So… today is my 27th birthday. I’m not sure how this happened, but I have apparently at some point entered my late twenties. Somehow, I even got a dog, married a husband, and am considering buying a house. Also, I seem to be less than a month away from earning my MD and being called “Doctor.” I have, for all the world, become a “responsible adult”… to my own horror, I might add. It’s been nearly 10 years since I graduated high school, but I have to say that I don’t feel any more “wise” or “mature” than I was then.

Like many other Asian women, I look quite a bit younger than I actually am. This has resulted in all sorts of hilarious situations: being carded for an R-rated movie when I was 23, getting questions about who the “older gentleman” is that I spend my time with (my husband is actually younger than me by several months), and being called “Dear,” “Honey,” “Baby,” etc. by more strangers than I care to acknowledge. That, coupled with the fact that I’ve never really spent any substantial amount of time out of school up to now, leaves me feeling like I really have no idea what the “real world” is like.

On (failing at) practicing what you preach

One thing that every health professional is always trying to do is to convince patients to change their behavior. Whether it’s the woman with diabetes who could really benefit from losing a few pounds, the guy with heart failure who needs to lay off the BBQ, or the teenager who just won’t take his meds, we spend a good portion of our days touting the virtues of whatever lifestyle modification it is this time, and probably an even bigger portion complaining to one another about how much healthier everyone would be if they just got off their asses and took more of an interest in their own health.

Of course, it’s easy to get self-righteous when we’re talking about other people. I’m pretty sure that if I had a chronic illness and had to take medications on a daily basis, avoid certain foods, etc., that I would be just as non-compliant as many of the patients I’ve seen in the hospital. You’d think that being highly educated (and not only that, but being highly educated in medicine and health) would motivate me to make healthier decisions (and I do try, I really do), but knowing the nitty gritty pathophysiological details gives me plenty of room to rationalize how this or that general recommendation doesn’t apply to me. Ironic, isn’t it?

The “deceptive” income of physicians

One perennial topic of profuse internet discussion, ranting, and general circle-jerking among medical students, American medical students in particular, is the idea that doctors’ incomes are “deceptively” high, and that really, when you take all the cost and effort of training into account, physicians don’t really make any more money than [insert some other “humbler” profession of your choice]. This is a topic that pervaded blogs and forums back when I was a bright-eyed pre-med seeking advice for my med school applications, and it continues to be a popularly repeated topic now, as I near graduation. Most recently, this article has been making the rounds on reddit, and to be honest, I’m really sick of it. Yes, medical education is expensive. Yes, the training is long. Yes, you have to work hard. And no, you probably shouldn’t decide to go into medicine if money is your only objective. And I do think that we probably deserve the high salaries that we’ll eventually get. But what’s this need to compare ourselves to everyone from high school teachers to nurses in order to “prove” how much “worse” we have it?

We were the ones who, of our own free will, decided to put ourselves through this. Because, after careful consideration, we thought that it would be worth it. Few of us came into this blind. Most of us could have succeeded in any number of other potential professions. And if we really thought that it would have been better to become high school teachers, dentists, and nurses, we would have picked a different path. Can we really not just be happy with our career choices without trying to convince everyone else that we’re all a bunch of self-sacrificing martyrs who have dedicated our lives to the thankless service of humanity?

I think the real reason that these kinds of discussions keep happening is that we’re afraid. With all the recent talk about runaway healthcare costs and “bending the curve,” many members of the lay public have looked at doctors’ salaries as a potential place cut costs. And so we’ve become defensive. We’re afraid that by the end of our grueling training (and I do agree, as anyone who has done 24-hour call or worked an 80+-hour week will, that the training is grueling), after we’ve all worked so hard to be worth what we thought we’d be worth, that by then, our salaries will have been cut to pieces and the journey wouldn’t have been worth it at all anymore. So we make ridiculous claims about how we should have all just become high school teachers instead (since no one could ever accuse a humble high school teacher of making too much money), not because we actually believe it, but because we want to convince everyone else to sympathize with us. And somewhere, deep down, with the smallest tinge of guilt (because most of us did go into medicine, at least in part, because we had some selfless notion of wanting to “help people”), maybe we do wonder if doctors might just be a little tiny bit overpaid after all. But as soon as that thought surfaces, we drown it again in another wave of facts and figures and comparisons.

“Humanism” and “professionalism” in medicine

I just finished my first set of exams for the year, so naturally, I’m slacking off to wax philosophical about my existence in general and my life as a medical student in particular.

“Humanism in medicine” or “humanistic medicine” has become a bit of a buzz phrase in medical education. Likewise, “professionalism” is a word that gets thrown around a lot, at least at my school, in reference to everything from lecture attendance to dress codes. As medical students, we’re expected to speak the appropriate language, to behave in the appropriate way and, above all else, to think the appropriate thoughts: the obese patient isn’t just fat and lazy, but the victim of poor education or cultural priorities. Likewise, the rude patient is more than just a simple jerk. They try very hard to make us empathetic, respectful, patient, considerate, and all manner of other wonderful things that you could hope for your doctor to be. That’s one hell of a lofty goal, and I can’t say that I’m not just the tiniest bit intimidated.

As much as I’d like to think of myself as a somewhat mature person, the truth is that I’m the kind of person that enjoys internet drama, that has trouble getting out of bed before the clock strikes noon, and that gets excited at the prospect of shoving sweets in my mouth. I’ve spent my entire life to date in the ivory tower that is academia and so, have no idea how real people actually live their lives. To think that in one more year, I’ll actually be on the wards in my white coat– it’s a bit of a terrifying thought.