International medical service trips

Everyone has this ideal about doctors. Or rather, those people who do not understand anything at all about the medical profession have this ideal about doctors. Doctors are supposed to be caring, passionate people who lovingly tend to the sick and wake up at 1am to do surgeries and see ill patients. The more I see real doctors, the less I actually believe that ideal is true. Or anywhere near the truth.

I struggle a lot over what doctors should do, how they should be compensated, what their moral obligations are. I'm not sure how many other medical students ponder over this, but I think I'll be posting a lot about this topic in the future. It's no secret that the most competitive fields are those that are, well, more useless than the others. Why is it that everybody wants to do dermatology rather than primary care? Why do people want to do radiology rather than family medicine?

Why do people want to practice medicine abroad when there is such a great need here at home?

It seems like everybody I've talked to wants to go practice medicine abroad. Whether it's a 2-week winter trip to Africa or a 4-week summer trip to South America, everybody here wants to go to a trip to some far-away "poor" country and "do some good." I'm exceedingly morally torn about these service trips. Students go to these places for a limited time and (in my opinion) do limited good. They mostly do things like, "educational classes" and "check-ups" for the local population with little to no sustained development in any area. And then they come back home and study like crazy so they can get into competitive specialties like orthopedic surgery so they can presumably go help somebody with a broken foot (and make half a mil doing it).

I've asked people why they want to practice medicine abroad or why they want to do these trips and they look at me all funny and ask, "why not? Don't you want to?" as if doing one of these trips is the most natural thing a medical student can do. It seems to me like there are about a million things a medical student could do here in the United States that could benefit many, many more people.

I guess what really bothers me is that... students go on these trips to stroke their moral ego. That is to say, they go and people say, "oh look, what a kind person you are! You went to AFRICA and helped out all those poor people!" And then these same students turn around and spend their career doing something that simply makes them a lot of money. I think the truly morally commendable thing to do as a physician would be to be a primary care physician. This country is in dire need of them and yet, nobody wants to do it. Why is that?

I feel like people should strive to be consistent in their ideals and their actions. If you know and you say that money, status, and fortune are your priorities, I have no problem with you gunning to be an anesthesiologist. But if you say you want to "help people" and do these peripheral things that help get you into competitive programs just so that 10 years later, you can be a 500k/year radiation oncologist, I'm going to have a problem with it. I don't believe there's anything wrong with wanting to make money. Or wanting fame and future. But hiding these true motivations with feigned moral righteousness is just wrong.

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What I'm studying now: nucleotide excision repair

Reasons Why I Hate Anatomy

I wanted to write a post about this for at least a week now because the reasons why I hate anatomy aren't really for the obvious reasons. The amount of material isn't really terribly bad (yet) and honestly, the smell is not uber-unbearable. This is because we no longer use a purely formaldehyde-based preservative and use instead, an ethyl alcohol one. Also, my group's body (we named him Henry, after Lord Henry) has very little fat and is therefore not entirely gross to handle.

Anyway, here is my list:

1. I hate when they tell us things that are related to what we're studying but don't actually tell us what those related things do. Or where they are. Or what they're for. Except in relation to the thing we're studying. This happens quite a lot. Sometimes, they'll even say, "oh, you'll learn about this structure a little later, so don't worry about it." Except we're responsible for that structure NOW --not later!

2. Related to #1, I hate it when they tell us we're not responsible for something.... except we are. This is an impossible standard because we're not required to learn EVERY artery, vein, and muscle in the body - it's just too much and not very relevant to becoming a physician. So they tell us the important ones and sometimes say we don't have to know certain things. Except we do have to know them. Except when we don't. See what I'm getting at?

3. I hate it when they keep referring to an idea and say, "Oh but you'll get this lecture in a couple of weeks from Dr. X so don't worry about it now." I hate it because, invariably, they will talk about this idea again. And again. And again. And I still have not had that lecture telling me what exactly it is. Can't I just have that other lecture first? PLEASE?

4. I hate it how there are many ways to say the same thing in anatomy... BUT THEY NEVER TELL US THAT THEY'RE REFERRING TO THE SAME THING. I was going around for the longest time worrying about the difference between the "accessory nerve" and "cranial nerve #XI" except... they're the same thing. Somehow, I'm just supposed to know.. or figure it out that they're referring to the same thing. WTF. Such a waste of time on my part to figure it out when they could just tell me.

So my theme here is, I believe anatomy is exceedingly poorly structured. Let me reiterate, exceedingly poorly structured. I guess there is no helping it since everything is interconnected in the human body and you must always be faced with more than the scope of what you're studying in the immediate term. I suppose there is no such thing as an "isolated" body part. But then, maybe that's just why I Hate Anatomy. Because everything is always supremely confusing.

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What's I'm studying now: serratus anterior

In your previous life...

Surgeons are interesting people. I hate the word "interesting" because it is so very vague and nondescriptive but what can I say, I'm a hypocrit and like using bad words. Anyway, I say this because everything that the administrators and other doctors tell me about medicine and medical school and how to be a good doctor is nearly always the very opposite of what surgeons say. Weird, isn't it?

One phrase I've heard over and over again in my anatomy lectures (taught by ex-surgeons) is this phrase, "In your previous life..." As if to say, once you've entered the medical profession, whatever happened so far in your life isn't really your life anymore. It's like this running theme in class.

It's odd because, well, every single medical school administrator, dean, vice-dean, student, doctor, etc etc, anywhere in the United States (at least 99% of them) will tell you that you should continue doing what you love to do in medical school and that becoming a physician doesn't mean you need to give up whatever you once enjoyed. Clearly, this is not the case for surgeons...

On the other hand, I guess it's a useful phrase and an accurate comparison because a lot of the lay medically-related terminology aren't accurate or don't apply anymore. For example, today, we learned that the "arm" as normal people will call it, is actually the "upper limb." The arm in anatomy is actually only the upper part of the arm. Another example: the terms, "ruptured disc" and "torn disc," are actually technically, "herniated discs."

I like to think that going to medical school is simply a step in my career path. Certainly, it's like opening the doors to a wonderous museum in which you MUST MEMORIZE EVERYTHING IN THE MUSEUM and that revolutionizes the way you think about the human body, health, and healthcare, but still... just a step. Like getting a promotion. Or getting a masters. Or something.

I haven't entired ruled out surgery (particularly because I have yet to experience it), but it doesn't look promising for me...

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What I'm studying: coracoid process

The All Boy's Club

Generally known as, "surgery," the All Boy's Club of medicine has always been particularly rough for females. I kinda sorta knew this going into school, but as a feminist and a medical student, I can now see how ingrained this model still is.

I would say that medicine, in general, is still an All Boy's Club. I guess it's not that surprising considering that in advanced science programs around our nation, men take up the vast majority of academic positions. The same is true for medicine. Now, I know it's been said that medical schools are accepting more women, etc etc, but this does not mean that it's not an All Boy's Club anymore.

Let me give some unique examples here at Tulane.

First, our anatomy class is taught entirely by ex-surgeons. They are all elderly white males, with one exception. In lab, my lab instructor (one of these elderly white male ex-surgeons) has twice told me to get a man to do a task I was trying to accomplish. The very first day of anatomy lab, while I was attempting to open our tank (the tanks hold our cadavers and the body rests at the bottom of the tank. In order to raise the body up, you must push down hard on these lever-like things), he told me to get a strong man to do it. Another time, I was trying to get the lamp set up and the outlet was up high, hanging from the ceiling, and my instructor told me to get a tall man to do it. These are both tasks that any normal, grown woman can and should be able to do. What, does he think the labs were designed specificially for men?

My friend told me a story from her year in anatomy and said that there was this one girl who performed really well on a test and the professor (one of these elderly white males) said, "And (so-and-so) did really well. She's really pretty too. I wonder how that happened." As if women can't be both beautiful and smart.

Another friend of mine told me this story from a surgical rotation his friend was on. His attending said, "There are two types of women who are surgeons: those who shouldn't be surgeons, and those who shouldn't be women."

What is most upsetting to me is not just the explicit undercurrent of sexism, but that many people in my class don't realize it's there. I was observing to my friend today that nearly all of our anatomy professors and guest lecturers have been male and she said that she had not yet noticed. And then she asked me why it mattered. I stared at her for about 10 seconds before I could respond properly.

I'm not sure if I should actually go into all the reasons why I think it matters that we have a sexually and ethnically diverse population of doctors and professors right now. I feel as if there should be an intuitive answer? Could probably save it for another blog. I just wanted to comment here on what I've observed so far at medical school and to confirm that yes, from my perspective, it is still an All Boy's Club.

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What I'm studying: Inferior and Superior coastal facets

Advice

So I've been gathering all this advice from various people from the time... well, I guess from the time I was a little girl, dreaming about becoming a doctor. But the most relevant advice for school has come recently from people who have gone through medical school, or have at least finished their first two years. And believe me, ALL of them are EXCEEDINGLY willing to dispense with advice. Sometimes I wonder just how useful they are. Or perhaps they just simply bear repeating over and over and over again?

A third year friend of mine at Tulane told me to do all the things he didn't do. Like, do well in class. I suppose he meant, do as best as you can in class. Don't just say you'll study hard and do well on the Boards, because, well, that's probably a plan for failure. But then, clearly if you are barely passing your classes, you can't possibly think you will do well on the National Board exams, right?

Loads of people say, don't procrastinate. But then, when have people encouraged procrastination? And of course everybody says to have a "balanced" life, to keep doing the things you enjoy doing for the sake of your happiness, blah blah blah. We even had a speaker come in and talk to us about "wellness."

I've wondered every day, what is the secret to success in medical school? How do you become a dermatologist? A radiologist? Or an anesthesiologist? These are the most competitive specialties and unless you have an uber fantastic record, you can basically forget about your chances. And then there are the slew of other specialties that are competitive as well: radiation oncology, many types of surgery, etc. How do I match into one of those programs?

AND THEN there's the question of, shouldn't you simply practice what you enjoy??? Or what about the question of, shouldn't a doctor, morally speaking, practice what is best for the community??? But those are questions for another post. Or two. Or a million.

Do you, my dear friends, have any advice for me? Perhaps there is no "secret" to success? Perhaps I simply do not possess the IQ high enough for such a feat?

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A new section! I'm going to put something random here that I'm currently studying in one of my classes. Just... because it might be interesting. Or COMPLETELY USELESS. :D

What I'm studying: Erector spinae muscles.

Follicular renewal

Today was the first day of lectures and it wasn't so bad! Well, I guess this is considering that we had 3 lectures planned and we only really had a true lecture in one of those classes. The other two were still yet more orientating stuff.

Anyway, an interesting idea was brought up in the "Gametogenesis, Errors, and Chromosomal Abnormalities" lecture and is the title of this blog. It's especially awesome for women. Basically, follicular renewal is the idea that some cells in a woman's ovaries can actually regenerate. This would mean that women are not limited to the ~400,000 primary oocytes (think: premature eggs) that are developed at the time they are a fetus, but could in fact have many, many more. Additionally, it could also mean that our previous theory that all 400,000 or so primary oocytes are developed back when the woman was a fetus, could be mistaken! There could, in fact, be many that are developed later in life!

Pretty remarkable!!!! Go science!

Note: unfortunately, my professor did mention that this theory is not yet completely validated so it could very well be fictional, but she indicated that this is the direction the field is going!

"First Day of the Rest of Your Life"

How many times have I heard this line? Actually, probably not too many times, but definitely at college graduation. I heard it again at our White Coat Ceremony yesterday, spoken from the lips of the most serious-looking surgeon I've ever seen. I wonder how true this statement can be. After all, "the Rest of My Life" is something that is beginning anew nearly every second.

Anyway, I was inspired to start this blog by my childhood friend, Yuan. I told her there were plenty of awesome medical school blogs out there, but she reminded me that she didn't know any of those authors and thus, my blog would be infinitely more interesting. Not sure if it quite came out that way, but that's my story. I'll post links to some of these awesome medical school blogs soon.

My blog is Dr. Huang with a question mark because though I'm not a doctor, many (especially in the city of New Orleans) mistakenly assume that ignorant medical students like myself wield the knowledge and skill of a physician. This is my journey to coming a real Dr. Huang!