Chapter 9- Knuckleheads and Nerds

Silvi Shah, member of the NSMC faculty and transplant nephrologist looks at chapter 9.

Knuckleheads and Nerds

“Knuckleheads and Nerds” is about various life phases that Vanessa and her husband Robert have matured through. Robert was a knucklehead during his teen years. Vanessa was a nerd.

Robert was from Richmond, California. He was taken to a juvenile holding facility  for intent to distribute (but not possess) drugs.  It was a traumatic experience for him. He was 15 years old.  

His relationship with his mother, Ginger was initially not the best. One time he received the silent treatment from his mother for stealing ten dollars from her. She didn't talk to him for two weeks. This hurt him to the core. His first serious girlfriend was a teenager named Jennifer and they had a baby, Cameron, when Robert was only 15.

Robert’s relationship with his mother improved. They started spending more time together discussing relationships, family, and friends. Robert told Ginger about getting Jennifer pregnant. His mother remarked, “I am so disappointed.”  Ginger admired four men - Martin Luther King Jr., Richard Caesar (a dentist) , Benjamin Elijah Mays (President of Morehouse College), Howard Thurman (pastor of Church for the Fellowship of All Peoples) and all four of them went to Morehouse. Robert also wanted to be admired by his mother, so he decided to go to Morehouse College.

Jennifer's pregnancy made Robert responsible for a child, Cameron, but not for Jennifer. She wanted a family.  Robert felt pressured and tried to have a perfect family- even though his heart was not in it. He proposed to Jennifer with a ring, but spent time with other girls. He did not give enough time to his son and involvement in his son’s life was soon reduced to dollars and cents. This was something Robert always regretted. He always wondered if greater maturity could have led to a different outcome.

On other hand, Vanessa went to Duke in North Carolina for college and medical school.  She was a nerd! She initially thought of becoming an obstetrician /gynecologist. The medical school curriculum at Duke required its third year students to pursue a research project and Vanessa decided to do it at the University of California in San Francisco (UCSF).  She made a five-day long road trip from Duke to San Francisco in her little burgundy Geo Metro and her first cell phone!  Vanessa returned to Durham for her final year of medical school. She was in a serious relationship with Avery’s father at that time. 

During her fourth year of medical school, she realized that each medical speciality attracted a distinct personality. A person who could engage children was attracted to pediatrics, while someone who wanted to fix things was attracted to surgery. Vanessa loved outpatient Ob/Gyn clinic, but hated the hospital side. Even though, obstetricians and gynecologists were wonderful physicians, they seemed angry and sleep deprived. Vanessa decided to pursue primary care-focussed internal medicine residency in Oakland, California.

During her residency, she met Robert who was the treasurer on the hospital's board of trustees. Her relationship with Robert played an outsized role in deciding to specialize in nephrology. Even though, she never made any effort to ask for specific rotations in nephrology during her residency, she was fascinated by the kidney transplant system in the country. She began researching kidney transplantation and realized that becoming a nephrologist would aid her in this field of research.

She was accepted at UCSF for nephrology fellowship in 2017.