Writer-in-Training
University of Illinois at Chicago College of Medicine
Currently an M2 at University of Illinois at Chicago College of Medicine. Interests include global health, health disparities, and emergency medicine. Also enjoys photography, classical music, travel, and medical history. Will work for dessert.
“This is a place where the dead are pleased to help the living.”
These words always greet me upon entering our anatomy lab. A similar saying in Latin is inscribed at the Palazzo del Bo at the University of Padua, home of the world’s oldest anatomical theater.
As medical students, we recognize that bias in medicine is doubly damaging: it burdens our peers and it harms our patients. In the opening narratives we see both of these at play: in Micaela’s self-doubt and frustration, and in the intern’s judgment of their older, Latina patient. Such clinician bias has been increasingly shown to contribute to widespread health inequities.
Shortly before returning to the United States for the holidays from Malawi, a truck full of police and military men pulled up next to my car as I was driving and demanded my driver’s license. They claimed I was “dangerously parked” while stopped in a long queue of traffic to let my friends hop out across from a bus station and would, therefore, be fined K10,000 (approximately $18).
Like poker, medicine has certain rules — patterns of clinical symptoms and lab findings each correlating with a specific spectrum of prognoses that vary in likelihood, the differential diagnosis. Physicians are like seasoned card players, trained to maintain composure and incorporate numerous variables into logical, calculated decisions at what seems like a “dealer’s table” of outcomes. Sometimes, we hedge our bets that the patient will self-resolve, so we elect not to treat; other times, we act conservatively with a battery of tests and pre-emptive therapy.
A fellow student writer recently wrote that she wondered if depression were “just part of life as a medical student.” One of her professors had given a lecture on depression asking students to “think of how many people we knew with the signs of depression listed on his lecture slide” — excluding medical students of course, “because you’ve all got some of these.” There is something so terribly and inherently wrong with that statement.
I have always toyed with the idea that I may have depression. Numerous times I have looked over the various depression diagnoses and their criteria. But then I settle on the idea that my thoughts and emotions and struggle are not severe enough. Everyone experiences sadness. Everyone experiences grief.
It should be no surprise that when I asked my fellow medical students their suggestions for ways to de-stress, one of the first answers I heard from all of them was: “Yoga.” I should admit that I have always been a bit skeptical of yoga — I enjoyed cardio-based workouts far more. However, after doing some research, I found a study by Bansal et al. which found that medical students in India who did yoga every day for just one month showed significant improvements in both their general and mental wellbeing.
Medical school is a notoriously challenging experience during which students undergo tremendous personal change and professional growth. Though the stressors that come along with this are varied and unique to each student’s context and experience, they may be categorized within a few common themes. Harvard psychiatrist Raymond Laurie has previously described the concept of “role strain” with respect to negotiating relationships with their families, friends, partners, peers, attending physicians and patients. Additionally, with regard to students’ concept of themselves, individuals who have high achievement may be challenged in new ways both intellectually and emotionally.
In class they ask me / What is love? / To prompt a philosophical discussion.
Throughout medical school and especially during our clinical rotations, students are often told to keep an open mind about choosing a specialty. This is sound advice, especially since many people change their minds once they are exposed to other fields. However, that does not mean that all specialties are perceived as equal — even in a primary-care focused medical school, third-year medical students often run into prejudice against FM. Worse, they may run into stereotypes about family med which could be enough to sway them away from the specialty they would really love.
With more applicants than ever, and a relatively static number of medical school and residency spots, there has been an increase in the use of metrics such as standardized test scores, GPAs and research publications to differentiate between applicants. Unfortunately, an emphasis on the unquantifiable attributes of physicians — the qualities that actually differentiate great clinicians from good ones — seems to have fallen by the wayside.
Doctored: The Disillusionment of an American Physician is Dr. Sandeep Jauhar’s second book. In keeping with good narrative nonfiction, Jauhar offers a mix of personal stories, thoughtful interludes and an obvious effort to back up claims with facts and statistics. He offers compelling anecdotes, which allow the reader to situate him or herself into the context of health care in New York City. These personal vignettes are especially helpful for highlighting concepts difficult to discuss; an ethical dilemma or complex criticism of the health care system becomes much easier to understand when tied to a tangible person or place.
Medical Student Editor, Writer-in-Training and Columnist Emeritus
Boonshoft School of Medicine at Wright State University
Brent Schnipke is a third year medical student at Wright State University Boonshoft School of Medicine in Dayton, OH. He is a 2014 graduate of Mount Vernon Nazarene University with a degree in Biology. His professional interests include writing, medical humanities, and higher education. When he's not studying, he can be found reading at a local coffee shop, training for his next race, or planning an adventure with his wife. Brent is also active on social media and can be reached on Twitter and Instagram @brentschnipke.
Prints, Pages, and Pagers
Prints, Pages, and Pagers aims to look closely at the lives of medical students and doctors, real or fiction, whose lives and experiences are told in novels, short stories, poetry, or any kind of writing. These book reviews are an opportunity for medical students to learn from the many fascinating stories produced by the field of medicine, and maybe to read something other than a textbook.
