M.D. or Bust

Archived column.

Ajay Koti Ajay Koti (17 Posts)

Columnist and in-Training Staff Member

Morsani College of Medicine at the University of South Florida


Ajay is a pediatric resident and a Class of 2017 graduate of the SELECT MD program at the University of South Florida. He is passionate about delivering primary care to underserved populations—specifically, low-income and homeless patients in urban centers. Ajay will be specializing in pediatrics, with a particular interest in child maltreatment.

M.D. or Bust

Numerous studies have documented that medical students lose empathy during clinical years, becoming jaded and pessimistic. This has been linked not only to diminished enjoyment of our work, but also to worse patient outcomes. My goal is to sustain the humanistic values that drive so many of us to medicine, so that, instead of being quelled by cynicism, our idealism can be refined by wisdom.




A Third Year Opus — Chapter Three: The Tenant

Delirium is a bread-and-butter presentation. The differential writes itself — stroke, infection, intoxication, electrolyte imbalances, shock, organ failure. The intellectual exercise this invites was practically invented for medical students, even if the final diagnosis (dehydration secondary to gastroenteritis) and its treatment (fluids) were relatively mundane.

A Third Year Opus — Chapter One: Incidental Findings

The white coats and patient gowns that confer the implicit power dynamic of the physician-patient relationship are not to be found here in the operating room. This place has neither the tolerance nor the patience for this subtle symbolism. Here, on the other side of the Rubicon, the rules are stark, the stakes laid bare. The patient lies naked on the table, arms extended on boards, Christ-like, as the surgeon holds the knife handle and plays God.

How to Make Challah: The Jewish Octopus

Challah bread is traditionally prepared for Jewish holidays and the Sabbath. We made ours on a Wednesday night. Helen and Marie stare warily from their wheelchairs as a dozen medical students file into the retirement home lounge, toting tubs of flour and challah dough. “We’re not playing bingo?” Helen asks, looking disappointed, as students and octogenarians begin matching up for the evening.

Wounded Healers

Kaitlyn Elkins was a medical student at the Wake Forest School of Medicine in North Carolina and a member of the Class of 2015. She excelled academically, named the valedictorian of her high school class and graduating summa cum laude from Campbell University. She wrote poetry in her free time. She had a cat, lovingly named Gatito. On April 11, 2013, just weeks before beginning her clinical rotations, Kaitlyn Elkins took her own life. She left …

Hemlock Societies

Mr. Lacey was irate, to say the least, as he rattled off a list of his symptoms. Constant pain. Nausea. Dizziness. Numbness. Weakness. Fatigue bordering on exhaustion. He said he had been spending most of the day in bed and had become dependent on his wife and children for basic daily tasks. “I’m serious, Doc. I’ve just about had enough of this. I’ve been looking into Hemlock Societies.” The interview screeched to a halt, and …

“I can’t do this anymore.”

Room One With one eyebrow arched and his thin lips pressed together in a smirk, Vic Davis’ face was in a perpetual state of bemusement. The twinkle in his eyes belied his own protracted health struggles. A diagnosis of prostate cancer had truncated a successful business career, and signs of wear were beginning to show. His hair had fallen out and his eyes were sunken in. His speech was encumbered by a slight stutter and …

Ajay Koti Ajay Koti (17 Posts)

Columnist and in-Training Staff Member

Morsani College of Medicine at the University of South Florida


Ajay is a pediatric resident and a Class of 2017 graduate of the SELECT MD program at the University of South Florida. He is passionate about delivering primary care to underserved populations—specifically, low-income and homeless patients in urban centers. Ajay will be specializing in pediatrics, with a particular interest in child maltreatment.

M.D. or Bust

Numerous studies have documented that medical students lose empathy during clinical years, becoming jaded and pessimistic. This has been linked not only to diminished enjoyment of our work, but also to worse patient outcomes. My goal is to sustain the humanistic values that drive so many of us to medicine, so that, instead of being quelled by cynicism, our idealism can be refined by wisdom.