Saturday, October 26, 2013

The Healthcare Problem

When I was three years old, I decided I wanted to be a surgeon. I made my mother get me an anatomy book, and long before I could read it myself, I studied it. My mother read it to me at night, sitting in our recliner with me in her lap. This blond haired, tiny, precocious girl didn't want anything to stop her.

I spent my ENTIRE elementary school life talking about it. I spent a ridiculous amount of time reading a thick, so-heavy-I-couldn't-hold-it book of common childhood diseases. (I literally had to lay my head next to the book on the couch so I could read it.) When we dissected frogs in the seventh grade, I was the only girl who didn't pair off with someone (mostly because they didn't like me), and I was thrilled to get the whole frog to myself.

When I finished my first year of college, I was asked by a local girl's high school to dissect a frog and a sheep's heart. I did so gladly, for a group of six very interested freshman and sophomore girls.

This is the only thing I have ever wanted to do. Though I've vaguely considered other things (teaching math and science, becoming a writer, musician, other things that could never happen), none of them have ever been serious considerations.

No one ever told me I'd have to take the MCAT or that getting into med school is damn near impossible. No one ever told me there was an extremely good chance I'd never get in. Until I got to college, I had never dreamed that my life-long obsession could be shot down with a simple "no."

Allow me to explain something about being pre-med. You have to take a year of chemistry, a year of biology, a year of physics, and a year of organic chemistry. Just short of none of this stuff is actually important for medical school, but it's still required.

So say that 60% of all incoming freshman (at my school it's waaay more) are pre-med. After chem and bio, it's down to 50%. After organic, it's 15%. If you survived organic but couldn't make it through physics, there's something seriously wrong with you. (No, not really, but really, organic is SO much everyone except me.)

So we've cut out 3/4 of the students who want to be doctors. Some of them may have done well in medical school, but many were probably not motivated or smart enough.

What's left is a group of highly motivated, crazy-smart, sometimes just plain crazy undergrads, dying for a chance to go to medical school.

Of them, how many have wanted to only be doctors?

I'm not sure of the answer, but I know that most of them don't care about the patients. From what I've seen, most of them just want the prestige of having M.D. at the end of their names. Some think they'll make a ton of money working as plastic surgeons in Beverly Hills. Maybe they will. But the compassion isn't there.

(Supposedly there's a class in the first year of medical school about compassion. I don't see how you can teach compassion.)

I'm not saying I'm the only qualified medical student candidate I know. That simply isn't true. But the vast majority of pre-med students just don't care about the patients.

Which, of course, was how I got to see something like ten doctors before someone was willing to sit down and explain that my joint and muscle pain are not all in my head. It's how I got to see a pediatric endocrinologist who insisted there was nothing wrong with my blood sugar. It's how I got to see a dermatologist who gave me an antifungal shampoo for eczema on my scalp. It's how I got to see an allergist who refused to give me an epi-pen for a nut allergy (and I almost died of anaphylactic shock six months later). It's how I got to see a pulmonologist who insists there's nothing wrong with my breathing, even though when I started to see her, I literally couldn't finish a sentence.

And it makes me wonder if medical schools are doing the right thing when they pick us based mostly (or solely) on academics.

The best doctors aren't the ones who got an A+ in Orgo. The best doctors aren't the ones who got a 45 on their MCATs. The best doctors aren't even the ones who graduated at the tops of their med school classes or got the best residencies and fellowships.

The best doctors are the ones who care enough to give a damn. They're the endocrinologists (without diabetes) who try on the OmniPod (when it first comes out) and all the pen needles so they know what to tell their patients. They're the (very, very nice) M.D. at Montefiore who had the EMG done on him first so he'd understand why patients ask him to stop. They're the doctors who run around and then breathe through a straw so they know what asthma feels like.

There aren't very many of these anymore. And though compassion can be made up for with diagnostic skills (assuming they have basic bedside manner), most doctors don't have this, either.

Now you're probably wondering why I want to go into a profession as cold and heartless as medicine, with the good sprinkled in like cookie dough bits in the larger ice cream. (Because there's usually so little cookie dough that you're surprised when you actually find one in-between all the bites of only vanilla, right?)

I want to be that endocrinologist who sits in with the parents of a newly diagnosed child and tells them that it's not going to be easy, but that it WILL be okay. I want to be that doctor who can tell the fifteen-year-old girl that I know exactly what it feels like to be excluded from the birthday party stuff because you can only have cake OR ice cream OR pizza, but not all three. I want to be that doctor who has been low during a college interview (and then went on the train afterwards and nearly fainted into the subway tracks and STILL has not told her father about it To. This. Day.) and can tell her patient that sometimes you get accepted to the program, anyway.

There is so much more to being a doctor than prescriptions and terrible handwriting. I have both the compassion and the people skills to help, maybe even make a difference in some patient's lives. The medical schools won't know it until I'm there, but I'm not one of those people who gets A's in everything but can't look you in the eye. (No, I don't get A's in everything...I kinda wish I did, though.) I just hope they can look past some of my lower grades and know that there's more to people (and me) than just the grades. I'm hoping they see me, not the number of B's I've gotten.

Maybe one of them will see the potential I hold. Medical stuff sticks in my brain. Physics? Not so much. But that won't make me a terrible doctor or even a mediocre one. My endocrinologist thinks I'll make a wonderful doctor, no matter what my grades are. I hope they can see that, too.

So yes, I'm applying to medical school now. I need all the luck I can get, and I can only hope that someone will look at me and say, "Yes, I think you'll do wonderfully here."

That, and now I want cookie dough ice cream.

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