Cockeyed Optimist

I am a first-year medical student, so I can afford to be an optimist. That’s what first-years do, we remind everyone of the good old days before billing codes and protocol and subpoenas. Before we realized that no test score could quantify our quality as a doctor.

In my class of just over 120 first-year medical students at UCSD, I am here to report that most of us are optimists, and it is not because we don’t know what we are getting into. It is because we know precisely what we are getting into, and can’t wait for the challenge to begin. Of course, I can’t speak for all of them, but more than a few would support my beliefs whole-heartedly.

One of the many gifts I have received on my journey thus far is the wisdom of some wonderful physicians who are literally tapped into the pulse of humanity. These are the physicians you want at your dying parent’s bedside. These are the physicians who heal because they are healed themselves. They are not threatened by things outside their realm of knowledge or experience, and they are able to support their patients in a uniquely unscientific way as a result.

One in particular is always reminding me of the importance of being able to stay in the room. Not physically, of course, but intellectually and emotionally. This is a big challenge for many doctors, and I have witnessed a few “leave the room” in the middle of a lecture or discussion when topics outside the realm of the “norm” arise. These topics constitute a wide range but include things like integrative and eastern medicine, chiropractic, energy work, yoga, meditation, and prayer. In a way, this makes sense. After all, none of these topics is included in a traditional medical school curriculum (although this is changing, even in some of our UC programs) and none of us knows much about them, except that there doesn’t seem to be a lot of research supporting any of it.

Unfortunately, I have to agree on that last part. (Although that is changing, too. Research follows money, and so-called “alternative” therapy is now a billion-dollar market.) But I do feel at a slight advantage in that I now have knowledge about all of the things I just listed — I have tried them all and experienced them first-hand. Now, while there is nothing scientific about this, I have to say that they all make me feel better. Period. None of them make me feel worse. And some of them are even free. Admit it, you’ve tried them too. Yet some part of you, when a patient or co-worker mentions them, shuts down and leaves the room.

This brings me to my original point: optimism. What does it mean to be optimistic? I define optimism as the ability to believe that anything is possible. Not just the things that have been explained to us or the things we have experienced, but anything. Of all people, doctors should be the ones most likely to embrace this philosophy: Doctors see miracles constantly. Yet still, we leave the room.

Of course, it isn’t just the doctors that leave the room. It’s the students, too. I recently had the pleasure of introducing a Japanese scientist by the name of Masaru Emoto to a standing-room only crowd of over one thousand at UCSD. Dr. Emoto exposes purified water to music, intention, prayer, or even images, then photographs how the water crystallizes. His research suggests that water is in fact a medium for energy. This is significant in that adults are 60–70 percent water, babies even more. Before the talk, I asked Dr. Emoto what we should say to those who felt his research was bogus. He explained that a fellow scientist had come to the conclusion that bacteria in a colony could be divided into three groups: 10 percent had a positive effect, 10 percent had a negative effect, and 80 percent just sat back to see who would win. A few weeks later, a pre-med student approached me to say she thought the talk she saw that night was preposterous. This was not just leaving the room, but in fact slamming the door. And as I talked to her, I realized she had a hard time being on optimist. She liked things to be predictable and precise, and she liked them to be logical.

If there is one thing I have learned in medical school so far, it is that the human body is often not logical. Drug effects are often not logical. And after an exam, none of my classmates is even logical. Logic is fickle that way. It pretends to be concrete. It pretends to be a friend, but at times it gets in the way. It gets in the way when it pulls your attention away from what is possible and toward what is preposterous.

It is clear that our medical model is failing. It can no longer support its own weight. But the future is light, optimistic. The generation of doctors in medical school today is not entering medicine because they expect financial reward, dazzling medical technology, or their own parking space. They are entering medicine because our consciousness as a society is changing. We are realizing that health is a precious commodity, and while wonder drugs that pack a punch cure millions, other quieter, softer things can often also tip a patient back into the delicate balance of health. We are entering medicine because our own doctors have failed us. They have written prescriptions for one drug using the pen of another. They have refused to meet our eyes when we tell them we get adjusted by a chiropractor regularly right after they’ve played golf with one, and they have talked down herbal remedies while sipping chamomile tea.

We are optimistic that we will do a better job, as you were. After all, doesn’t every generation try to undo the mistakes of the previous one? But at no other time in medicine has the need for change been so clear. At no other time have the patients been so ill. And at no other time have so many options been available to heal.

What better time to learn the most difficult skill in medicine: the skill of staying in the room?