Awakenings

McGill's medical curriculum had undergone a series of reform in previous years. Even during the first year when hard science was to be lectured, we were given a number of interesting electives. First, everyone had to choose a long-term patient for follow-ups every month. Second, we had to attend a surgery and a child delivery. Also, we were divided into small groups, each of which was headed by a family practitioner to lead the monthly meetings where we could discuss anything related to medicine. More academically, the small groups had to work on problem-solving of clinical cases related to the lecture material every week.

The first small group session was actually not clinically, but rather scientifically oriented. It was led by a molecular biologist who used his expertise to help us understand the basic mechanisms of some protein trafficking diseases. Near the end of the session, he raised an interesting question: "if the treatment costs a lot, would you go for it?"

People murmured and before anyone of us said something, he spoke again: "let me ask you this, why are you guys here? Why do you go into medicine?"

"To help people!" one of us yelled without hesitation.

"Good, anyone knows what's killing most of the people in the world?"

"Infectious disease," I remarked, after attending a talk on tuberculosis some weeks ago.

"Yes, malaria, TB, etc. Most of the common vaccines now cost less than $1 a shot, and so with $10,000 you can help more than 10,000 people in these poor countries. Now, less than 0.01% of the population suffer from this protein defect, and the treatment costs a lot. Would you go for it?"

The room was silent as a stone.

"Think about it, guys. And let's call it a day!" The session ended.

A few weeks later I had a lecture on obesity. The lecturer mentioned that a special diet was available to help people lose weight, but it was barely palatable and cost $300 a day. "This money can be better spent for vaccines in third world countries," I whisper to my friend. And he added: "and many of these problems can be preventable if they watch their diet in the first place. There's so much injustice in this world. You just can't believe it!"

The first small group session in the hospital took place in the Palliative Division which housed and cared for patients who were expected to die within a month or so. These patients did not expect any live-saving support, but over there their pain was managed and their quality of life maintained. Our leader was the head of the department, whose job was nothing more than making sure that comfort was provided for these patients until they died.

"You all hear that medicine is about helping and curing people. How many patients do you think we cure everyday?" he asked. "Not many. In fact more than 30% of patients we deal with now are geriatrics with long-term problems," he jumped at his own question.

"So tell me, why did you choose to practice medicine?" Every one of us has certainly answered this question at our med school interview. But when asked again, our answer was different and, surprisingly, the same among us. Not that we lied at our interviews--the reasons we had given back then were truthful but may be of minor importance--yet the definitive reason was... we didn't really know! However nonsensical this might sound, we thought that the desire to pursue medicine resides deep inside of us-- we just knew we wanted to do it.

Awakened, I asked myself: "What has got me into this? And can I do more than medicine?"