The ambulance would not move until the fuel was paid for.

I started high school in the middle of all of it — hospital bills, surgeries, a father who could not walk, a family whose money was going somewhere else. I chose the science track that year and I have not deviated since.

I want to be honest that the choice was not noble at the time. It was closer to stubbornness. I had watched something happen that I did not understand and could not affect, and studying the thing I did not understand was the only available response.

The understanding came later, and it turned out to be about arrangement more than about biology.

When the scholarship to study medicine in Cuba came, I did not take it simply because it was the opportunity in front of me. I took it because the Cuban model is one of the very few in the world built around delivery first.

The physician there is stationed inside the community rather than waiting at the end of it. She holds a defined population. She is expected to know that population before it becomes ill — by name, and by address. For someone whose entire question was “why did it take so long for anyone to reach him”, that is not an interesting curriculum. It is the answer to the question.

Six years at the “Enrique Cabrera” Faculty of Medical Sciences, University of Medical Sciences of Havana. My degree was conferred on 18 July 2026 with an academic index of 4.67 out of 5.

The patient was eighty years old, she was on my list in Ward C, and on paper she was stable. What I noticed that morning was small enough that I spent a moment deciding whether to raise it at all. Raising it meant interrupting a specialist with something I could not yet fully justify.

I raised it. She was entering a critical state. The multidisciplinary committee reviewed her the same day and the team was able to act while there was still room to act.

I have thought about that morning often — not because the diagnosis was difficult, but because of how close I came to waiting until the afternoon. That is the decision medicine is actually made of, repeated: not what is wrong, but whether you say so now or later. I do not experience raising a concern early as an inconvenience I am imposing on a senior colleague. I experience it as the job.

At Consultorio del Médico y la Familia No. 4 I was given fourteen families — five obstetric patients, eight paediatric, ten geriatric — and every fortnight I went to their homes.

Any competent intern performs well when the patient is in front of them. The distinguishing skill in primary care is going to find the patient who has not come: the elderly woman who has quietly stopped attending, the pregnant patient whose partner has moved her out of the district, the child whose vaccination has slipped.

Seeing people in their own rooms changes what you can say to them. The advice I gave stopped being general: it was the arrangement of a bathroom for an elderly patient at risk of falling, the storage of medication in a house with small children, the ventilation of a room where a pregnant woman had started coughing. All five of my obstetric patients were enrolled in prenatal care before twenty weeks — which is only possible if you know a woman is pregnant before she comes to tell you.

I am a Christian, and it is not a decoration on top of the medicine. Six years in a language that was not mine, a long way from home, on wards that were sometimes overwhelming — there had to be somewhere to stand that was not my own competence, because my own competence had bad weeks.

The Church of Pentecost community in Cuba is where I did most of my standing. I served in it and it carried me, and the small silver medal in the gallery below — “Top Soul Winner”, from the Light Cell of the International Church — matters to me more than it probably should, because it was given for the part of my life nobody was grading.

It also does something specific to the clinical work. If a person in front of me is not reducible to their presentation, then the extra ten minutes are not generosity. They are accuracy.

For the 2025–2026 term I served as General Secretary of the National Union of Ghana Students in Cuba, representing the Enrique Cabrera faculty — the administrative spine of a scholarship cohort that is a long way from home and, quite often, has nobody else to call.

Much of it was unglamorous: minutes, records, welfare cases, the logistics of Ghana Day, chasing the paperwork of students whose documents were stuck somewhere between two ministries. It is the same instinct as the house-to-house rounds, honestly. Somebody has to keep the list of who has not been heard from.

The Union's certificate of appreciation, countersigned by the Ghanaian Ambassador to Cuba, is dated 6 August 2026.