Sarah Vélez

“No tengo todo lo que quiero, pero quiero todo lo que tengo (I do not have everything I want and would love, but I want and love everything I do have).” —  Ayita

In Spanish, “quiero” expresses different sentiments based on context. It can mean both to want or desire something; it also means to love and adore someone. Ayita, my grandmother, has woven quotes into every aspect of life. Of all her inspiring aphorisms, the one above shapes my definition of true wealth. It allows me to honor the challenges in my financial journey while remembering to enjoy present blessings.

sarah velez

Sarah Vélez

“I do not have everything I want and would love”

Although Ayita lacks material wealth, she is rich in spirit. Not once have I heard her express the desire for more things; rather, she has confided in me her sadness at being limited in what she could provide my father and his siblings. When my father moved from Medellin, Colombia to California on his own at age 17, I imagine she yearned to send him off with more than a home-sewn blanket. Having married on the eve of her 17th birthday and days before her high school graduation, she spent her early 20s chasing five young children. She found ways to cover minor expenses, like selling homemade cakes to friends. As a homemaker her entire life, she relied monetarily on my grandfather, Ayito, to provide for the family. While there were enough resources some months, the fluctuating nature of his job auctioning cattle meant the family’s income was highly uncertain. On top of this, she managed a close family member's lifelong and debilitating substance addiction. Since my grandfather's passing 21 years ago, she has been economically dependent on her children. This brings her daily anxiety, as she fears being a burden.

Like Ayita, I worry about money. I grew up middle class and had consistent access to food, shelter, and safety. But my young body still tensed as I overheard my parent's hushed conversations about managing expenses. My maternal grandmother is from Peru, and both she and my father sent money to their respective families in South America. I soon realized, my parent's income was not just for us; it supported loved ones abroad who struggled more. To defray costs, I began working at age 14 to cover personal expenses like clothing. I also was careful when asking my parents for new items and conservative with spending my earnings.

Financially, I am still not where I wish I could be. The whirlwind medical school offer and acceptance process landed me 2,045 miles away from my long-term partner, my brother, and my parents. Given the $40,000 out-of-state yearly surcharge atop attendance costs, it is a hard reality knowing trips home will be infrequent. Additionally, I take great pride in living debt-free and within my means. Thus, much cognitive dissonance arose when I officially accepted my financial aid package which consisted of almost exclusively loans. As I turn 31 in my first year of medical school, I can slip into comparing myself to those who landed on this path earlier than me.

Luckily, I know where to draw inspiration from, to remember what is of true value.

“I want and love everything I do have”

Ayita’s lack of material wealth has not stopped her from being the most grateful person I know. She truly delights in small things, and her delight is infectious. She modeled this appreciation on her rare trips to visit us in the United States. Ayita adored our Saturday garage sale excursions and could not believe people had so many possessions (garage sales are uncommon in Colombia). Many magical adventures ensued as we hunted for deals side-by-side. I vividly recall my 4-year-old self strutting up to the homeowner at one garage sale and translating Ayita’s offer: “Will you accept $3 for this Santa Claus mug, priced at $7?” They agreed.

Appreciation is central to how I view my financial picture. Though a scarcity mindset colored my adolescent and 20-somethings lens, I choose to redefine what I thought was possible for myself—both professionally and fiscally. This attitude shift is a direct outgrowth of my conscious efforts to live Ayita’s advice. I now cherish the material and intangible fortune already in my life. For example, I worked full-time for two years before medical school. While my accumulated savings only covered this year's out-of-state surcharge, I felt pride in investing my earnings into my education. And through the generosity of family and friends, I lived rent-free while completing my self-directed post-baccalaureate courses. This allowed me to scale back to part-time work, which afforded me increased study time.

In addition, I prize my internal drive to dig and discover financial opportunities and the associated courage to ask others to invest in my journey. Through studying White Coat Investor resources, and seeking out budgeting advice from physician mentors, I feel more financially literate to craft my path. I seek a nontraditional physician career and therefore must be fiscally strategic to create this professional flexibility. First, I aspire to pay off student loans within 3-5 years of graduating fellowship and plan to enroll in the REPAYE program. By initiating the series of 120 payments at the start of residency, I will be eligible as early as possible for the Public Service Loan Forgiveness program. This fiscal freedom will enable me to take the knowledge gained through either adolescent gynecology or psychiatry training and apply it beyond clinical settings.

I am passionate about empowering young women of color in their reproductive, sexual, and mental health. Eventually, I hope to design interdisciplinary programming within public schools and clinics where these women learn health autonomy skills and how to care for their bodies, hearts, and minds. Knowing my loans are paid off means I can invest my time and energy to best create this dream role.

Ayita’s modeling has taught me how to access great wealth. She has shown me that while I may experience limits in my finances, the most important things in life are not things. Rather, they are treasured moments spent in connection with those I love. Today, I video-called Ayita while she is awaiting emergency open-heart surgery. Her swollen eyes were closed and her voice was wispy. Yet, she still managed to sneak in new pearls of wisdom:

“No te dejo oro, pero te dejo amor. Amor y mas amor (I cannot leave you gold, but I leave you love. Love, and more love).”

As I hustle to develop more economic ease while training to be the first U.S. physician in my family, I cannot think of anything I would want and love more than her words: I truly “quiero todo lo que tengo.”