People always say that you don't know what it's like to be a parent until you're older.
Well in the past couple of weeks I realized that if I don't talk to my mom for two days, I get really worried.
I usually genuinely have something to ask her about every couple of days, but even if I don't, I make up some reason to email or call her.
Wednesday, February 4, 2009
Sunday, November 9, 2008
(Pre)Medicine. Part I.
I've started to read Pauline Chen's columns in the NYTimes. There are two columns that I want to bring up together, Stories in the Service of Making a Better Doctor and The Misery of the Med Student. Both of them ask basically the same questions. What makes a good doctor? How do we train medical students to be good doctors? The consensus is that well-rounded individuals make good doctors. We want doctors who can related to their patients, who can talk to them well, who care about them as a person and not as a disease, etc.
But I'm not sure how to judge medical schools' efforts at making well-rounded doctors. Are they really successful? Or are they just making some insincere effort at making it seem like medical schools care about more than the science of human body function?
Chen writes positively about the addition of narrative medicine in medical school and residency curricula. These are classes in which students read fiction and non-fiction works to gain better insight into a patient's Her column has anecdotal evidence for it and she says that studies have shown that it is successful. But it is also true that most doctors don't love literature, the arts, or the social sciences as much as people with advanced degrees in those fields. Otherwise they wouldn't be doctors. I think narrative medicine classes valuable if they can be taught so that even med students who don't like literature can discuss it in a meaningful way that helps them as doctors. Otherwise, as one comment said, it's just a glorified book club.
Med schools now require a certain number of humanities credits so they can accept more well-rounded applicants. But how do you know who took humanities classes as a undergrad because they really liked them or because they needed it to apply to med school?
Or do you even think this distinction matters? It is really hard to study anything other than medicine when you're in medical school because there's so much medicine to learn. Everything else has to get put on the backburner. One comment talks about the difficulty in fitting in other interests in med school:
I am a medical student with a literature background from undergrad. I wholeheartedly agree with the purpose of these programs, but the reality is this: the things one must learn in the med school — anatomy, physiology, pathology, immunology, microbiology, etc. — are simply too time-consuming to allow more than a cursory study of literature in some kind of throwaway class. Those students who are interested in it will explore further, but the vast majority won’t find it useless and will just resent it.
Dr. Chen had a similar experience in medical school. There was just so much to learn that these other efforts didn't diminish the amount of sheer information they had to learn. She writes:
Some of my professors tried to 'humanize' the process. They invited us to dinner in their homes, supported our extracurricular efforts to set up health screening clinics in low-income neighborhoods, and tried to make our basic science courses more relevant to working with patients. But sitting where I am now, as someone who teaches medical students and who loves helping others as a doctor, I can understand the challenge they faced. Given the fire hose of information medical students must learn in just four years, how does one ever gently take a sip?
Is waiting to go to medical school after earning some "life experience" the remedy to the lack of empathy, humanities, and high burnout? Several of the comments were from people who had a career before entered medical school and they seemed happy with their decision. I think this is generally a good idea, but it doesn't address whether or not medical education as it is should be changed. It simply gives med students time to steel themselves before plunging in.
I don't know the answer to these questions. In an ideal world, we would all be Renaissance men and women. Our journals will contain anatomic diagrams alongside sketches of landscapes, the Madonna, and fantastic flying machines. We'll spend our days in the chemistry lab and write music by night. We'll all be well-read, empathetic, intuitive, doctors.
But in reality, our time is finite. We have to make choices, prioritize, and prepare for standardized exams. And I have physiology lectures to watch. Oh, and I could be totally wrong about everything because I haven't actually gone to med school.
That's all for tonight. The next post about this matter is going to get a lot more personal. I reflect on how I have taken to trying to be a well-rounded (future) physician.
But I'm not sure how to judge medical schools' efforts at making well-rounded doctors. Are they really successful? Or are they just making some insincere effort at making it seem like medical schools care about more than the science of human body function?
Chen writes positively about the addition of narrative medicine in medical school and residency curricula. These are classes in which students read fiction and non-fiction works to gain better insight into a patient's Her column has anecdotal evidence for it and she says that studies have shown that it is successful. But it is also true that most doctors don't love literature, the arts, or the social sciences as much as people with advanced degrees in those fields. Otherwise they wouldn't be doctors. I think narrative medicine classes valuable if they can be taught so that even med students who don't like literature can discuss it in a meaningful way that helps them as doctors. Otherwise, as one comment said, it's just a glorified book club.
Med schools now require a certain number of humanities credits so they can accept more well-rounded applicants. But how do you know who took humanities classes as a undergrad because they really liked them or because they needed it to apply to med school?
Or do you even think this distinction matters? It is really hard to study anything other than medicine when you're in medical school because there's so much medicine to learn. Everything else has to get put on the backburner. One comment talks about the difficulty in fitting in other interests in med school:
I am a medical student with a literature background from undergrad. I wholeheartedly agree with the purpose of these programs, but the reality is this: the things one must learn in the med school — anatomy, physiology, pathology, immunology, microbiology, etc. — are simply too time-consuming to allow more than a cursory study of literature in some kind of throwaway class. Those students who are interested in it will explore further, but the vast majority won’t find it useless and will just resent it.
Dr. Chen had a similar experience in medical school. There was just so much to learn that these other efforts didn't diminish the amount of sheer information they had to learn. She writes:
Some of my professors tried to 'humanize' the process. They invited us to dinner in their homes, supported our extracurricular efforts to set up health screening clinics in low-income neighborhoods, and tried to make our basic science courses more relevant to working with patients. But sitting where I am now, as someone who teaches medical students and who loves helping others as a doctor, I can understand the challenge they faced. Given the fire hose of information medical students must learn in just four years, how does one ever gently take a sip?
Is waiting to go to medical school after earning some "life experience" the remedy to the lack of empathy, humanities, and high burnout? Several of the comments were from people who had a career before entered medical school and they seemed happy with their decision. I think this is generally a good idea, but it doesn't address whether or not medical education as it is should be changed. It simply gives med students time to steel themselves before plunging in.
I don't know the answer to these questions. In an ideal world, we would all be Renaissance men and women. Our journals will contain anatomic diagrams alongside sketches of landscapes, the Madonna, and fantastic flying machines. We'll spend our days in the chemistry lab and write music by night. We'll all be well-read, empathetic, intuitive, doctors.
But in reality, our time is finite. We have to make choices, prioritize, and prepare for standardized exams. And I have physiology lectures to watch. Oh, and I could be totally wrong about everything because I haven't actually gone to med school.
That's all for tonight. The next post about this matter is going to get a lot more personal. I reflect on how I have taken to trying to be a well-rounded (future) physician.
Wednesday, November 5, 2008
Monday, October 27, 2008
Lists, Nobel Prize, Science Funding, Depression
Before: Regular jellyfish.Prasher's relationship to this year's Nobel Prize in chemistry is that he was the first scientist to isolate the fluorescent protein gene from jellyfish. The Nobel was awarded to Osamu Shimomura, Martin Chalfie, and Roger Y. Tsien for the technique of inserting this gene into other organisms to use as a marker. Prasher gave the gene to Chalfie when they were both working at Woods Hole and Prasher then left Woods Hole.
But reading the blog post and Chang's original article, it struck me that this attribution ignores larger structural problems with science research: lack of funding. Prasher's story through this lens would read something like this:
- Applied for 5-year NIH grant to study fluorescent protein gene. Application denied.
- Applied for 2-year American Cancer Society grant to study the same. Grant received. But it was less money than the NIH grant.
- Quit job at Woods Hole Oceanographic Institution.
- Gets job at USDA. Quits job. Beginning of depression.
- Gets job as NASA subcontractor. Position eliminated due to lack of funding.
- Depression returns.
- Gets job driving van for Toyota dealer.
But depression seems to me only a part of the problem. I don't think this is sufficient evidence to make this an example of the American individualist psyche that blames failure (and glory) on individuals, but I'm tempted to make the generalization. I'm also tempted to turn this into a policy pitch for increased federal funding for science research. The bad news is that NIH funding has remained flat since about 2003 and flat funding is in essence decreased funding because of inflation.
--
I try to keep a short list of things I want to write about soon but I usually never get to write about most of these things because my (un)productivity is about one entry a week. I hope that now that I write these out, I'll feel like I have an obligation to write them.
This week I want to write about:
- Nicholas Kristof's NYT column about the global effect of a potential Obama presidency.
- Pauline Chen's post on the Well blog about literary medicine and its role in medical education.
- The Man Who Set Stage of a Nobel Now Lives a Life Outside Science
--
After:
Mouse neurons. source
An image drawn with fluorescent bacteria colonies on an agar plate. source
Thursday, October 16, 2008
I'm not over the hill
Rebecca Walker said during the student colloquium last Friday that she was "maxed out on feminism" when explaining her unusual, and some would say unfeminist views. Her lecture was not a rallying cry to stand up, speak out. It was the opposite. She had no grand schemes to spread her idea of openness but seemed to describe it as something that happens between individuals or entirely from within the individual.
So after that lecture, I got the feeling that she had moved beyond her activist past. She was born to be an activist -- a movement child -- a symbol of the Civil Rights movement, a interracial marriage. And she was an activist at Yale and the founder of an activist foundation. But she is an activist no longer.
Her lecture seemed a bit like an older person tut-tut-ing at young foolish kids. Her point may be right for a 40 year old. But I'm not over the hill. I haven't lived those years.
In 20 years I may very well be married, have children, drive them around in a minivan, and (insert gendered role you love to hate). I might actually enjoy it. But I'm still working my way through those twenty years.
I'm young. I'm idealistic. I think I can put off having children for as long as I want. I will never compromise my feminist views. I strive for social justice. And I am not over the hill of my feminist ideals.
This also might well be true, that in 20 years I may not be an activist. But I will always care.
So after that lecture, I got the feeling that she had moved beyond her activist past. She was born to be an activist -- a movement child -- a symbol of the Civil Rights movement, a interracial marriage. And she was an activist at Yale and the founder of an activist foundation. But she is an activist no longer.
Her lecture seemed a bit like an older person tut-tut-ing at young foolish kids. Her point may be right for a 40 year old. But I'm not over the hill. I haven't lived those years.
In 20 years I may very well be married, have children, drive them around in a minivan, and (insert gendered role you love to hate). I might actually enjoy it. But I'm still working my way through those twenty years.
I'm young. I'm idealistic. I think I can put off having children for as long as I want. I will never compromise my feminist views. I strive for social justice. And I am not over the hill of my feminist ideals.
This also might well be true, that in 20 years I may not be an activist. But I will always care.
Saturday, October 11, 2008
Rebecca Walker, what I agree and disagree with.
Over the past couple of days I had several chances to hear Rebecca Walker speak and speak to her. I was grateful for these three opportunities -- her talk on Thursday night, a student discussion, and a luncheon on Friday -- because they gave me a more complete understanding of her ideas about not just the election but also feminism and activism.
To be honest, after the first talk, I wasn't convinced by everything she said. I agreed with some of her critiques but felt there were convincing alternatives or ways to achieve the alternatives she proposed.
AGREE: I agreed with her critique of the election, that identity politics continues to play an undeserved role in influencing voters. She used this presidential election to illustrate that our lens of seeing the world in terms of race, class, and gender is used against us, by ourselves and by others. We remain locked in identity politics. Some people will not vote for Barack Obama because he's black. Some people will not vote for Sarah Palin because she is a woman. Some people will vote for her because she is a woman. Voters are being manipulated by the strategists who understand their weakness. Thus Palin was picked to win the votes of white women. I agree with all this.
CONFUSED: But I was lost on her alternative: to practice "openness", to reject race, class, gender, and history. She encouraged us to be human, to let go of the histories of the bitterness of the oppression suffered by ancestors belonging to our race, class, and gender. I wasn't sure how to achieve openness or how to spread this idea of openness to others once I achieved it myself. Of course Walker would just call this "disbelief" and tell me to "stamp it out", but I wasn't sure how to stamp it out. I needed some steps to take, some plan.
CONFUSION RESOLVED: On Friday, Walker explained that she believed we still should participate in interpersonal dialogue about openness, resolved my confusion about what I thought was the private nature of "openness". The better way to reach other to people is to share our ideas through education and dialogue.
DISAGREE: In addition, it seemed to me that she talked about openness in conjunction with a critique of America's political system. Politics is a not a way to achieve progress because politics is civic warfare. Engaging in warfare for peace is impossible, like planting corn and expecting to harvest wheat. I do agree that American politics has its flaws. But I also believe that a liberal democracy is far from the worst system of government one could have, not only because I study this government and politics so I naturally want to feel that my studies aren't for naught, but also because having lived in not-democratic places, I rather like the rights we have in America.
I don't disagree with all of Walker's criticism, I just don't think we need to be unduly alarmist about it. She said that the presidential candidates should calm the public about the financial crisis. I think we also need to be calm over the state of this country.
Yes, these rights are being eroded, which is why Walker no longer believes America is as safe and free as it used to be. Indeed, the US has dropped to a "moderate" country in the Failed States Index from a "sustainable" one, but we're joined by countries such as the UK, France, Germany, South Korea. There are only 15 sustainable countries, mostly Scandinavian ones, Canada, Australia, and New Zealand. (I think Iceland won't be "sustainable" on next year's list.) But try giving this same criticism of the government in say, Burma or China. I guarantee you a much better chance of being hauled away by the government and never seen again.
I'm running the risk of sounding like a deluded lunatic "patriot" (Republican) by lauding some aspects of America but I feel this attitude that America is the Titanic going down seems arrogant in the face of people who do live in failed or nearly failing states. It's like saying, I understand extreme poverty in the global south because I'm below the poverty line, I live in the housing projects, and I drive a crappy old car. You don't. America still has a lot of power and influence in the world, not the most power and influence, but a lot.
To be honest, after the first talk, I wasn't convinced by everything she said. I agreed with some of her critiques but felt there were convincing alternatives or ways to achieve the alternatives she proposed.
AGREE: I agreed with her critique of the election, that identity politics continues to play an undeserved role in influencing voters. She used this presidential election to illustrate that our lens of seeing the world in terms of race, class, and gender is used against us, by ourselves and by others. We remain locked in identity politics. Some people will not vote for Barack Obama because he's black. Some people will not vote for Sarah Palin because she is a woman. Some people will vote for her because she is a woman. Voters are being manipulated by the strategists who understand their weakness. Thus Palin was picked to win the votes of white women. I agree with all this.
CONFUSED: But I was lost on her alternative: to practice "openness", to reject race, class, gender, and history. She encouraged us to be human, to let go of the histories of the bitterness of the oppression suffered by ancestors belonging to our race, class, and gender. I wasn't sure how to achieve openness or how to spread this idea of openness to others once I achieved it myself. Of course Walker would just call this "disbelief" and tell me to "stamp it out", but I wasn't sure how to stamp it out. I needed some steps to take, some plan.
CONFUSION RESOLVED: On Friday, Walker explained that she believed we still should participate in interpersonal dialogue about openness, resolved my confusion about what I thought was the private nature of "openness". The better way to reach other to people is to share our ideas through education and dialogue.
DISAGREE: In addition, it seemed to me that she talked about openness in conjunction with a critique of America's political system. Politics is a not a way to achieve progress because politics is civic warfare. Engaging in warfare for peace is impossible, like planting corn and expecting to harvest wheat. I do agree that American politics has its flaws. But I also believe that a liberal democracy is far from the worst system of government one could have, not only because I study this government and politics so I naturally want to feel that my studies aren't for naught, but also because having lived in not-democratic places, I rather like the rights we have in America.
I don't disagree with all of Walker's criticism, I just don't think we need to be unduly alarmist about it. She said that the presidential candidates should calm the public about the financial crisis. I think we also need to be calm over the state of this country.
Yes, these rights are being eroded, which is why Walker no longer believes America is as safe and free as it used to be. Indeed, the US has dropped to a "moderate" country in the Failed States Index from a "sustainable" one, but we're joined by countries such as the UK, France, Germany, South Korea. There are only 15 sustainable countries, mostly Scandinavian ones, Canada, Australia, and New Zealand. (I think Iceland won't be "sustainable" on next year's list.) But try giving this same criticism of the government in say, Burma or China. I guarantee you a much better chance of being hauled away by the government and never seen again.
I'm running the risk of sounding like a deluded lunatic "patriot" (Republican) by lauding some aspects of America but I feel this attitude that America is the Titanic going down seems arrogant in the face of people who do live in failed or nearly failing states. It's like saying, I understand extreme poverty in the global south because I'm below the poverty line, I live in the housing projects, and I drive a crappy old car. You don't. America still has a lot of power and influence in the world, not the most power and influence, but a lot.
Monday, October 6, 2008
BlogPoll
I apologize for not posting an Entry of Substance.
It's already past 2 and I'm not done with my homework for tomorrow so I can't write about Joe Biden or the crazies I talked to while phonebanking, or how important melamine-laced White Rabbit milk candies are to my childhood.
Because I feel like it takes so long to write a good blog entry, I want do ask how much my fellow bloggers spend composing a blog entries:
Less than 30 minutes?
30 minutes - 1 hour?
more than 1 hour?
It's already past 2 and I'm not done with my homework for tomorrow so I can't write about Joe Biden or the crazies I talked to while phonebanking, or how important melamine-laced White Rabbit milk candies are to my childhood.
Because I feel like it takes so long to write a good blog entry, I want do ask how much my fellow bloggers spend composing a blog entries:
Less than 30 minutes?
30 minutes - 1 hour?
more than 1 hour?
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