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On Productivity in Medical School

As a medical student, there is nothing more precious to us than time and brain space. More than once have I left a lecture thinking, “That was a complete waste of my time.” With the volume of information thrown at us, it is paramount to focus on the high yield. Every kind of resource, from Pathoma to First Aid, focuses on the high-yield information that will show up on Step 1. Sometimes, I don’t even think that far. If it’s not going to be on the test in three weeks, I couldn’t care less. “Proof-of-concept” means I don’t have to know it (right now, at least). Information presented to us needs to be justified, because our precious resources of time and brain availability are limited. When we study and when we learn, we anticipate that somewhere down the road, the information we’ve taken in will be useful and applicable.

Recently, The New Yorker released “The Pursuit of Beauty,” a profile piece on Yifang Zhang, a calculus professor who was awarded a MacArthur Award this past September for his work determining whether there is a boundary between which two consecutive prime numbers can be found.  Initially, the overwhelming reaction I had was, “Who cares?” Even if this boundary is found, at the end of the day, what does this prove, and why does it matter?

The piece spoke to me for several reasons. One, like Zhang, my dad is a Chinese immigrant who is also a college math professor. When I was first learning proofs in geometry, my ultimate complaint was, “Who cares?” to which my dad’s response would simply be to explain the proof again, followed by a, “Don’t you get it? The proof is very elegant and beautiful.” The sheer simplicity and the sense of a mathematical proof make the proof beautiful and worthy of learning. In a similar vein, in “The Pursuit of Beauty,” Zhang states that his award-winning research is “useless for industry” — it is pure, theoretical math “done with no practical purposes in mind. It is as close to art and philosophy as it is to engineering.”

The story of the Chinese immigrant math genius is one that is awfully familiar and stereotypical because math connotes utility, mechanical applicability and lack of creativity. But what people will miss about Zhang’s pursuit for this theoretical boundary is how incredible and creative it is — he is literally pursuing an intangible art form, math for math’s sake, proving above anything that mathematics, quite contrary to its reputation, requires a level of deep and imaginative understanding to tackle intangible problems. Mathematics as a domain transcends linguistic and cultural boundaries, and pure math research aims to understand what I believe is the closest thing to universal truth, untainted by personal bias.

But in our very capitalistic and for-profit Western world, Zhang’s research is the complete opposite of productive. It isn’t productive in terms of results, applicability, or even labor process; Zhang’s work procedure is to simply “walk and think,” which to any casual onlooker seems to be more idle than productive. The pursuit of knowledge in academia has its own standards of productivity, which Zhang also failed — he did not obtain an academic position after receiving his Ph.D. because he did not publish any papers during that time. Even prior to his MacArthur-winning research, Zhang had only published one other paper, in 2001. Though the MacArthur Award seems to reverse all those years of “unproductivity,” the fact that stories like Zhang’s are only deemed successful because they win awards shows how deeply inspiration and productivity are tied for us.

In a very long-winded way, the profile piece relates back to medicine (though not exclusively). Medicine requires applicability to health. Nothing is truly useful unless it is capable of helping others or us. But in medical school, the archetypal fountain of knowledge is not one you can drink from simply because you want to. You drink to quench thirst, particularly the thirst of someone else. In medicine, knowledge is power because power can be wielded. Knowledge that doesn’t contribute to correcting a problem becomes unproductive and unessential.

So if this is truly the case, then what is the point of Zhang’s research? What is the purpose of the pursuit of any other kind of beauty: art, music, literature? What is the point of asking questions when they can’t be answered — or worse, when the answer is “pointless” and won’t change anything?

This question isn’t one particular to medical school, or even applicable to everyone in medical school. I fully acknowledge that many students want nothing more than to keep learning more and more about pathologies or pathways that interest them. But even though I am interested and fascinated by what I do learn, the moments of marveling over such beauty are rare and few. Indeed, it doesn’t seem to be appropriate to marvel at the beauty of medicine or disease — the intricacies of the human body hardly are beautiful when there is so much potential for things to go wrong and impact the health and lives of others, and to marvel at disease in theory seems to be at the expense of those who suffer through its reality.

I don’t mean to present a problem or a solution (so I suppose you could see this article in and of itself as thoroughly unproductive). All I can offer is an observation: that Zhang’s pursuit of beauty, that drive to pursue something that seems pointless, is something we have a high potential of losing in medical school.

There are things we learn — then, now, in the future — that may be used tomorrow, next year or never. Our interpretation of what is productive, and what is not, should not determine the limits of what we deem worthy of knowing. The perceived uni-dimensionality of the medical school life should not be representative of either our own lives or the lives of patients we see. Though our time seems perpetually limited, to concentrate solely medicine without pursuing knowledge beyond the realm itself may not only impact our medical interactions but also our own self-care.

Be it wondering whether there is a boundary between which two consecutive prime numbers can be found, or thinking about why and how structural systems of power exist, or be it pursuing water-coloring techniques or pottery, the pursuit of knowledge for knowledge’s sake — in and outside of medicine — is something we should we should cling to. I don’t believe that the value of knowledge is in its applicability.

Rather, I think it lies in how it shapes our own understanding of the world, both in and outside of the medical realm, and that pursuing the “purposeless” may be in and of itself a method for us to make sense of the vast depth of what we don’t know.

Jennifer Hong Jennifer Hong (6 Posts)

2016 Writers-in-Training Program Director

Emory School of Medicine

Hi, I'm a third year medical student at Emory University. I graduated in May 2014 from Duke University with majors in Neuroscience and English. I like fiction, penguins, discussions about race relations and feminist theory, makeup tutorials, and bubble tea. I may not be able to give you lots of medical advice, but if you need a couple cat videos to brighten up your day, you've come to the right person.