Category Archives: Medical School

Work is Poetry

My foul-mouthed, mustachioed boss had been a roofer for years. I had been a roofer since college let out in May, but I had already learned that it was a messy, exhausting, and inglorious job. Every morning at 4:30 my boss picked me up, and he always listened to country music. Perhaps the songs reminded him why he’d been working so hard for so long:

“Calloused hands told a story for the small town Southern man,
He gave it all to keep it all together, keep his family on his land.
Like his daddy, years wore out his body, made it hard just to walk and stand.” 
— “Small Town Southern Man,” Alan Jackson

People are poetic to the core. We write songs about love, make movies about history, write books about everything imaginable, and we sing to our children at night. We wax poetic about anything and everything, including our careers, whether glorious or mundane.

Most of us can’t be even partly satisfied with our work unless we have a high view of what we’re doing. For me, medical school is no different. Studying is long and tiring, but I can’t think of it as just working for a grade–I’m learning vital information that can save my future patients. And when I finally do have patients, I won’t merely be a doctor, handing out antibiotics to kids with ear infections. I’ll be a picture of God, healing people’s physical wounds, and hopefully pointing them to Jesus, who can heal their spiritual wounds. Work–whether scrubbing toilets or piloting planes–is poetic, because we’re not doing ordinary work, we’re doing God’s work.

“Whatever you do, work at it with all your heart, as working for the Lord, not for men, since you know that you will receive an inheritance from the Lord as a reward. It is the Lord Christ you are serving.”
–Colossians 3:23-24

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Med school year 2 to date–as a list!

Highlights so far:

– We start preceptorships with clinicians in a few weeks!
– I’m taking a “Critical Care Medicine” elective that’s almost as exciting as a preceptorship.
– My classes are very interesting, and they seem more relevant to patient care than much of the material last year.
– This most recent weekend with my wife–sometimes we just have a lot of fun together.

Low-lights so far (whatever that means):

– I still seem to be perpetually behind–I guess that’s just a fact of life in medical school.
– The classes are far more interesting and relevant, which means I feel a lot more pressure to do well in them, which means I’m working a lot harder.

In fact, I’d better go study, being as I’m behind and my classes are important…

The Art of Death

Awhile ago there was a display at my medical school titled “The Art of Pathology”. On display were pictures of human flesh–perhaps a microscope slide of a liver with fatty deposits, a section of a lung destroyed by smoking, or a heart with a large infarction.

I spent most of this morning looking at slides of diseased organs, and probably the last thing that might have gone through my head is “What a beautiful image.” Each organ had caused someone great pain. Then it had killed them. I don’t know much about art, but if art is something beautiful, then pathology slides and sections are most definitely not art. Pathology is death, and death is not beautiful.

Looking at pictures of dying organs is an impersonal way to learn medicine.I study alone, and while I’m studying things that are relevant to all of us, I don’t actually get to interact with any people. One image I saw this morning was of a massive infarct in the temporal lobe of a brain. I don’t get to comfort this person–I only get to see the aftermath. And the aftermath is gruesome. Whatever used to be in the infarcted section of the brain has been replaced by a huge, gaping hole. Even if, by some method, we could extract memories and thoughts from the connections and organization of neurons in a brain, we couldn’t extract any memories from this brain. There was just no structure left. Perhaps she lost function slowly as successive parts of her brain succumbed. Perhaps her memories blinked out of existence one by one, like in The Eternal Sunshine of the Spotless Mind.

Studying pathology is impersonal because each of us is more than just the sum of our parts. I am different from my body, because I am a soul, and God has blessed me with a body to interact with others and experience life. The difference between staring at books all day and seeing patients on the wards is that patients have souls. Patients can smile, cry, and express their concerns. But the world is tainted by sin, and our bodies–vessels for our souls–are dying. Pathology is happening in each of us, and eventually, one of our pathologies will kill us.

“By the sweat of your face
you shall eat bread,
till you return to the ground,
for out of it you were taken;
for you are dust,
and to dust you shall return.”
-Genesis 3:19 (ESV)

If pathology is art (I still have serious doubts), it’s because it reveals us as we really are–as dust. Slowly, imperceptibly, we’re broken down into dust, and eventually, we’ll return to dust. If we’re followers of the Lord, dust isn’t the end of us. As our bodies decay, our souls are perfected.

In Ephesians, Paul talks about our “old self.” If we’ve been renewed as Christians, we are new. The part of us that makes mistakes, that hurts people we love, that desires comfort more than service to God–that part of us is old, and God is working in us to destroy the old and build up the new. Just like our bodies, the “old self” is being destroyed. Death and pathology is God’s judgement on sin, and each of us will die. But this judgement is out of love. The parts of us we hate are falling away, and as we grow in closeness to the Lord, the new self grows in vitality. Once we’ve finally died and been made new, what more could we want? We’ll be with God, and in God’s presence “is fullness of joy; in [his] right hand there are pleasures forever.” (Psalm 16:11)

I tell you this, brothers: flesh and blood cannot inherit the kingdom of God, nor does the perishable inherit the imperishable. Behold! I tell you a mystery. We shall not all sleep, but we shall all be changed, in a moment, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, and the dead will be raised imperishable, and we shall be changed. For this perishable body must put on the imperishable, and this mortal body must put on immortality. When the perishable puts on the imperishable, and the mortal puts on immortality, then shall come to pass the saying that is written:

Death is swallowed up in victory.
O death, where is your victory?
O death, where is your sting?

The sting of death is sin, and the power of sin is the law. But thanks be to God, who gives us the victory through our Lord Jesus Christ.”
-1 Corinthians 15:50-57 (ESV)

I’m the cream of the crop, I rise to the… middle?

For most of my life, I have been among the best of my peers in everything academically related. This changed for me in medical school, as it does for most people. The thing a lot of first year med students have trouble dealing with is the fact that nearly every one of their peers was also at the top of their college class. Unless you have a rare intelligence (or are masochistically hard-working), you won’t be at the top of your med school class.

Don’t get my wrong, I did just fine during my first year of medical school. I’m going to be an excellent physician. My grades are good, and there are plenty of students who didn’t do as well as me. My point is that there are also plenty of students who did much better than me. The ego I had going into medical school was tested and found to be much too big for its britches. So at the end of my M1 year, I was feeling a little defeated, since, like everyone, I’d been hoping to be the best of the best. In a fateful coincidence, I also didn’t have anything to do over the summer. I’ve always been good at research, and a professor at school had invited me to work in his lab over the summer. Hungry for some good hard science (which I’ve always loved) and the chance to do something I’m actually good at, I decided to do a little bench research. I don’t anticipate that it will look particularly good on a resume, I just thought I’d enjoy it.

The summer was wonderful. I was a scientist now. No longer a dejected first-year medical student, I was seeking to know something no one on earth has ever known before. My project was to isolate and characterize a protein involved in RNA processing. I started out very excited, working hard at transfecting bacteria with cloned DNA so they would produce massive amounts of the protein I was interested in.

Then, for awhile, I got discouraged–having come from a physics background, I wasn’t quite aware of the grueling hard work and failures that come with biomedical research. For awhile it looked like I might not even isolate my protein, let alone characterize it. But finally, two weeks ago, in the eleventh hour of my summer, I got protein! I grinned from ear to ear when I saw the big black splotches of protein in my gel. I even had time to run a few experiments and find out a little about how my protein behaves and what its function might be.

Now I was really something. Not only had I done some real science over the summer, but I’d finished the project I’d proposed to do. All through the summer, people had been asking me about whether I was doing an MD/PhD, and I started to seriously consider it. I was good at this, and I could just imagine myself being the best of the best again, doing cutting-edge research and understanding things no one else understood…

I guess the ego comes back easily. Since my grades are only good, and not excellent, it’s unlikely I’d get accepted even if I wanted to spend three extra years in medical school. So on Friday it was out with the research, and this morning it was in with more medical school. Back to the still slightly-dejected, middle of the bell-curve life of me as a medical student.

(Again, don’t get me wrong. I love medical school, but a little conceited part of me still misses being on top.)

“My heart is not proud, Lord,
my eyes are not haughty;
I do not concern myself
with great matters or
things too wonderful for me.
But I have calmed myself
and quieted my ambitions.”
-Psalms 131:1-2

The Last Summer of My Life?

My second year of medical school begins on Monday, which means 70+ hours a week of class and studying, little sleep, and quite a bit of stress for the foreseeable future. The summer break after M1 year is the only summer break in medical school–for the final three years school goes straight through June, July, and August. This past summer has been amazing–I went fly-fishing in Montana, visited the Maine coast with my wife, relaxed on weekends and evenings, and spent my days doing research in a lab at school.

Last year, as the M1 class discussed summer, the M2s frequently gave us lots of advice, usually referring to this summer as “the last summer of your life.” The advice was predictable–have fun, travel, see family, don’t do anything stressful–but did they really need to be so ominous about all the other summers we’re going to live through? What exactly am I getting myself into?

For all the complaining we do, medical students are pretty fortunate people–the AAMC says only half of applicants to medical school are admitted. As medical students, we get to sample a number of specialties before choosing our career. In most fields of work, this isn’t an option. Once we finally do start working, our wages are pretty reasonable, even with all the debt from school. I know medicine is going to be difficult and time-consuming, but it’s also going to be interesting. No other field of work has such a blend of cutting edge science, social interaction, and the opportunity to directly make a difference in someone’s life. God has blessed me by allowing me to become a doctor.

So am I really about to end the last summer of my life? I don’t think so–I only took three weeks of real vacation this summer anyway. There will be plenty of other summers, and although I’ll be working hard, I’m pretty sure I wouldn’t want to be doing anything else with my life.