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Shiny cars screeching down the road. Grocery stores filled with bright lights and food-stuffed aisles. TV screens flickering colorfully.
Cesar Ramirez stepped – mesmerized – into American life for the first time as a child.
Born in rural Honduras, Ramirez only knew poverty. He lived in a one-bedroom shack with his mother and no water, electricity, or healthcare. His father, in the U.S. to work, sent money home.
“We just had enough to survive, that was enough for us,” Ramirez said.
Ramirez, with the support of his parents and resiliency from childhood, is now a medical student at Sam Houston State University, pursuing his dream to be a doctor who cares for patients and improving healthcare systems.
He is also an intern at the Institute for Health Promotion Research at UT Health San Antonio and the Mays Cancer Center, an NCI-designated Cancer Center at UT Health San Antonio.
But his path to get here hasn’t been easy.
A Culture Shock from Honduras to the US
The Ramirez family lived in El Bálsamo, a green, but impoverished town near the northern border of Honduras.
They lived without the most basic of resources – but they were happy.
Ramirez’ father left when he was 1 year old to work in the US to support them.
“During that time [in Honduras], I had to grow up a little bit faster. I really didn’t know much about anything, I was just a kid, but I definitely did see a lot of the struggles my mom and I, a lot of my family, was going through,” Ramirez said. “And that was the whole reason my dad came to the US, because he wanted to give me a better future.”
When he was 7, Ramirez and his mother joined his father in the US.
Aside from the culture shock of ready access to luxuries like TVs and washing machines, he also faced the challenges of speaking only Spanish.
“It was necessary for me to learn how to understand and speak English to help my parents. I can remember being 8 years old translating at my mom’s doctor appointments and helping my dad fill out work applications,” Ramirez said. “At times, I was unsure of my ability to accurately translate and mediate, but I learned quickly and adapted because my parents needed me to. From buying their cars to establishing our family business, I have had to educate myself on challenging topics, even though I often knew nothing about the subject.”
“These experiences have helped me become more adaptable and resilient to challenges.”
And the challenges would be many.
A Painful Challenge and Inspiration to Help Others
After a few years in the US, Ramirez began to feel severe pain in his knee.
The pain spread to his hip, hindering his ability to walk.
His parents rushed him to Cooks Children’s Hospital in Fort Worth, Texas, where they learned he had an acute and serious case of osteomyelitis, a bone infection.
He needed three surgeries and a four-month hospital stay to save his leg.
But his experience left a bigger imprint than just scars.
“Dr. Vera, my orthopedic surgeon, showed me what it meant to be a competent and compassionate physician,” Ramirez said. “He went above just treating my condition. He saw I had a curious mind and always took the time to stop into my room and show me something interesting or teach me something new.”
“So that always inspired me, you know, to do something bigger than me.”
From there, Ramirez knew he wanted to make a difference and be to others what his doctors were for him.
More Challenges on the Path to Medical School
As Ramirez went through high school, he began preparing for the SAT and other college entrance exams. After doing well, he decided it was time to begin applying to colleges.
But he soon faced a roadblock.
His school counselor told him he couldn’t apply to college because he lacked citizenship.
“For me, that was a moment that time just stood still, and I was a kind of in disbelief. Because I was like ‘What did my parents do all this for? What did I do all this for?’ So, it was just kind of a very impactful moment,” Ramirez said. “I didn’t realize that not being from this country would limit me so much and would pretty much deprive me of a future.”
Ramirez found a beacon of hope that came through the federal Deferred Action for Childhood Arrivals (DACA) program. DACA
“[DACA] allowed me to get a driver’s license and Social Security and things like that. And, you know, I was able to apply to college,” Ramirez said.
This would ultimately help Ramirez get closer to his goal.
As a student at the University of North Texas, Ramirez juggled pre-med classes, three jobs, and volunteer/shadowing opportunities.
However, another obstacle emerged.
After graduating in three years at the top of his class with a degree in biology, he began applying to medical schools. But to his surprise, Ramirez wasn’t hearing back from anyone.
“I called around a few schools and when I asked them if they accepted DACA, half the schools didn’t even know what that was,” Ramirez said. “So it was just a very difficult thing because my whole dream was to stay here in Texas, practice medicine in Texas, like I’ve been here my whole life, I consider myself a Texan.”
Ramirez eventually found opportunity with Sam Houston State University’s College of Osteopathic Medicine, where he recently finished his first year.
“I see a lot of people, you know, a lot of doctors who I’ve talked to in the past, and they always tell me all it takes is one,” Ramirez said. “And for me, that was my case and I’m so grateful for it.”
Aligning with His Mission to Help Others
Part of his education includes his current six-week internship in summer 2022 at the Institute for Health Promotion Research (IHPR) at UT Health San Antonio and its Mays Cancer Center. Ramirez and fellow intern Javier Cintron are part of the 2022 Robert A. Winn Clinical Investigator Pipeline Program supported by the Bristol Meyers Squibb Foundation and others.
Working under Dr. Amelie Ramirez, director of the IHPR and associate director of cancer outreach and engagement at the Mays Cancer Center, he will help analyze data for the Avanzando Caminos (Leading Pathways): The Hispanic/Latino Cancer Survivorship Study.
Funded by a 6-year, $9.8-million grant from the National Cancer Institute, Avanzando Caminos is a clinical trial to recruit 3,000 Latino cancer survivors to help understand how different issues, such as discrimination, depression, chronic stress, diet, biological markers, and genetics, impact survivors’ symptom burdens, health-related quality of life, and disease activity.
“This was one of the few programs that actually felt like I would fit in perfect, and it also aligned with my mission, you know, just trying to expand my knowledge and widen my horizons and do something that could have monumental impact on people’s life,” Ramirez said.
Not only is Ramirez eager to learn and grow during his internship, he also wants to become a doctor who advocates for systemic changes in healthcare.
“Just seeing how simple adjustments in life can have huge impacts and the outcome of somebody’s condition can make all the difference, you know, especially coming from a third-world country where medicine, doctors are not as frequent as here or as affordable as here,” Ramirez said. “So just simple things like that, that can drastically change somebody’s outcome it is, I feel like it should be invested in a lot just because those underserved populations can benefit so much from it.”
Ramirez also plans to encourage his future patients to participate in studies like Avanzado Caminos and clinical trials, as it will benefit many.
“I think it’s very important that we build that trust and education between the community of Hispanics/Latinos and doctors, physicians and whatnot, just so we can create, you know, like a working team to pretty much help advance medicine and the way we practice medicine,” Ramirez said.
Ramirez knows he has the right mindset to fulfill his dream of helping others.
“Whether it was at work, first one coming in last one to leave, whether it was studying for tests, staying up till 4 a.m., waking up at 6 a.m., working three jobs to pay for my education, help my parents out, it was things that I had to do,” Ramirez said.
Though Ramirez has worked vigorously to get where he is, he expressed gratitude and appreciation for those who helped him along the way.
“My parents, I feel like they’re my number one fans, they have always encouraged me to do to do more than what I can just because and they’re always telling me that no matter my situation, it’s no match for God.”
By The Numbers
This success story was produced by Salud America! with support from the Robert Wood Johnson Foundation.
The stories are intended for educational and informative purposes. References to specific policymakers, individuals, schools, policies, or companies have been included solely to advance these purposes and do not constitute an endorsement, sponsorship, or recommendation. Stories are based on and told by real community members and are the opinions and views of the individuals whose stories are told. Organization and activities described were not supported by Salud America! or the Robert Wood Johnson Foundation and do not necessarily represent the views of Salud America! or the Robert Wood Johnson Foundation.