Contributing Writer Emeritus
University of California, Irvine School of Medicine
Born and raised in Cincinnati, OH. Studied Bioengineering at UCSD and now finishing medical school at UC Irvine. Applied for residency in Otolaryngology-Head and Neck Surgery.
Medical students are subjected to a barrage of advertising that inevitably leads to a physician-industry connection that can be harmful to our health care system. Medical students’ exposure to pharmaceutical marketing begins early, growing in frequency throughout their training.
Almost every morning, one of our physiology lecturers asks a question. Usually, it’s a question to which most of my 200 classmates would know the answer. Every day, the professor asks their question, often losing their rhythm in the twenty seconds it takes to shake an answer out of us. The silence lingers until finally they get a response, often whispered like an embarrassing secret by someone sitting near the front. The timid self-consciousness on display in this small ritual is a major part of the socialization that happens in medical school.
you may have seen / serpents before / on a white coat lapel / or a hospital door
A 45-year-old with no past medical history presented to the emergency department with altered mental status. He was found face down in his driveway with no memory of an inciting event, or of his ride to the hospital. In the emergency department, the patient revealed that for the past two months he has experienced headaches, dizziness and left-sided weakness. On a hospital admission two months prior the patient reported similar symptoms but left against medical advice before any meaningful diagnostic testing could be conducted.
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.
I am honored by this opportunity to offer you some advice on how to prepare for your professional career in what has become a treacherous health care system. I will not elaborate on why I think the health care system is “treacherous.” I will assume — and even hope — that you have at least some inkling that things are not rosy in the world of medicine.
Approximately one in three women under the age of 45 have had an abortion. Approximately one in three women under the age of 45 have a tattoo. Think about your community. How many tattoo parlors can you think of? How many can you easily access? How many abortion clinics can you think of? How many can you easily access?
As physicians-in-training, it is tempting to accept that we have no place to stand up to our colleagues or superiors. That we should just hold our tongues, keep our mouths shut, dodging confrontation like the plague. This is false. From the day you received that acceptance letter in the mail, you committed your life to protecting others. What was it uncle Ben said to Peter Parker? “With great power comes great responsibility.” At times, this might mean getting uncomfortable to do the right thing.
Physicians in-training are granted a privilege unparalleled in society. Human beings generously donate their bodies for our learning. They lay naked, exposed on cold stainless steel tables while strangers, who will never know their name, study them intimately. Like a grandfather telling stories to the next generation, their organs reveal to us a story of life.
“Puedo tomar su presión? Puedo tomar su pulso?” I butchered in Spanish, over and over again. Sometimes I received a smile and laugh in return, sometimes a look of confusion, sometimes a placid unfolding of the patient’s arm. I pumped the cuff up repeatedly and listened intently over the screams of playing children and the chatting of a long line of patients.
The traditional structure of medical education begins with teaching normal anatomy and physiology followed by the various pathologies and treatments. Once students reach the clinical years, we are taught to think in the form of a SOAP note. First, perform a history and physical; then, order the necessary diagnostic tests to obtain your subjective and objective information. Next, form your assessment and plan — what is the problem, and how do you fix it?
The circumstances under which Jane and I met were less than ideal. That day, I had already seen a family of maggots making a happy living in someone’s foot and been chastised by my attending for failing to recognize the imprecision of my visual acuity in assessing a patient’s ascites — how else could I do so without a measuring tape in my pocket and daily charts of his abdominal circumference?
Contributing Writer Emeritus
University of Florida College of Medicine
Sean is a member of the University of Florida College of Medicine Class of 2016 and graduated from New York University with a major in philosophy and a minor in chemistry. When not contemplating medical ethics, culture in medicine, and sustainable approaches in global health, he can be found on the nearest hammock jamming to the tunes of the Caribbean and West Indies.
