What does it feel like to want to be part of the system you question? I listened to a Hidden Brain episode in the shower last night (the optimum time for podcast listening), where they detailed the tragic trajectory of the Ford Pinto. The focus of the episode was on hindsight bias, which, while interesting, didn’t capture the brunt of my attention. Instead, I felt most drawn to the story of their primary interviewee — a former Ford employee who had joined the company with a passion for reform, only to play a role in the continued existence of the Ford Pinto, a dangerous vehicle, on the market.
It looks like the last time I wrote a blog post was the day after I got into the medical school I currently attend. It’s been an interesting 8 or so weeks since I started. In many ways, I dedicated myself to medicine not only because I am passionate about helping and connecting to others and enjoy the problem-solving model of learning — do I sound like I’ve been through multiple med school interviews? — but also because I am passionate about contributing to a movement that focuses whole heartedly on patient well-being and less on the financial bottom line. Like that former Ford employee, I came in with a passion for reform, wanting to improve on the care I received. Over the past couple of months, however, I’ve reckoned with my identity, trying to find the line between being a patient and being a medical student. I’ve spent the last four years using my experiences to enhance the empathy of medicine while attempting to help those like me who have not yet found their voices feel less alone. Do I stop now?
During our patient care class, we discussed possible causes for abdominal pain. I rattled dozens off as though I was reciting the digits of pi, fueled by years of googling possible etiologies behind my own pain. When my professor didn’t know the risk factors for kidney stones, I felt both emotionally and intellectually inspired to list these as well. Do I contribute that I was only aware of them because I have two kidney stones? Do I mention how much they hurt? How I used to keep some oxycodone around so I could get to the emergency room in an Uber when one of them hit, so as to not pay for an ambulance? How much is too much? When we mention Adalimumab, do I say how scared I was when I had to do my first four injections? Is it my responsibility as a patient advocate passionate about reform to volunteer my illness experiences in an attempt to encourage my classmates to think about the lived experiences behind the drug names they’re memorizing or the symptoms we’re discussing? When we breeze over the side effects for prednisone, do I talk about how bad they really are? How it makes you irritable and your face puffy and makes you feel like you could eat your lunch three times over? Where do I draw the line?
I understand that when I begin to actually interact with patients, the times that I choose to share my own experiences lying in a hospital bed will likely be minimized. My experiences will inform my care, I’m sure. I won’t ever tell them to get a good night’s sleep — because who can actually do that in a hospital — but I will refrain from detailing my own illness narrative. The spotlight is on them and their experiences, and the etiology behind my potentially increased empathic capacity from my own story should not often be shared. However, when I was applying to medical school, an advisor told me that perhaps schools would admit me in an attempt to contribute to the empathy of their students toward the patient. Is that my job now? To make up for the lack of lived experiences in our curriculum by sharing my own? Or can I simply recede into my flashcards and my PowerPoint slides, not contributing to the conversation in the way that I feel like I’ve been programmed to.
At some point, I’m sure I’ll be doing Anki from a hospital bed. Is that the time? In not sharing, am I potentially increasing the probability that a surgical resident will have an insensitive comment for an 18 year old in a hospital bed, like one had for me? Am I contributing to an industry that fuels trauma for so many? At what point do I stop being an advocate and I start being a medical student? And what’s the best way to be both?
My Intestines and Me 