Contributing Writer Emeritus
University of Pennsylvania
Matt Trifan is a current resident of emergency medicine at Thomas Jefferson University Hospital in Philadelphia. He was a former medical student at the University of Pennsylvania. In his free time, he reads, writes, travels, and never misses a chance for brunch. He owes his life philosophy to Albert Camus and Adventure Time, equally.
Cadaver. The word itself seems devoid of life. And, so too does the white plastic bag lying unceremoniously before me. It’s the first day of anatomy, and I unzip the tarp and stare down at a wet, grey lump of clay. There it is. There is what, exactly? What was I expecting? Some warm human soul, freshly sprung from the loins of life? No. That’s not this. The essence of life is gone — absolutely, irrevocably, unquestionably, gone.
On a recent visit to my parents’ home in Upstate New York, just as the snow had finished melting and our tulips were beginning to sprout, my dad and I went out for a walk. As we made our way down our driveway to the railroad-tracks-turned-walking-trail that runs through the woods near our house, we bumped into one of my dad’s patients. With a hearty grin, the middle-aged man proudly told my dad how his morning blood sugars were improving. My dad beamed, and gave him a big high five. Later, as we walked along the trail, he told me how thrilled he was to see this patient getting the exercise that would help treat his diabetes and high blood pressure.
On November 27, 2015, a horrific shooting at a Planned Parenthood clinic in Colorado Springs left three people dead. This tragedy is a stark reminder of the grave consequences that may accompany inflammatory political rhetoric and poor legislation. After his arrest, Gunman Robert Dear declared “no more baby parts” to investigators. Dear’s terrifying actions have been linked to the national ongoing attack on reproductive rights as well as inadequate gun control laws. As a medical student, I fear that we will have many more Robert Dear’s in this country unless we make sure that political interests do not continue to impede on patient-provider relationships.
With each new year, we are pressured to construct a “new self” guided by resolutions. We design a “new year, new me,” fueling the marketing of self-improvement products around December and January. The explosion of fitness equipment in stores during this time attests to the pervasiveness of an annual self-improvement routine in our culture. Importantly, this phenomenon of constructing resolutions to improve body image represents some of the elements of our potentially misaligned “beauty culture,” where popular culture could be involved in driving individuals to extreme measures to achieve weight loss.
At Albany Medical College, upon our orientation to gross anatomy, we are asked to draw our feelings on blank index cards prior to entering the cadaver laboratory. As we progress through the year, our sentiments regarding anatomy may remain the same, or may change, and these drawings allow us to look back at this milestone we crossed as budding medical students.
If you’ve had the chance to look away from your class notes and at the news over the past few weeks, you’ve undoubtedly heard about the Zika virus. You may have even had family members ask about the virus and if you, as a future health care provider, are concerned about the recent outbreaks. Consider this your SparkNotes for the Zika virus.
There’s a lot of talk about mindfulness these days — its importance, its effectiveness, the benefits of meditation and even the structural changes in the brain that result from it. (Do you want a less reactive amygdala and increased neuronal density in the hippocampus? Meditate!) It’s one thing to read about the benefits of doing something, but as many know, it’s another thing to actually apply it and understand it. So how can medical students use stress reduction strategies “in the context of the high-stakes, high-stress and time-limited environment of medical school.”
The cultural competency framework that has become the mainstay of medical education is often times employed in incredibly reductionist ways. It seems to propose that exposing physicians to homogenized, static and packaged ideas of culture will aid them in estimating patient behavior, preference or response in the clinic, thereby diminishing health care inequality. Training like this paves the way for even well-intentioned student-doctors to be explicitly ignorant under the auspices of clinical benefit. It spoils the good intent to create better patient outcomes by legitimizing the validity of stereotypes and the development of physician bias.
My cadaver has pink fingernails. I saw them on the first day of class, after we pulled back the white plastic sheet with the number “22” scrawled on it with permanent marker, and cut away the damp cloth that had been covering her cold skin. Her arms were folded across her chest, and on her fingers was a sparkly, ballet-pink polish, not chipped or peeling despite having been there for the 13 months since she’d died. I don’t know why it’s there. I don’t know if she painted them thinking she was going to survive to enjoy it, or if she was someone who always wanted to look her best, even in death.
Vaccines have become a cornerstone of modern public health and have greatly reduced the burden of infectious disease across the globe. They are also the center of major debate in America. Conjuring furious arguments with divided opinion, where vaccine safety gets more attention than vaccine effectiveness. In the era of Facebook, Twitter and every imaginable social media outlet, opinions and facts flood computer screens, distorting truth and instilling doubt. To support an argument, it is not difficult to find an article or group that agrees with you. Medical professionals constantly find themselves concerned and restrained by an apathetic response to reason and science.
The images of water from Flint, Michigan water came into my mind and I lingered at the sink a few minutes too long. I became heartbroken for the children whose bodies may have been irreversibly and negatively impacted. I became enraged at a system that would prioritize saving pennies over properly protecting its citizens from preventable harm. Governor Rick Snyder, his appointed “emergency financial managers” and other leaders allowed this crisis to develop over years as they mistreated Black citizens through racist policies, violated the public trust, and endangered lives. A significantly poor and majority black city was told it was okay to use polluted water to prepare their children’s dinners. Families washed their dishes in what could be mistaken for urine. They scrubbed their pearly whites with toxins to avoid cavities.
Although there is really never a right time to die or even witness death, it is important to acknowledge that death is a reality, and one to which all health care practitioners will be subjected at some point in time. For that reason, I raise the question: is there an appropriate time to lose a patient? From my perspective the answer is yes, and for good reason.
Contributing Writer Emeritus
American University of Antigua College of Medicine
George is an MD/MHA candidate at AUACOM currently completing fourth year electives at various hospitals in Brooklyn, NY. He has participated in research studies at Drexel University College of Medicine as well as Wyckoff Heights Medical Center in areas of both adult and pediatric medicine. He originally obtained a Bachelors of Arts in Religion and later decided to pursue a career in medicine upon working for a hospice agency shortly after graduation. Now currently in New York, George feels fortunate enough to experience the spectrum of patient cultures and ethnicities which he feels has provided him with the most diverse foundation owing to opportunities he never thought were possible.
