Caring for her mother, a medical student learned how a little compassion can make a difference

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When Diana Castillo Bonilla tells the story of how a little girl from Colombia grew up to be a medical student in Michigan, her face shows nothing but smiles.

As she describes her journey, it's easy to envision her as a child, clutching her mother's old medical textbooks, running around in a white T-shirt that was the closest thing she could find to a doctor's lab coat.

But behind the happiness and hope is a story of loss and struggle – and lessons learned about caring for others.

Castillo Bonilla, now a second-year medical student at Oakland University William Beaumont School of Medicine in Rochester, Michigan, grew up in her grandparents' house in Cali, Colombia, surrounded by cousins. Helping people was a family tradition. "My great-grandmother was a midwife, and then she passed that along to my grandmother, who was also a midwife," the type whose treatments included teas, plants and herbs.

Before Castillo Bonilla was born, her mother, Elizabeth Bonilla, studied medicine herself. "She was always considered very smart," Castillo Bonilla said. But her mother also had been born with a heart murmur and was frequently sick as a child. "She often experienced shortness of breath, couldn't run long distances, and would sometimes pass out unexpectedly."

In her late teens, Bonilla underwent surgery to replace her heart's mitral valve. But the valve became infected, and the infection spread to her tricuspid valve. She had another surgery to replace both valves. She ended up spending three months in a coma.

When she woke up, she had long-term memory loss. Although her memory gradually returned, "she was never able to go back to medical school," Castillo Bonilla said.

Years later, after Castillo Bonilla was born, her mother's textbooks were still around the house. "I would play with them and be like, 'Yeah, I'm going to be a doctor one day.'"

She ended up having plenty of exposure to actual doctors.

Her mother remained in stable health for many years, but in time, she developed a series of problems that included heart failure, an inability for the heart to pump enough blood.

Castillo Bonilla became her primary caregiver, taking her on walks that became shorter and shorter over the years, accompanying her to medical appointments. "I started taking on that role when I was pretty young, around 7 or 8 years old."

It felt "natural," she said. Her grandmother, Eugenia Ocoro de Bonilla, had modeled how to think about others' needs.

"Sometimes at home, we didn't have food," Castillo Bonilla said. But when visitors came, if anything was on hand, her grandmother would say, "'Oh, take a seat. Do you want to eat something?'"

Young Castillo Bonilla would think, "What?! What are you going to give them?" and worry that the family's food for the next day had been given away. But her grandmother "just always cared about having the doors open for everyone."

Castillo Bonilla saw the same generous spirit in her mother.

She remembers emergency room visits where, instead of focusing on her own problems, her mother would look around for people who were struggling – then send her daughter to assist.

"At the beginning, it was kind of annoying" to have to, say, escort a woman she didn't know to the restroom, Castillo Bonilla said, when the person she wanted to focus on was her mother. But her mom wanted her to learn "that you need to just be very compassionate about other people and understand what they're going through, and that you can always be of help for someone."

Watching the medical personnel in action, Castillo Bonilla also witnessed the difference a little compassion could make.

One time, her mother was in a hospital bed, cold despite her blankets. A doctor came in to discuss some results. Noticing that her mother was so cold, he retrieved a pair of socks and put them over her existing pair, saying, "Maybe this is going to help you warm up a little bit."

Castillo Bonilla "could see how my mom was feeling so loved, and that she was being so taken care of by someone that barely knows her."

That type of comfort is "something that we can do through medicine," she said. "And I would love for my patients to feel that way."

She also learned what the absence of care could do.

In time, her mother received a pacemaker and should have had another double-valve replacement surgery. But the family's health insurance balked, and at times, they lost coverage completely. "She'd have periods of stability, and the doctors would say there was no longer a need to replace the valves. It became a cycle of temporary improvement followed by decline."

Some years she had no follow-ups, Castillo Bonilla said. "I think that contributed to the fact that she got worse, because she didn't have the treatment that she needed."

Elizabeth Bonilla died in 2014. She was 48.

Soon after, Castillo Bonilla moved to Miami, where her father, Florentino Castillo, lived.

Amid the grief, the move turned out to be healing, as it enabled her to build a relationship with him after many years of living in different countries. "We have a great relationship now," she said. "He's become my best friend, the first person I call when something good or bad happens."

The move also enabled her to get on the path toward a formal medical education at the age of 24.

Her mother had not wanted her to become a doctor and had warned her that the work would be all-consuming. But Castillo Bonilla started at Miami Dade College, focused on learning English. She found work as a hostess in a tourist area to make sure she had a chance to practice.

Castillo Bonilla then transferred to the University of Miami, where she finished her bachelor's degree in biology. She took two years away from school, during which she worked as a patient navigator with the THRIVE clinic, which helps victims of human trafficking. It was there she met Dr. Katrina Ciraldo, an assistant professor of clinical medicine at the University of Miami's Miller School of Medicine.

She has seen how Castillo Bonilla uses the lessons she had learned while caring for her mother. "Diana was a key partner for every single patient that was referred to us," Ciraldo said.

As a busy physician, Ciraldo acknowledges she can be focused on checking off the steps needed to evaluate a patient – lab work, ultrasound, whatever comes next on the list. "We can lose the forest for the trees." But Castillo Bonilla was able to "do a really human assessment of where somebody's at" and figure out how to get them the care they needed.

She is "extremely sweet," but also determined, Ciraldo said, and "never gave up on anybody."

At the medical school Castillo Bonilla attends in Michigan, Dr. Pierre A. Morris, the associate dean of clinical education, has seen the same traits.

"She is tenacious and unrelenting," Morris said. He's worked with her and student colleagues to add an elective class on medical Spanish to the school's curriculum, and he's helping her on an effort she started after she spent time working in a "street medicine" program that provides care for people who don't have housing.

Castillo Bonilla had noticed that many people needed better foot care, Morris said. That means more than just looking for diseases. "It's washing their feet as well, because one of the things she realized is that homeless people don't get a chance to wash their feet very often." She's trying to address the need by bringing in podiatrists and podiatry residents.

Her tenacity is never argumentative, Morris said. She's a listener and a problem solver. "If you tell her, 'Well, we've got this barrier here, and this is one of the things that we have to overcome,'" she'll figure out how to overcome it, he said.

As Castillo Bonilla learns about the science of medicine, Morris said she's already demonstrating the art of being a doctor, which "takes a will, a drive and determination to be that kind of altruistic person that fundamentally is guided by the mission of what a physician should be, and putting your patient above yourself and making sacrifices for your patients."

Her learning process has included being chosen as a scholar in the American Heart Association's National Hispanic Latino Cardiovascular Collaborative, a mentoring program that aims to promote the treatment and prevention of heart disease and stroke within the Hispanic community.

Castillo Bonilla's main interest at the moment is cardiology, but she'll be considering her options in the years ahead. She feels drawn to working with under-resourced communities and to putting her experiences as someone who is Black and Hispanic to work. She's been serving as an interpreter at clinics that help Spanish-speaking people, and "seeing how their faces light up" when they realize they can express themselves fully "is amazing for me."

Her mother didn't live to see all her progress, but "I can feel it through my grandma, because she's always telling me how proud she is."

She thinks her mother would approve, too. But not just because someday people will call her "doctor."

More than any title, Castillo Bonilla said, her mother wanted her to be someone who could show people love, who could make a person "feel like you're at home" and know that someone is there for them.

"And I think it took me some time to get there," she said, her voice wavering a bit. "But I feel like I do try to give that from myself to other people. And I think she would appreciate the fact that at least I'm trying just to be a better person."

The compassion that she hopes to deliver to her future patients is something that goes beyond just words. "I feel like you can say so many things about who you are," Castillo Bonilla said. "But it's just through your actions that you actually show that."