to justify that she deserved to be in medical school. “So it was the little things like that where it was always, “You got in because you’re black, not because you’re smart enough, [not because] you worked hard enough, it was because they need the black number.”
When Dr. Warnsby first entered medical school, she wanted to become an OB. There, she met a female trauma surgeon, who she later described as a role model on her path to becoming a surgeon. The trauma surgeon was nicknamed the “ball crusher” among male surgeons, and she terrified all of the male residents. “She [the trauma surgeon] was a nice, strong woman, who told me, ‘You can be tough, you can be nice, but you don’t have to take their crap.’” This trauma surgeon was the first person to tell Dr. Warnsby that she would be a surgeon, which Dr. Warnsby responded to with, “I’m not crazy.” The trauma surgeon had told Dr. Warnsby that she’d see Dr. Warnsby back in the surgical department soon after Dr. Warnsby finished her surgical rotation.
Eventually, Dr. Warnsby had her OB rotation, and a funny thing happened—she was what nurses consider a “white cloud”. A white cloud is somebody, often a physician, who conveniently comes in right when there are no patient cases or concerns. It’s a phrase often used out of superstition.
“Nothing happened when I was on call. No babies were delivered, no admissions. The nurses loved me because they knew, ‘Oh, the white cloud is here, we’re not going to have any work today!’” The entire weekend Dr. Warnsby spent in the OB department she spent watching every Clint Eastwood movie made, as there was nothing else to do. “It was Clint Eastwood’s birthday,” she told me.
Because there was nothing to do, Dr. Warnsby wandered back to the surgical department, where the trauma surgeon she looked up to sat. Dr. Warnsby finally admitted that she wanted to become a surgeon.
When Dr. Warnsby began doing her surgical rotations, she loved it. “I was the weirdo who kept saying, ‘Can I stay to see the end of this surgery?’”
When applying for residency, Dr. Warnsby was one of the first black students to ever receive a five on her surgical exam. For reference, scores were based 1-5, five being the highest score. Her score was impressive to her classmates, as she was both black and a woman. (Not to mention that scoring a five is incredibly difficult.) This was a testament to her hard work and intelligence—proving that she did not get into medical school just because she was black. Despite her fantastic score, Dr. Warnsby was nervous to apply to residency programs. She made a cardiothoracic surgeon she had watched operate write her a plethora of letters. “‘Why are you making me write all these letters, you’re going to get in!’” He had said, “‘The reality is you’re a black woman. There’s very few black women surgeons. You’re going to get into a program.’” Dr. Warnsby didn’t want to get into a program just because she was black, though. She wanted to get in because she was qualified, intelligent, and a hard worker. He told her, “‘I know it sounds bad, but this is the time you’re going to use that affirmative action whatever crap to get what you want…That’s what you have to learn with surgery: You have to use it to get what you want.’” So Dr. Warnsby sent her applications to different residency programs and ended up getting accepted into a program at Brookdale Hospital Medical Center in Brooklyn, New York.
In New York, Dr. Warnsby experienced culture shock. She had known about the different cultures around the globe but had never interacted with such a diverse group of people in such an intimate setting. This was very overwhelming at first. “It was all the different cultures and their expectations of what women should be. So you have the whole sexist part of ‘Women should be at home’ and then you have the ‘Black woman? Well… you should be a pregnant teenager at home.’”
During Dr. Warnsby’s residency, they used the “pyramid system” (this program set-up is not used anymore). Using the pyramid system, residency programs would admit as many students as possible and weed them out. Each year, someone was cut from the program, leaving students to compete and wonder who would actually graduate the program. The program later changed to a categorical system, where they allowed only three students to graduate each year. The goal for each resident was to beat the categorical. “It was like Survivor of medicine,” Dr. Warnsby explained. She never knew how or when it was going to end.
Due to the structure of the program, residents turned against each other. Dr. Warnsby explained that nobody helped each other; in fact, people would intentionally not help others in order to advance forward. Dr. Warnsby proceeded to explain a specific time when she had trusted somebody to help her. In the program, she had met a man from Cashmere who had always been very nice to her. He had had a reputation among their peers for being a hard-worker, as he had always helped other residents on their tasks without complaint. Assuming he’d help her like he had helped others, she asked him to complete some tasks for her. At 2 a.m., Dr. Warnsby followed up with the man to see if he had completed the tasks. He hadn’t, claiming he didn’t get to them. At first, Dr. Warnsby was confused. He had always been such a hard worker for everybody else and had broken his back to do things for others. Yet, he hadn’t even tried to help her. “And I realized he didn’t like taking orders from a woman,” she explained.
That’s when Dr. Warnsby realized she had to make accommodations in order to make herself heard and not someone people could step on.
By the time residents are a PGY-5 in general surgery residencies, they can be considered as a “chief resident”. However, with seniority comes more tasks, authority, and blame if things don’t get done efficiently and effectively. “Initially, I would run behind them [the residents] and make sure they did their work so when they said they did it and they didn’t, I know it’s done.” There was a trust nobody type of mentality, and it began to drain Dr. Warnsby.
“I call it [residency] the tunnel… We always say you’re stuck in a train tunnel and you knew it was going to be dark and you’re walking through and hoping it’s okay, and then you see a light and that’s your third year of residency… And you go, ‘Oh my god, I can almost see the end of the tunnel’… And then when you come out [after a year of research] and you start doing all your consults and you start learning more, you realize that light was the train that was hitting you. And then after that, you finally get to the end and you’re like, ‘I’m out of the tunnel!’”
Right after residency, Dr. Warnsby got a job at Oaklawn Hospital in Marshall, Michigan. She worked there for sixteen years before transferring to a hospital in North Carolina to get a change of scenery.
Residency left mental scars on Dr. Warnsby that she had to bear in her early career, though. She had difficulty trusting colleagues and felt stressed in confiding in them. She decided to seek out a therapist to talk to about all of the awful things that had happened throughout her residency. “I went to therapy and… I was explaining residency to her [the therapist] and she was like, ‘Seriously? You went through that?’ I was like, ‘Oh, god, yeah, it was like Survivor… Go back to residency in the 80s-90s, that’s a whole other scary level of Survivor… Not just your physical life, but your career depended on it, and people would backstab you and say they would do their work, and then the horrible rounds at six in the morning or five in the morning when they swore to God they did it so you didn’t have to do it, and now it’s all on you because it didn’t get done. And now you have your chief yelling at you, your attending yelling at you, and never mind the patient didn’t get taken care of.” Through therapy, Dr. Warnsby learned that it’s okay to confide in colleagues. She began to realize that not everybody was out to get her—a thought her residency program had ingrained in her head.
Luckily for Dr. Warnsby, she had an amazing role model throughout all of this: her mother. Dr. Warnsby explained that her mother is very tough. She taught Dr. Warnsby that if there was something she couldn’t do, she could take a class to learn it. “Her rule was: Until they physically come to remove you, you do not leave a class, a building, anything you think you deserve to be in and to work in, because you deserve to be wherever you want to be.” When student loan checks didn’t come in soon enough, Dr. Warnsby would call her mom, afraid of going to class because she didn’t want to get kicked out. Every time, her mom would say, “‘Just go to class, it’ll [the financial aid check] be there, don’t worry, just keep going, keep going, keep going.’ That was her [Dr. Warnsby’s moms] mentality…And so that perseverance stuck with me.”
To finish our conversation, I asked Dr. Warnsby if she had any advice for high school, pre-med, or medical school students. She said:
“You have to love whatever specialty you decide to go into, even if it’s no specialty, family practice… You’re dealing with patients every day.”
“It is possible to change [specialties].”
“If you don’t love this and having to deal with all the ills that come with [it], and changes in medicine, it is going to be a very difficult road… It’s just a love of… healing someone or helping them heal themselves. It is a calling. It’s not a job where you can flip every three years. You’re going to hate it, then.”
“I would tell women: If you want to have children, do it. If you can figure out how to do it in med school, and in residency when you’re younger, go ahead and do it. Because that fertility issue is real.” She wants young women to know that if you have the partner you want to have children with, have children. Even if it’s hard. Because “As I tell my daughter: You can do hard things.” Dr. Warnsby explained that everyone talks about getting married and having their career set and then having kids, but it doesn’t always work out so smoothly. Dr. Warnsby explained that she had done everything right with her career, but it had been too late for her to have children by the time she was ready. She had always wanted children and had always wanted the experience of being pregnant. Eventually, Dr. Warnsby did have children, just not the traditional way: Dr. Warnsby has two beautiful, adopted children
“And then for the women and the minorities, you do have to have that thicker skin. And it’s okay to cry, you just have to do it not in front of anybody… Sometimes when I was in residency, I remember I was on neurosurgery [rotation] when Saving Private Ryan came out. And I’d go see that movie multiple times just so I could have a legitimate reason to be somewhere in public crying… And I was like this is such a good emotional release.”
“And to say all that [sadness and stress] in therapy is good. It is okay to find someone to talk to when you’re having a problem… Find someone not associated with your program.” Dr. Warnsby said to find someone not associated with the program to avoid information circling around people in the program
“I would tell women: If you want to have children, do it. If you can figure out how to do it in med school, and in residency when you’re younger, go ahead and do it. Because that fertility issue is real.” She wants young women to know that if you have the partner you want to have children with, have children. Even if it’s hard. Because, “As I tell my daughter: You can do hard things.” Dr. Warnsby explained that everyone talks about getting married and having their career set and then having kids, but it doesn’t always work out so smoothly. Dr. Warnsby explained that she had done everything right with her career, but it had been too late for her to have children by the time she was ready. She had always wanted children and had always wanted the experience of being pregnant. Eventually, Dr. Warnsby did have children, just not the traditional way: Dr. Warnsby has two beautiful, adopted children
The best lesson of all, though? Dr. Warnsby says to continually persevere. Even when people tell you no or put you down, keep pushing forward. “Don’t let them take your smile or your laugh or your inner joy away. Whatever you’re there for, whatever calling you have that you knew you were supposed to be here, you are supposed to be there. No one can take that away from you, and don’t let anybody.”
Even at age 50, Dr. Warnsby can’t think of any other job she’d love to do more. She is passionate about the OR. “Going into the OR, it’s recess for me. I get to play my music, I get to laugh with people, we get to joke, it’s so relaxing…. Once you get through the stressful point in the case, it’s back to the relaxation, the listening… If you really love it, it’s worth it.”
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