During Brother's Graduation, They Called It 'Just Fatigue'—His Dean Read My Medical File

The email from my mother arrived Thursday morning. Subject line: "Alex's Graduation Weekend - Final Details."
"Rachel, we're so excited for Alex's medical school graduation on Saturday! We've reserved seats with the family—Dad, me, Aunt Caroline, Uncle Tom, and Grandma. Unfortunately, the auditorium seating is limited and we could only get six tickets in our section. Since you've been having trouble with fatigue lately, we thought you might prefer to watch the livestream from the hotel room? That way you can rest and won't have to deal with the crowds. We'll celebrate together at dinner after! Love, Mom."
I read it three times, my hands shaking slightly—not from emotion, but from the muscle tremors that had become constant over the past eight months.
My younger brother Alex was graduating from Cornerstone Medical School, fulfilling our parents' dream of having a doctor in the family. For four years, every family gathering had revolved around his studies, his clinical rotations, his upcoming Match Day. Mom kept a countdown on her refrigerator. Dad had already ordered business cards that said "Father of Dr. Alexander Chen, M.D."
When I'd started experiencing symptoms eighteen months ago—crushing fatigue, muscle weakness, difficulty swallowing—I'd initially brushed them off. I was a researcher at a biotech company, working long hours. Stress and exhaustion seemed like reasonable explanations.
But the symptoms worsened. I began falling frequently. My speech slurred. My hands trembled so badly I couldn't hold a coffee cup. After six months of tests, the diagnosis came: Myasthenia Gravis, an autoimmune neuromuscular disease where my immune system attacked the communication between my nerves and muscles.
I'd tried to explain it at a family dinner. "It's called Myasthenia Gravis. My immune system is attacking my neuromuscular junctions, causing progressive muscle weakness. I'm starting immunosuppressive treatment and—"
Alex had interrupted, barely looking up from his phone. "Sounds psychosomatic. Classic conversion disorder presentation. You're stressed about work, your body's manifesting physical symptoms. Pretty common, actually. You should see a therapist."
"I've seen six neurologists. I have a confirmed diagnosis. The antibody tests—"
"Antibody tests can be false positives," he'd said dismissively. "Med school teaches you that first year. Most of these 'mysterious' autoimmune conditions are just anxiety and attention-seeking behavior."
My parents had nodded along. Dad patted my hand. "Alex would know, honey. He's almost a doctor. Maybe you are just overdoing it at work. Have you tried yoga?"
After that, my health became "Rachel's fatigue problem" in family conversations. When I had to use a cane after a particularly bad flare, Alex told relatives I was "being dramatic." When I missed his white coat ceremony because I was hospitalized for a myasthenic crisis, he'd sent a text: "Nice guilt trip. Real subtle."
What they didn't know—what I'd stopped trying to explain after being repeatedly dismissed—was that my case had become medically significant. My neurologist, Dr. Patricia Morgan, was one of the leading researchers in autoimmune neuromuscular disorders. My disease presentation was unusual enough that she'd asked me to participate in a study on treatment-resistant Myasthenia Gravis.
That study was being conducted in partnership with Cornerstone Medical School's neurology department. My case files, anonymized, were used in their fourth-year neurology curriculum as an example of complex autoimmune disease management. Dr. Morgan had mentioned it casually during an appointment: "Your case is actually teaching medical students right now. You're contributing to future doctors' education."
Including, unknowingly, my brother's education.
What they especially didn't know was that Dr. Morgan wasn't just my neurologist. She was the Dean of Cornerstone Medical School. She'd been promoted to the administrative position two years ago but still maintained a clinical practice and research program. Alex had mentioned his dean in passing—"Dr. Morgan is giving the commencement address. She's intense. Everyone's terrified of her."
I'd said nothing. Why bother? They didn't listen anyway.
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