Island Med Student

According to the dictionary, the definition of compassion is, “a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering.” I have always believed that compassion is a necessary prerequisite for a physician, yet I have met some physicians and physicians-to-be who don’t appear to have a well developed sense of compassion.

After a conversation that I had with a fellow medical student the other day, I started thinking about which qualities are inherently necessary for a medical student to possess, and which ones can be learned from instruction. Can common sense actually be taught? Is a knack for science a necessary prerequisite for being a good doctor? Must a doctor actually be compassionate in order to be effective?

I can’t help but think that compassion is most definitely an integral component in effective healthcare. Perhaps I just can’t comprehend a world in which people would be able to heal the sick without being compelled by a need to alleviate suffering. But, we’ve probably all known a few doctors who don’t seem to truly care about their patients. The reality is that they exist, and the truth is that it is sometimes the educational system, as well as a largely disjointed healthcare system, that actually contribute to the apathy of physicians.

I look around at my fellow classmates and I wonder if all of them are inherently compassionate people. Do they even need to be? Should the educational system be designed in such a way that compassion is taught with the same fervor as biochemistry? If medical students are not compassionate to begin with, will the system end up helping them grow into caring doctors, or will it have a deleterious effect on their humanity?

To me, it seems like compassion should either be a prerequisite to medical school, or it should be integrated into the curriculum. I know that admissions committees do everything they can to only accept qualified candidates, and that many of them value compassion as an important quality. But would they be more apt to admit the 4.0 GPA student who doesn’t have any obvious compassionate qualities, or the 2.0 GPA student who truly believes in alleviating the suffering of the sick? It certainly is a tough decision.

Many medical school administrations are taking active steps towards guaranteeing that they are producing proficient, as well as compassionate doctors. But I’m not convinced that they are always successful. It seems harshly ironic that the very system that is dedicated to producing skillful, compassionate doctors, is the cause of many students’ declining empathy towards patients. Perhaps the real question we should be asking is, “can compassion even be taught?”

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So, I have been a very busy beaver lately. Tomorrow is my final lab practical for gross anatomy, and the next two weeks of my life will be one exam after another. The pile of class handouts on my bookshelf is staring back at me right now with its menacing smile. I’ve been spending crazy hours in the anatomy lab every day, and I have strangely gotten accustomed to the smell of the moldy corpses. Apparently, they are going to cremate the bodies next week and send the ashes to the donors’ respective families. The boxes for the ashes are sitting in the lab, with the name of the donor and their family’s address. I can’t express how amazing it is that someone gave their body to us so that we could use it to learn. I sometimes wish I could tell their family thanks.
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It’s truly amazing what you end up doing when you are desperately trying to avoid studying pulmonary physiology. I took this footage last week. Thanks to Micah for the AV support.

A Desperate Kendra + An Excess of Pulmonary Physiology Problems + A Goat Obsession + Micah Watching Every Episode of Star Wars and Making Kendra Watch = Return of the Goats

Enjoy.

I can’t believe it’s Thanksgiving. I mean, I really don’t believe it at all. It was swelteringly hot today, and I’ve been so busy today that I absentmindedly left my laptop in the library and just had to run down to campus to go grab it. Oh yeah, I forgot to tell everyone – I got my laptop back! She’s now safe and sound and a brand new shade of white. My day started this morning with my daily visit to the anatomy lab with Sarah. We’ve decided to go to the lab every morning and review for at least an hour. It’s awesome in the morning, because the whole lab is completely empty and you can actually hear yourself think. I had some lunch and reviewed stuff until it was time to go back to the lab to do our dissection of the posterior mediastinum. My group managed to pull that off in less than an hour, so I had just enough time to run to the Annex building to get certified to take blood pressure. Since I already knew how to take blood pressure, and have done it a million times, I just had to prove it to one of the TAs, and now I get extra credit for physio, and some type of card that says I can take blood pressure. After watching all of today’s lectures at the library, I then hiked back home. Did I ever tell you all that I have to walk to school uphill, both ways? I’m not kidding. There is a valley between my house and the campus, so I actually have to walk up a hill to get to school, and walk up a hill to get back home. Anyway, I’m now trying to convince Micah to do anatomy flash cards with me, which we both seem to enjoy. Happy Turkey / Tofurkey Day to All of you! Now we don our gay apparel!!

iTunes has turned me into a criminal. It’s a long and torturous story, but the short of it is that I legally purchased tons of songs from iTunes, and I just recently lost all of them because I upgraded to the latest version of iTunes. I’ve decided to boycott iTunes, and I’m now using Limewire. iTunes has forced me into a life of crime. I’ve been downloading songs like crazy tonight, and I just came across a mix of Benny Bennasi’s “Satisfaction” and 50 Cent’s “In Da Club.” Are you serious?!?! I am in music heaven! I can’t stop shaking my thang all over my apartment. It’s possible that I won’t sleep tonight. Thank you iTunes for turning me into a sleep deprived, monstrous thief.

We had a lecture last week on hypertension for our “Doctor, Patient and Society” class. Our professor made an interesting comment, which I’ve been pondering over for the past couple of days. He mentioned that untreated hypertension is an important cause of kidney failure. If left untreated, hypertension can lead to a patient having to go on dialysis and can eventually lead to death. For more affluent patients in the U.S. and other developed countries, this is not something that they’ll ever have to face. With the proper medical attention, a patient with hypertension can live until a ripe old age and will never have to worry about facing the frightening prospect of undergoing dialysis. But there are many people who are not so lucky as to have the benefit of adequate medical care.

My professor used an interesting analogy to describe the current situation of hypertensive patients worldwide. He said that if you blindfolded him, and placed him in the dialysis unit of any hospital in the world, he would immediately be able to ascertain how developed the country was, merely by looking around at how many of the dialysis patients were there because of untreated hypertension. The reality of healthcare in America is that the dialysis unit of a hospital in Kenya, compared to a hospital in an impoverished neighborhood in Chicago, may look exactly the same. Most of the patients on dialysis are not there because all attempts at preventing kidney damage had failed, but because they had not received any preventive medicine which would have treated the hypertension before it led to organ damage.

The solution to our international healthcare problems is certainly not obvious. Everyone has their own version of the answer. The reality is that improving the health of humans on this planet is a task which will never be completely finished. But it seems obvious to me that one of the easiest things we can do is focus on preventive medicine. If we can do something now to address the health of the world’s population, perhaps we can alleviate the need later on to find ways to heal the sick.

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I broke the golden rule the other day. I told my friends the Ren brothers that I would take them to the beach, but I forgot to come back later because I became busy with studying. Yesterday, they saw me and told me that they had waited all day for me to come and take them, but I never showed up. Don’t ever make a promise to a child if you can’t keep it. They won’t forget! To make it up to them, I offered to take them to the beach today. This time, I took all five brothers, including the baby. We built sand castles and played at the beach until sundown. They asked me if I could take them to the beach every Sunday, and I told them I would. Looks like it’s going to be Sundays at the beach for Kendra.

Here are a few of the pics that I managed to take, in between chasing Renfa around and helping build sand castles.

The little incidents that happen when you live in Dominica are really what keeps life interesting. For example, I now have “2 fake dogs.” The dogs aren’t actually my dogs, and I don’t know who they belong to. But, they really like following me around and pretending like I am their owner. Last night, as I was walking down to campus, they were following me, as usual. Suddenly, out of nowhere, a goat came charging out of the bushes and head butted one of the dogs. I’ve never seen a goat do that before, and it made me almost trip over my feet. The dog wasn’t hurt, and it gave me something to laugh about.

Today, we had a visiting professor give a lecture on single gene disorders for our Biochem and Genetics class. Apparently, the biochem department is trying to hire some new professors, so they’ve been trying new ones on for size. I actually like this guy a lot, especially because he is French. One of the neat things about our professors is that a lot of them are from other countries. There’s something exciting about having professors who come from all over the world, and I really enjoyed him talking about “cafe au lait” spots caused by neurofibromatosis with his heavy French accent.
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I just got my unofficial grades back from my second mini. I totally rocked it!! My grades actually went up in all subjects except anatomy. But I passed every class and totally rocked biochem this time! I’m so happy and I’m actually excited about the next mini. My goal was to get straight A’s, and if I work my toosh off again, I might just make that goal. Rock on studying!

My last blog entry about medical school feeling like a cloning colony generated some interesting feedback. It seems like many people were supportive of my choice while others were critical. I realized that I didn’t fully explain myself, so I’d like to do that now. I made the decision to go to medical school during my last year of college. However, I ended up taking time off after undergrad to experience the working-adult world. After an amazing stint at a psychiatric hospital for three years, I changed fields and went into the field of academic medicine. I spent almost four years working for the Association of American Medical Colleges (AAMC). During my third year there, I took the MCAT and went through the American Medical College Application Service (AMCAS) system to apply to medical schools in the U.S. I was a straight-A student in college, and I had a decent score on the MCAT. With my medical experience and recommendations, I had a pretty good shot at getting into a good school. But then I hit a wall.

The combination of stress, lack of money, and apprehension caused me to withdraw my application. I realized that I was young, and had a decent job, which offered plenty of room to grow. All of my friends were already out of school, had good jobs, and were set on their career paths. Honestly, I was scared. I was afraid of giving up the safety of my job and the comfort involved with not having to worry about grades or failing school. I let fear triumph and decided to pursue the safer alternative of staying at my job.

About a year later, a series of events led me to realize that I had made the wrong decision. I knew that I wanted to be a doctor, and I wasn’t about to let my trepidation of the unknown keep me from my dreams. Unfortunately, though, I had horrible timing. It was too late to apply to U.S. schools. If I wanted to attend a school in the States, I would have had to wait until the next year to apply, which meant that I wouldn’t actually be able to begin school for another two years.

Surprisingly, someone at the AAMC suggested that I look into attending a Caribbean medical school. Before then, I hadn’t even considered it as an option. When I was a pre-med student, everyone had scoffed at the idea of attending a Caribbean school, and it was jokingly referred to as “the last resort” if you couldn’t get into a U.S. school because your grades or MCAT scores were too low. But, I decided to look into the option, as I really didn’t want to wait two years to begin medical school.

Working at the AAMC afforded me the resources to thoroughly investigate my options. Since I worked closely with the Liaison Committee on Medical Education (LCME), which is the accrediting body for U.S. medical schools, I was intimately familiar with the criteria that are used to evaluate the quality of a medical education.

After doing all of my research, I narrowed in on Ross University School of Medicine. There were many reasons why I chose Ross, but the important ones were that it had a good reputation, decent USMLE pass rates, and the fact that Ross graduates more medical students each year than any other medical school in the U.S. or the Caribbean. I talked to several doctors who had graduated from Ross, and they all had good things to say. Finally, the fact that Ross University is approved by the U.S. Board of Education sealed the deal. This meant that I would be eligible for full financial aid, and when I return to the U.S., I will be able to practice in all fifty states without having to jump through any extra hoops.

After speaking with some of my colleagues at the AAMC, it seemed that the biggest drawback associated with attending a Caribbean school was the lack of prestige. If I wanted to go on to publish research, it would make more sense for me to graduate from a U.S. school with a good reputation. But I’m not interested in prestige. As one of the commenters on my last blog entry so astutely put it, “I am reminded of one of the less noble reasons I am called to medicine — to save my patients from having to be treated by a doctor who is more concerned about where his or her degree came from than providing compassionate and effective medical care.”

My goal is not to dazzle my colleagues or patients with a framed degree on my wall from a famous or prestigious medical school. While I value the importance of research, I’m not compelled to have my name published in a prominent medical journal. I simply want to be a doctor who treats her patients skillfully, humanely, and compassionately.

To decide whether attending a Caribbean medical school was the right choice for me, I merely had to answer one important question: Could I acquire a well-rounded medical education, which would equip me with the skills to be an excellent doctor? All signs pointed to “yes.”

Although my basic science education is on the island of Dominica, I will be doing my clinical rotations at U.S. hospitals. I also have the option of potentially doing my fifth semester on the island at the local hospital here in Dominica. This seemed like the perfect combination to me. I get to live on a beautiful tropical island for eighteen months while I learn the basic sciences, and I have the option of beginning my clinical education at the local hospital. When I get back to the States, I will have the opportunity to learn at many different hospitals all over the U.S.

I actually just returned from my second exam, and I’m really beginning to feel like I can make it through medical school. I have realized that while it’s important to have competent professors, adequate facilities, and supportive services, there is more to a medical education than just the name on the outside of the building. The best medical school in the world can’t turn an unmotivated or incompetent person into an effective and caring doctor. It requires dedicated labor, an unwavering commitment, and an eagerness to excel, all of which are the responsibility of the student. Medical school is a two-way process, which requires both a skillful teacher, and a student who is eager and willing to learn. With medical school, as with everything in life, you get out of it what you put in.

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