WALL STREET JOURNAL: MED SCHOOL BURNOUT 

PROGNOSES FOR BURNT-OUT MED STUDENTS AND THEIR PATIENTS

https://blogs.wsj.com/experts/2017/09/12/how-medical-schools-can-better-fight-burnout/

MED SCHOOL BURNOUT PRODUCES INEFFECTIVE UNENGAGED MEDICAL STUDENTS AND ULTIMATELY POOR MDS.

A problem that needs to be addressed and appropriately managed. Open discussion and encouragement of such discussion should be implemented by all medical schools.

Better mental health care for medical students, ditching the mental health stigma, and employment of mental health resources for medical students will lead to better prognoses for not only burgeoning physicians but for their patients.

MY MEDICAL SCHOOL INTERVIEWS

HOW BOB DYLAN HELPED ME GET INTO MED SCHOOL

Applying to medical school is a long, arduous, complicated, and expensive process. Throughout undergrad, I constantly analyzed every choice I made–what courses “look good” on those sheets of paper submitted to medical schools, what community service activities or leadership roles would the admissions committee “want to see” more than others. I did this too often. 

And I regret it. I regret not taking that journalism class or that anthropology elective. Or that sociology lecture or that political science group discussion. Or joining that art club or swim group. Or taking the time to rally with other students around a political issue or campaign for a non-medical-related cause. The list could make a book. If it didn’t link directly or somehow creatively indirectly with medicine I probably didn’t do it–but I should have. I locked myself into a medical crate and quasi-permanently chained myself to a professional pole, without even once remotely realizing I had limited myself in, what now seems, an irrevocable way.


I did deviate a few times; there were a couple instances in which I did leap over this subconsciously constructed mental gate, but these deviations were mostly during my Freshman and Sophomore years when I had that wiggle room and not that load that comes with the looming deadline to dominate the MCAT. I took a human rights class. I loved it so I took a legal studies class next. But there wasn’t–or didn’t seem to be–enough time to be a legal humanitarian and a pre-med student so that was the end of my short-lived legal career. I took a philosophy course and loved it–but the concept that the inanimate objects around us might not actually exist conflicted too much with the “facts” I was learning in Physics. So, again, at some non-existent academic fork in the road, I chose science once more. I did stick with French for a year–until the course requirements to major in molecular biology, and their available time slots, barred me from continuing the only 5 unit class on campus, since all foreign language classes required an hour-long commitment at the same time every Monday through Friday. Whenever I tried to “explore” other realms of thought there was an inherent conflict during enrollment that forced me to choose: science or these other electives that might not take me anywhere professionally.

Same went for volunteering or leadership positions. No medical school wanted to admit a politician or columnist, did they? Not unless the columnist zeroed in on discussions based only on current healthcare issues, I thought. So I chose science time and time again, although sometimes I decided to swim upstream toward something that interested me instead of leisurely floating downstream in a scientifically inflated raft.


I diverged from the “perfect medical school application” stream in one significant way. I tangentially decided to found and instruct an English Department-sponsored course on the music and lyrics of Bob Dylan and their influence on American history, society, and culture. But I didn’t decide to do this in some conscious rebellion against my predetermined professional fate to become a doctor. I did it because it confused and infuriated me that there was a class on the Beatles and Pink Floyd but not Bob Dylan–how fucking ridiculous. How could there not be a class on Bob Dylan at fucking UC Berkeley of all places? Brown had a class and so did Columbia. But not Berkeley? Well then I was going to start one.


So I spent an entire summer re-reading every Bob Dylan book I owned, every interview with Dylan since 1961, every article about him I could find. And eventually compiled a class reader–it was thick–and course curriculum that spanned Dylan’s 50 year career that continued to dominate any contemporary band’s weak attempts at music, in my opinion. It took me all fucking summer and swallowed up all the time I wasn’t spending trying to wrap my head around biochemistry; I had wanted to get that difficult biochem class out of the way since I had heard it was much easier to get an A in this challenging pre-med pre-req when burnt-out professors just didn’t give two shits in the summer.

The final stamp of approval, before I submitted my curriculum draft to the meticulous eyes of the English Department, had to come from Greil Marcus. Per Wikipedia, “Greil Marcus (born June 19, 1945) is an American author, music journalist and cultural critic. He is notable for producing scholarly and literary essays that place rock music in a broader framework of culture and politics than is customary in pop music journalism.” He was a professor at Berkeley at the time and is still the leading Bob Dylan expert in the country. He’s written two books on Dylan and has even presented an award to Dylan in person.HAD TO meet Marcus and I wanted his approval. So we met at Caffe Strada and he told me his story. Marcus was the first Records Editor at Rolling Stone Magazine. Jann Wenner–the founder of Rolling Stone Magazine–was Marcus’s best friend–still is–and roommate when they were both Berkeley students years back. He shared so many immersive stories, I never wanted to leave that table at Strada. He told me the trouble him and Jann used to get into at Berkeley. How after he gave Dylan an award, he asked if Dylan had read his biography on him, how Dylan had said he did but “he got a few things wrong and should write another one.” So Marcus did. And when he did he sent Dylan’s manager a note, asking for a quote from Bobby. He got a letter back from Dylan’s manager: “Bob doesn’t have anything to add. He said: ‘you know more about his life than he does.'” I couldn’t believe who I was sitting across from but in the end what mattered most was Marcus’s approval. And after two tense silent minutes of anxiously sipping coffee across from my one direct link to Dylan, while Greil read over my curriculum and flipped through my reader, He finally spoke. He smiled and chuckled. And nodded in agreement. “I think Dylan would approve.” That was good enough for me.

loved creating that class out of thin air. I had decided I would abide by Dylan’s own rules and respect his spiteful remarks over the course of five decades and center the class around individual interpretation rather than on trying to “pigeon-hole”–in Dylan’s words–Dylan and his impact on music and society at large. Fortunately for me, Greil and the English Department agreed with my thoughts. And a Berkeley English professor who typically lectured on American literary culture decided to sponsor my initiative. I recruited my friend Natasha to help in the course’s actual execution and while we knew the class would be popular we didn’t anticipate how many other students wanted a class on Bob Dylan as well.

Initially, we had pitched the class to the English Department as a 2-unit upper division course with around 75 students enrolled. Instead, over 100 signed up and we thought “what the hell” and capped the class at 110 students. So 110 students showed up to an auditorium in the School of Journalism building once a week for 4 hours. It was awesome. After one particularly loud lecture, a professor at the School of Journalism actually burst in and threw a tantrum, threatening to report us to the school. We won that argument and received a signed email of apology a week later.

We hosted guest speakers I didn’t even initially imagine we’d be able to enlist–including THE Ben Fong-Torres. That’s right. Ben Fong-Fucking-Torres. Same Ben Fong-Torres you might’ve seen portrayed in the film Almost Famous. “Hello, this is Ben Fong-Torres calling from Rolling Stone Magazine. Is this William Miller?” THE former fucking editor of Rolling Stone Magazine, editor of Rolling Stone when it was in its glory days of the late 1960’s and early 1970’s. THAT SAME BEN FONG-TORRES. I still have him saved as a contact in my phone–just in case. I’ve always been concerned that I might make the poor decision to dial him early one morning after too many vodka sodas and an intoxicated run-in with other Dylan enthusiasts at a bar. But I haven’t–yet at least.


It was a fantastic experience and I’ve never regretted it. When I applied to medical school I, of course, included it in my application under “Leadership Experience,” but I mostly wrote it off as just another piece of cotton in my application–something to fluff up the pillow a bit. A little “off topic” but “hmm..interesting. I don’t think we have another Bob Dylan enthusiast in our applicant pool,” I hoped one admissions committee member would think to themselves when perusing the final submission of my every decision over the course of 4 years.

But it ended up not being just a minor application plumper. It actually was the one thing every single medical school asked me during that significant final step in getting into an MD program: The Interview.

At all five institutions that invited me to fly to their school–on my dime by the way–to put the final stamp on that envelope and mail it in to receive my MD, asked me about this class I had started–why had I started it? Did I enjoy teaching it? When did I first start listening to Dylan? Wasn’t I a bit young to be a Dylan fan? The interview would suddenly take an informal and cheerful turn and there was often several moments of shared laughter and mutual agreement between the interviewer and myself. All of them, not surprisingly (you’d have to be a fucking idiot not to and what are the odds that a high-up member of the staff at a top medical school in the US was entirely intellectually limited) were Dylan fans.

It ended up not being just a talking point but a way for me to take off that constricting conservative blazer and for the interviewer to shed the formality of his or her white coat and for us to, metaphorically, share a joint while enjoying some Dylan music as two human beings with a shared interest. Suddenly the situation would turn from some aging MD asking me routine questions to me sitting with someone who I just realized was a Dylan fan too and discussing which Dylan song was our favorite, as if over glasses of beer at a dive bar. It provided much needed comedic relief to the coldness that had moments before held the conversation in an uncomfortably stiff grip.


I wish, not just for that reason, that I had deviated from that typical pre-med student path more often. I wish that I had taken more varied courses, in a broader range of Berkeley academic departments. Because now, when I’ve finally closed that door on being a “fucking doctor” instead of some “fucking writer,” as my father would say, most of my experiences have only been medical-related. I should have spent more time exploring the different paths that were so opportunistically right in front of my eyes. This is one of the unavoidable faults of medicine; we admit students who lack the varied experiences that are often so important in being able to relate to others–specifically patients. I was blinded by the idea of becoming an MD and I let it consume most of the best four years of my life. College is the best four years of anyone’s life and you should appreciate every second of it without blinders on.


But I did start that Bob Dylan class. And with that deviation and experience came some of the most awesome memories of my life thus far. I actually think I’m prouder of starting that class than I am of getting into medical school.


Strange, isn’t it? How some minor decision can alter life in such a major way and leave an impressive imprint on your future?

In the end, when you’re on your deathbed, will you remember the names of every MD who ever treated you? Who added those days to your life? Probably not. Instead, you’ll most likely revive the names of every friend who made each of those days worth it. Because, we’ll “meet them all again on the long journey to the middle.”


“I always tell the girls never take it seriously. If you never take it seriously, you never get hurt. If you never get hurt, you always have fun. And if you ever get lonely, you can just go to the record store and visit your friends.”

STRANGER THINGS: THE MONTAUK PROJECT AND MKULTRA 

THE SCIENTIFICALLY STRANGE HISTORY BEHIND NETFLIX’S HIT SHOW

If you haven’t already binge-watched, with reproachfully debasing interruptions from Netflix (“are you still watching?” Your reflection glaring back at you in disappointment,) the cult phenomena that is Stranger Things, you should set aside an hour–or 10–to begin Season 1 of the series before your friends begin discussion of Season 2 over draft beers. For starters, because it’s inexplicably addicting even if you aren’t a sci-fi fan. And secondly because it’s deeply rooted in conspiracist-propagated “true” events that supposedly began in the early 1980’s. I won’t include any spoilers but will delve into the show’s inspiration and foundation: the Montauk Project. In fact, writers pitched the show under the working title “MONTAUK.” But what’s eerier is the show’s mirroring of actual government sanctioned experiments that occurred over the course of several decades: the CIA’s implementation of MKUltra. It’s probably even stranger.

Prepare yourself because both stories–if true–are disturbing, wholly unethical to be modest, and makes you think “fuck if this happened then was 9/11 really a conspiracy theory? Oh fuck what about JFK?” You might consider packing a small lightweight suitcase, putting it under your bed, and carrying your passport in your wallet from now on “just in case.” Then you’ll probably start applying tape over your MacBook’s camera while jacking off to porn and unscrewing all your lightbulbs and demantling your iPhone to search for tiny wiretaps too (OK one spoiler–sorry.) But before you walk yourself into paranoia and a diagnosis of psychosis just yet, take a Xanax (just kidding…but really you should consider getting some) and read on.

The first is another story not unlike Area 51, involving space aliens and outrageous experimentation–all performed on a U.S. military base.

The second details experimentation on human subjects without their consent, government cover-ups, and disappearing documents.

So let me open your curiosity door and let’s learn a little about “Papa”…


THE MONTAUK PROJECT 

The Montauk Project was an alleged series of covert United States government projects conducted at Camp Hero or Montauk Air Force Station located on Montauk, Long Island. The project’s purpose was, purportedly, to develop psychological warfare techniques and conduct “exotic” research, including exploring the concept of time travel. Believers say that people were kidnapped at said U.S. Air Force base and subjected to mind control and time travel experiments. And extraterrestrials all actively participated in it.

Clearly nobody has been able to actually prove these allegations and all that’s left of this “Montauk facility,” which is now a state park, are the above-ground remnants of the original Air Force base. According to a document issued by the Air Force Historical Studies office, the Montauk base, then known as Camp Hero, was decommissioned in the early 1980s.

The quaint town of Montauk is a small seaside resort community on the tip of Long Island that draws vacationers to its shores every year. Camp Hero, located a short distance outside of Montauk, has origina as far back as the Revolutionary War, during which it was used to test military cannons. Later, during World War II, Camp Hero operated as a coastal defense installation against any possible Nazi intrusions into America.


Three men, Alfred Bielek, Stewart Swerdlow and Preston Nichols, claim that Camp Hero instead ended up as an underground site for the execution of scientific atrocities and unethical medical experimentation.


Bielek, a retired electrical engineer, maintains he was part of the mysterious Philadelphia Experiment, where in 1943, the U.S. Navy reportedly attempted to assemble a small destroyer undetectable to radar. The test ended in disastrous results, including the ship vanishing from the Philadelphia Navy yard and — “allegedly”– traveling through time.

According to Bielek’s story, he was uprooted, abducted, from Philadelphia, and transported ahead in time. He claims extraterrestrials were responsible for the technology used in this so-called Philadelphia Experiment. He also affirms he was recruited in 1970 to work on mind control and time travel projects at Montauk Facility.


Swerdlow’s story involves being kidnapped as a teenager from his Long Island, N.Y., home, taken to the Montauk base, and subjected to a variety of experiments.
Swerdlow recalls being subjected to horrific experimentation while at the Montauk facility.

“Beatings, a lot of torture, electrical shock, burials, near-drownings,” Swerdlow asserts. “They’d bring you to the point of death, and then they would save you, and the person doing this would be your rescuer or god, and would say, ‘I’m the one that saved you and remember that.’ And that became your handler — your programmer.”

He insists, “The walls were very damp, oozing water, so it appeared to be deep underground or even underwater. I was always on this cold, hard table. Sometimes there’d be other people around, either my age or older, and electrodes were put into me and injections.”


All three men profess to have seen first-hand extraterrestrials while employed at the underground Camp Hero facility.

“Well, there were quite a number of aliens at Montauk,” asserts Bielek. “Some were there on a semi-permanent basis. A lot of them were just visitors that came in and looked at what they wanted to see and went back home. There were little grays there, which I suspected were degenerated humans from out of the future. Large gray aliens (which are a different species) were also at Montauk, and they were highly intelligent.”


Nichols, like Bielek, was an electrical engineer at the time. He says he worked with Bielek in the mind control and psychic aspects of the Montauk Project.

“There were definitely alien beings at Montauk,” Nichols claims. “We had the little grays and the larger grays as well as a variety of reptilian beings. The large grays didn’t want anything to do with me because they couldn’t reach me telepathically. When I entered a room they would leave. They were the strangest thing that I ever saw. At that point, I was beginning to doubt my own sanity.”

And Swerdlow also avows an alien presence at Montauk: “Most of the time my interaction was with human beings, but I did come into close contact with alien beings. I did see, occasionally, intelligent reptilian humanoid beings as well as gray aliens who were once human beings but were physically altered as a result of degeneration and radiation toxins in their system. Most of them communicated with mental telepathy.”


In addition to igniting the flame that is Stranger Things, the myths, or realities, of Montauk Facility have also served as a basis for an upcoming film, “Montauk Chronicles,” written by Christopher Garetano.

Garetano shot much of his project at the actual site of Camp Hero.

“When you walk through the area now, you see this giant, imposing radar tower that still stands,” Garetano told AOL Weird News. “The park currently has strange regulations: You’re not supposed to use any radio equipment there and you are cautioned about unexploded ordnance. While filming my movie here, I couldn’t understand why people are allowed to walk around a park where there are still unexploded devices or why radio equipment isn’t allowed if the radar tower is now defunct and the entire base is completely non-operational.”


That question may be answered by a brochure issued in 2001 for visitors to Camp Hero. It includes a section called Unexploded Ordnance (UXO) Warnings: “Please follow the following steps if you think you have come across Unexploded Ordnance:”

  • Never transmit radio frequencies (walkie talkies, citizen’s band radio) near UXO.
  • Never attempt to touch, move or disturb UXO.
  • Avoid any area where UXO is located.

Garetano has pondered the ordinance’s bizarre warnings, stating it’s “strange that they don’t want you to use radio devices that may set off unexploded bombs, yet they allow the public to walk around a potentially high danger area!”

In addition to the enormous, looming, abandoned radar tower at the Camp Hero site, there are also giant doors, or bunkers, cemented and sealed into the side of various hills dotting the forest area. Also strewn throughout the wooded park are numerous apparatuses that appear to be above-ground manhole covers.

“These are entrances that obviously go down into something,” Garetano stated in the interview. “There are claims from people that these are entrances to underground tunnel systems that ran beneath the military base that allegedly would take you to the true entrance of the facility.”


Among the unusual reports included in the assertions made by the individuals who insist their experience of the Montauk events is a device they called “The Montauk Chair.” According to these alleged participants, a powerful psychic would sit in this specified chair and could then inexplicably materialize objects out of thin air and transform them into physical reality.


After spending countless hours with the men who are the subjects of his film, Garetano says he didn’t always believe their stories and suppositions.

“At first I didn’t. These men have not benefited financially — they didn’t gain anything from this. And they’ve endured ridicule as they maintain their story,” Garetano said.


As for Netflix’s hit show Stranger Things, the creators were inspired by the repressed memories of those who survived the Montauk horrors:

“Described as a love letter to the ’80s classics that captivated a generation, the series is set in 1980 Montauk, Long Island, where a young boy vanishes into thin air. As friends, family and local police search for answers, they are drawn into an extraordinary mystery involving top-secret government experiments, terrifying supernatural forces and one very strange little girl.”

An article published by Thrillist highlights a man named Preston Nichols, who also claims to have memories of being involved in the experiment known as the “Montauk Chair,” which, as I mentioned before, purportedly manifested the ability to initiate and amplify psychic powers.

An excerpt from Nichols’ book “The Montauk Project: Experiments in Time” describes one specific experiment he experienced at the facility:

“The first experiment was called ‘The Seeing Eye.’ With a lock of person’s hair or other appropriate object in his hand, Duncan [Cameron, supposed psychic] could concentrate on the person and be able to see as if he was seeing through their eyes, hearing through their ears, and feeling through their body. He could actually see through other people anywhere on the planet.”

Sound familiar? Do any esoteric mental images come to mind? Maybe an Upside Down portal?

And in this excerpt from Nichols’ book he writes how Duncan summoned a monster while on the chair:

“We finally decided we’d had enough of the whole experiment. The contingency program was activated by someone approaching Duncan while he was in the chair and simply whispering ‘The time is now.’ At this moment, he let loose a monster from his subconscious. And the transmitter actually portrayed a hairy monster. It was big, hairy, hungry and nasty. But it didn’t appear underground in the null point. It showed up somewhere on the base. It would eat anything it could find. And it smashed everything in sight. Several different people saw it, but almost everyone described a different beast.”

MKULTRA

The series Stranger Things also echoes another governmental project–this one indubitably somewhat legitimate, although details vary–known as Project MK-ULTRA, the CIA’s secretive, illegal program. Throughout its operation, the government carried out scientific research on human subjects. During the Cold War, the CIA subjected ill-informed patients to experiments with drugs, most notoriously LSD. Some argue the program was for the sole purpose of mind control.

Project MKUltra, also referred to as the CIA Mind Control Program, was the code name given to a program and implementation of experiments performed–at times illegally–on human subjects. The program was designed and enforced by the United States Central Intelligence Agency. The intention of these experiments on humans was to identify and develop drugs and procedures for use during interrogations and torture, so as to weaken the victim to force confessions through “mind control.”


The project began in the early 1950’s and was officially sanctioned in 1953. It was subsequently reduced in scope in 1964, further curtailed in 1967, and officially halted in 1973. The program engaged in an extraordinary number of illegal activities, including the use of unwitting U.S. and Canadian citizens as test subjects, which obviously led to widespread controversy regarding the project’s legitimacy.

MKUltra employed numerous methodologies to manipulate people’s mental states and alter brain functions: the surreptitious administration of drugs (especially LSD) and other chemicals, hypnosis, sensory deprivation, isolation and verbal abuse, as well as other forms of psychological torture.


The scope of Project MKUltra was notably broad, with research performed at 80 institutions, including 44 colleges and universities, and even at multiple hospitals, prisons, and pharmaceutical companies. The CIA operated through these institutions using front organizations. Yet top officials at these institutions were oftentimes aware of the CIA’s involvement. As the US Supreme Court later noted in CIA v. Sims 471 U.S. 159 (1985) MKULTRA was concerned with:

“The research and development of chemical, biological, and radiological materials capable of employment in clandestine operations to control human behavior.”

The program consisted of 149 subprojects, which the Agency contracted out to various universities, research foundations, and other similar institutions. At least 80 institutions and 185 private researchers participated and because the Agency funded MKUltra indirectly, many of the participating individuals were unaware that they were under the direction of the CIA.

Despite the Supreme Court ultimately upholding the CIA’s insistence that sources’ names could be redacted for their protection, it nonetheless validated the existence of MKULTRA to be used in future court cases and confirmed that for 14 years the CIA performed clandestine experiments on humans to study human behavior.


So, between 1953 and 1966, the CIA financed a wide-ranging project, code-named MKULTRA, which was concerned specifically with the research and development of chemical, biological, and radiological materials. These materials were to be utilized in clandestine operations to control human behavior but the existence of Project MKUltra wasn’t brought to public attention until 1975 when the Church Committee of the U.S. Congress, and a Gerald Ford commission began investigating CIA activities within the United States.

Investigative efforts were, however, hampered by the fact that, in 1973, CIA Director Richard Helms ordered all MKUltra files destroyed. As a result, the Church Committee and Rockefeller Commission investigations were forced to rely exclusively on the sworn testimony of direct participants and on the relatively small number of documents that survived Helms’ order that all evidence of MKUltra’s existence be destroyed.


In 1977, a Freedom of Information Act request uncovered a cache of 20,000 documents relating to project MKUltra, leading to Senate hearings in the last few months of the year. Interestingly, in July 2001, some surviving information regarding MKUltra was finally declassified.

As mentioned previously, 44 American universities, 15 research foundations or chemical or pharmaceutical companies, 12 hospitals or clinics, and three prisons are known to have participated in the project that was MKUltra.


In case you were wondering the origins of the project’s intentionally obscure CIA cryptonym. MKUltra is made up of the digraph MK, meaning the project was sponsored by the agency’s Technical Services Staff,) followed by the word Ultra (which previously had been used to designate the uttermost secret classification of World War II intelligence.)


Headed by Sidney Gottlieb, the MKUltra project began on April 13, 1953, on the order of CIA director Allen Welsh Dulles. Its aim was to develop mind-controlling drugs for use against the Soviets, largely in response to alleged Soviet, Chinese, and North Korean use of mind control techniques on U.S. prisoners of war in Korea. The CIA thought the methods were novel ones and hoped to use similar techniques on their own captives. The CIA was also interested in developing the capacity to manipulate foreign leaders with such techniques and would later invent profuse schemes in order to intoxicate and mentally override Fidel Castro.

Experiments were too often conducted without the subjects’ knowledge or consent. Further, many academic researchers who were funded through grants from the CIA’s front organizations were unaware of the manipulative purposes of their work.


The project’s quintessential goal was to produce the ideal “truth drug” to use during the interrogations of suspected Soviet spies during the Cold War. However, the program’s intentions generalized to explore any other possibilities of human mind control.

Because most MKUltra records were deliberately destroyed in 1973 by order of then CIA director Richard Helms, it has been difficult, if not impossible, for investigators to gain a thorough and definitive understanding of the more than 150 individually funded research sub-projects sponsored by MKUltra and other related CIA programs.


Returning to the project’s birth, MKUltra materialized during a period of, what Rupert Cornwell described as, “paranoia” within the CIA; the U.S. had lost its nuclear monopoly and fear of Communism was at its height. James Jesus Angleton, head of CIA counter-intelligence, postulated that the organization’s protective shell had been infiltrated by a mole at the highest level.

So, the CIA poured millions of dollars into studies examining methods of manipulating and controlling the mind to enhance their ability to extract information from resistant subjects during interrogation.


One 1955 MKUltra document gives an indication of the size and range of the effort; this document refers to the study of an assortment of mind-altering substances described as follows:

  1. Substances which will promote illogical thinking and impulsiveness to the point where the recipient would be discredited in public.
  2. Substances which increase the efficiency of mentation and perception.
  3. Materials which will cause the victim to age faster/slower in maturity.
  4. Materials which will promote the intoxicating effect of alcohol.
  5. Materials which will produce the signs and symptoms of recognized diseases in a reversible way so that they may be used for malingering, etc.
  6. Materials which will cause temporary/permanent brain damage and loss of memory.
  7. Substances which will enhance the ability of individuals to withstand privation, torture and coercion during interrogation and so-called “brain-washing”.
  8. Materials and physical methods which will produce amnesia for events preceding and during their use.
  9. Physical methods of producing shock and confusion over extended periods of time and capable of surreptitious use.
  10. Substances which produce physical disablement such as paralysis of the legs, acute anemia, etc.
  11. Substances which will produce a chemical that can cause blisters.
  12. Substances which alter personality structure in such a way that the tendency of the recipient to become dependent upon another person is enhanced.
  13. A material which will cause mental confusion of such a type that the individual under its influence will find it difficult to maintain a fabrication under questioning.
  14. Substances which will lower the ambition and general working efficiency of men when administered in undetectable amounts.
  15. Substances which promote weakness or distortion of the eyesight or hearing faculties, preferably without permanent effects.
  16. A knockout pill which can surreptitiously be administered in drinks, food, cigarettes, as an aerosol, etc., which will be safe to use, provide a maximum of amnesia, and be suitable for use by agent types on an ad hoc basis.
  17. A material which can be surreptitiously administered by the above routes and which in very small amounts will make it impossible for a person to perform physical activity.

CIA documents indicate that “chemical, biological and radiological” methods were investigated for the purpose of mind control by MKUltra . An estimated $10 million USD (roughly $87.5 million adjusted for inflation) or more was spent in total.


LSD

Early CIA efforts focused on LSD9/589, which later came to dominate many of MKUltra’s programs. The CIA aimed to investigate whether or not they could make Soviet spies defect against their will and whether the Soviets could do the same to the CIA’s own operatives.

Once Project MKUltra officially commenced in April 1953, experiments included administering LSD to mentally ill patients, prisoners, drug addicts and prostitutes, or as one agency officer put it simply, “people who could not fight back.”

LSD, among other drugs, was usually administered without the subject’s knowledge or informed consent, an explicit violation of the Nuremberg Code (a code drafted to establish international human rights laws and signed by the US.)

The aim of administering such medications was to discover drugs which would irresistibly evoke deeply seated confessions or wipe a subject’s mind clean–deleting unwanted information–and subsequently re-programming the individual as “a robot agent.”

Some subjects’ participation was in fact consensual but in these cases they were specifically singled out for even more extreme experiments. In one case, seven volunteers in Kentucky were given LSD for 77 consecutive days.


Eventually, LSD was dismissed by MKUltra’s researchers as too “unpredictable” in its results. They gave up the notion that LSD was “the secret that was going to unlock the universe.” Nevertheless, the drug still remained within the CIA’s arsenal of potential interrogative methods of operation.


By 1962 the CIA and the army had developed a series of “super hallucinogens,” including the highly touted BZ which was thought to hold greater promise as a mind control weapon. This resulted in many academics and private researchers withdrawing their support and ultimately LSD research became less of a priority altogether.


HYPNOSIS

Declassified MKUltra documents prove that hypnosis was studied as  early as the 1950’s. Experimental goals included: the creation of “hypnotically induced anxieties,” “hypnotically increasing ability to learn and recall complex written matter,” investigating hypnosis and polygraph examinations, “hypnotically increasing ability to observe and recall complex arrangements of physical objects,” and studying the “relationship of personality to susceptibility to hypnosis.”

Experiments were conducted with drug induced hypnosis and with anterograde and retrograde amnesia while under the influence of such drugs.


DEATHS

Given the CIA’s purposeful destruction of most records, its failure to follow informed consent protocols with thousands of participants, the uncontrolled nature of the experiments, and the total lack of follow-up data, the exhaustive impact of MKUltra’s experimentations on human subjects, including resultant deaths, may never be known.

However some deaths associated with involvement in Project MKUltra’s experimental process have been reported. The most notable case is that of Frank Olson.

Olson, a United States Army biochemist and biological weapons researcher, was given LSD without his knowledge or consent in November, 1953, as part of a CIA experiment. One week later, while still under the influence of LSD, Olson committed suicide by leaping out of a window.

The CIA physician who was assigned to monitor Olson during these “trips” claimed to have been asleep in another bed in a New York City hotel room when Olson exited the window and fell thirteen stories to his death.

In 1953, Olson’s death was declared a suicide following a severe psychotic episode. The CIA’s own internal investigation concluded that the head of MKUltra, CIA chemist Sidney Gottlieb, had conducted the LSD experiment with Olson’s prior knowledge, despite the other men taking part in the experiment later asserting that they had not been informed as to the exact nature of the drug until approximately 20 minutes after its ingestion. The report further suggested that Gottlieb was nonetheless due a reprimand, as he had failed to take into account Olson’s previously diagnosed suicidal tendencies, which clearly might have been exacerbated by the administration of LSD to Mr. Olson.


The Olson family disputes the official version of events. They maintain that Frank Olson was murdered. According to their statements, Olson had become a security risk and was eliminated out of fear he might divulge state secrets associated with highly classified CIA programs, about many of which he had direct personal knowledge.

A few days before his death, Frank Olson quit his position as acting chief of the Special Operations Division at Detrick, Maryland (later Fort Detrick) because of a severe moral crisis concerning the nature of his biological weapons research. Among Olson’s concerns were the development of assassination materials used by the CIA. The CIA’s use of biological warfare materials in covert operations, experimentation with biological weapons in populated areas, collaboration with former Nazi scientists under Operation Paperclip, LSD mind-control research, and the use of psychoactive drugs during “terminal” interrogations under a program code-named Project ARTICHOKE.

Further, ensuing forensic evidence conflicted with the official version of events; when Olson’s body was exhumed in 1994, cranial injuries indicated that Olson had been knocked unconscious before exiting the window. The medical examiner subsequently declared Olson’s death a “homicide.”

In 1975, Olson’s family received a $750,000 settlement from the U.S. government and formal apologies from President Gerald Ford and CIA Director William Colby, though their apologies were limited to informed consent issues concerning Olson’s ingestion of LSD.

On 28 November 2012, the Olson family filed suit against the U.S. federal government for the wrongful death of Frank Olson.

A 2010 book by H. P. Albarelli Jr. alleged that the 1951 Pont-Saint-Esprit mass poisoning was part of MKDELTA, that Olson was involved in that event, and that he was eventually murdered by the CIA. However, academic sources attribute the incident to ergot poisoning through a local baker.


MKULTRA AND INFORMED CONSENT 

The revelations about the CIA and the Army prompted a number of subjects or their survivors to file lawsuits against the federal government for conducting experiments without the explicit consent of its subjects, which is required in all medical practice. Although the government aggressively, and sometimes successfully, sought to avoid legal liability, several plaintiffs did receive compensation through court order, out-of-court settlement, or acts of Congress. As previously mentioned, Frank Olson’s family received $750,000 by a special act of Congress, and both President Ford and CIA director William Colby met with Olson’s family to apologize publicly.

Previously, the CIA and the Army actively and successfully sought to withhold incriminating information regarding MKUltra, even whilst secretly providing compensation to the families.


The medical trials at Nuremberg in 1947 deeply impressed upon the world that experimentation with unknowing human subjects is morally and legally unacceptable. The United States Military Tribunal established the Nuremberg Code as a standard against which to judge German scientists who experimented with human subjects. In defiance of this principle, military intelligence officials began surreptitiously testing chemical and biological materials, including LSD through Project MKUltra.

Justice Sandra Day O’Connor wrote:

“As Justice Brennan observes, the United States played an instrumental role in the criminal prosecution of Nazi officials who experimented with human subjects during the Second World War, and the standards that the Nuremberg Military Tribunals developed to judge the behavior of the defendants stated that the ‘voluntary consent of the human subject is absolutely essential … to satisfy moral, ethical, and legal concepts.’ If this principle is violated, the very least that society can do is to see that the victims are compensated, as best they can be, by the perpetrators.”

In separate posts I will discuss the significance of informed consent in medical practice and its development through historical, often atrocious, events.


THE AFTERMATH OF MKULTRA

At his retirement in 1972, Gottlieb dismissed his entire effort for the CIA’s MKUltra program as useless. Although the CIA insists that MKUltra-type experiments have been abandoned, some CIA observers, disturbingly, insist there is little reason to believe it does not continue to operate today under a different set of acronyms.

Victor Marchetti, author and 14-year CIA veteran, stated in various interviews that the CIA routinely conducted disinformation campaigns and that CIA mind control research has in fact continued to remain a governmental experiment. In a 1977 interview, Marchetti specifically called the CIA’s claim that MKUltra was abandoned a “cover story.”


BACK TO STRANGER THINGS

Despite the series’ clear reflection of two separate but not entirely dissimilar apparent events, although the disputed legitimacy of each vary, the creators of Stranger Things, Matt and Ross Duffer, have been strangely coy about any connection the show’s theme has to the Montauk Project (or any other potential government covert experimental operations.) Instead, they have only remarked that ditching the original “Montauk” title was “very painful.”


Sounds strange to me. Have stranger things occurred? Probably. But this is definitely one of the strangest. Scientifically speaking.

What else might be stranger? Winona Ryder and her facial expressions…but that’s off-topic.

WHY HAVING A MENTAL ILLNESS DOESN’T MAKE YOU “MENTAL”

ALONE IN A CROWDED WAITING ROOM

First, you’re not alone; and I don’t mean that in some bullshit condescending cliche way.

In fact not only are you not alone but you’re surrounded daily by others in similar emotional, social, financial, familial, professional states not unlike you’re own. You probably walk right by them in the mornings or sit next to them in traffic on the freeway.


Let’s begin with some statistics (remember this is a medical blog written by someone with a scientific, evidence-based mindset—who can also put sentences together. Plus statistics help put complicated issues into perspective) then I’ll share my own personal struggles that might alleviate any pain you yourself might be struggling with. Even if you’ve been fortunate enough to have never personally experienced depression or crippling anxiety or panic attacks or thought-racing or impulsivity or relationship issues, you should know how fortunate you are and you SHOULD educate yourself about mental illness and develop empathy and compassion for those who have struggled with mental paralysis.

Also know that if you are struggling mentally, psychiatrically, this doesn’t place you at the bottom of the totem pole. Some of the mostly successful members of society—leaders, parents, politicians, entrepreneurs, doctors, lawyers, business owners, teachers—suffer daily from some form of mental illness. But it doesn’t have to define you. Just as Diabetes Mellitus Type I doesn’t define someone who needs Insulin daily.


OK so the statistics: Mental Health in Numbers.

First, 43.8 million adults experience mental illness each year. This means:

  • 1 in 5 American adults struggle with mental illness annually
  • 1 in 25 (nearly 10 million people) adults in America live with a serious mental illness

Prevalence by diagnosis:

  • 1 in 100 (2.4 million) adults in the US suffer from schizophrenia
  • 6.1 million adults in America (2.6%) live with bipolar disorder
  • 16 million American adults live with major depression–this represents 6.9% of the population
  • 42 million adults in the US (18.1% of all US adults) battle anxiety disorders daily

These numbers are significant. What are the consequences and impact of this high prevalence of adults struggling with mental illness?

  • #1: Depression is the leading cause of disability worldwide, and is a major contributor to the global burden of disease.
  • -$193 BILLION: Serious mental illness costs America $193.2 BILLION in lost earnings each year.
  • 90%: percentage of those who die by suicide have an underlying mental illness.
  • #10: Suicide is the 10th leading cause of death in the United States.

Are these Americans being treated? What help are they receiving?

  • 60%: the percentage of Americans with a mental illness who DID NOT receive mental health services the previous year.

Why the stigma? Why are we isolating those already isolated? Fear? Disregard? Inability to relate? Using them as scapegoats? Projecting our own problems onto the most vulnerable individuals in our society? Confusion or miseducation about mental illness?

During medical school in my third year, on rounds, whether during my internal medicine rotation or my surgery rotation, I saw interns and residents recoil when we learned a patient with a mental illness had been admitted and assigned to our team. They often sighed and exchanged glances amongst each other. I get it–they aren’t psychiatrists. In these other specialties, physicians are not trained to deal with mental illness and, to them, it “gets in the way” of tackling the medical conditions that do fall within their realm of expertise. What I didn’t endorse or tolerate was the occasional laughter in the resident rooms or swapping of “crazy patient” stories. It bothered me. It bothered me because I’ve struggled with mental illness and my mother suffers from Borderline Personality Disorder. How dare you chuckle and take pleasure from someone else’s suffering. It infuriated me.


This should NOT stop you from seeking help. Again, this blog is a critique of the medical system, its shortcomings, what improvements should be made, and a blunt description of the reality of living in the medical world–what med students do and think, what residents do and think, etc.

You should reach out for help if you’re struggling with anything that is keeping you from becoming the best version of you. Or that’s how I convinced myself to get the help I needed. I felt I wasn’t living life, I was trapped, and I was missing out. I didn’t want to look back in 20 years and feel that life had passed me by because I was too afraid of what others thought of me.

There are physicians who will listen and do sincerely care; many aren’t just putting on a show during your visit and rolling their eyes and laughing when you leave. You just need to do the research. Find the psychiatrists who take the time to listen to you. They are out there.


The anxiety started in medical school during my first year. It came on so suddenly that it was like being hit by a giant wave you didn’t see coming, at night, when you’re waist-high in the ocean. Standardized Patient Examinations were every Friday. Basically, my medical school (and every other US medical school) hires actors and pays them to pretend to be patients afflicted with something we had learned about the previous week. The mock appointments took place in rooms that were set-up to look like your standard family practice examination room–with a table, a stool, a sink, cotton balls, the works. One caveat: in each room (there were about 10 of these pseudo-doctor rooms) a camera was positioned in the farthest corner of the room, opposite from the door you entered through to begin your theatrical performance. Behind these rooms was a larger room and in that room sat our professors, watching us through the cameras, watching us walk through a typical physician-patient “appointment.”

I didn’t see it this way. I saw the room as a stage, the camera as judgment, and knew there was an audience watching me through that camera waiting for me to fuck up, or critiquing my every word and movement, and on that second Friday of my first year I panicked. The standardized patient got out of character and, in addition to being surprisingly different in demeanor from the patient she was playing, helped me sit down on a plastic chair against the wall, my head down between my knees.

it was awful. I was shaking, my tongue went numb from hyperventilating, and all I could think about was that video camera and then then the thoughts of overwhelming embarrassment began to infect my mind. I felt like it would never end. The thoughts just kept racing: “what if this keeps going? What if they think I can’t be a doctor now? They are probably all watching. I fucked up. I’m screwed.” And the thoughts made the panic worse and I had to think of my favorite Bob Dylan song and tried to sing it in my head to distract the flood of thoughts that were keeping me paralyzed in that chair. Anything to “Ativan” the thoughts in my head.

With the help of a classmate who said, “don’t worry I was feeling the exact same way,” the panic dissipated, but slowly. I left the building as quickly as I could, my head down in shame, avoiding eye contact with everyone I passed. I wanted to get home, be alone, and cry. So I sped-walked home, re-playing what had happened over and over in my head like a tape recording, unlocked my apartment door, locked it, tossed my books on the couch then sat on the floor and cried for an hour.


All I could think about the entire rest of the evening, well into the night, the next morning, the next day, the next night was: this is going to happen again. And just as quickly as an intramuscular injection of epinephrine fuels the heart to the point of tachycardia (fast beating,) so did the anticipation of future panic attacks instigate their monstrous reappearance.


I later learned, through a psychiatrist and once I entered third year and completed my psychiatry rotation, that I was indeed not alone. What had happened to me happens to thousands of people everyday and is a classified disorder in DSM IV (and now V)–the Bible of psychiatry.

Panic Disorder. An anxiety disorder. DSM V is the system psychiatrists use to diagnose mental health disorders–basically the psychiatry rule book. Panic disorder–this type of anxiety disorder–is based primarily on the occurrence of panic attacks, which are recurrent and often unexpected. Further, at least one attack is followed by one month or more of the person fearing that they will have more attacks. This causes the victim to change his or her behavior, which often includes avoiding situations that might induce an attack.

Since panic attacks are key to a panic disorder diagnosis, they are specific and well defined for psychiatrists. This is where the updates in DSM-5 are significant. The previous version classified panic attacks into three categories: situationally bound/cued, situationally predisposed, or unexpected/uncued. DSM-5 has simplified it into two very clear categories: expected and unexpected panic attacks.

Expected panic attacks are those associated with a specific fear, like that of flying or spiders or clowns or birds. Unexpected panic attacks have no apparent trigger or cue, and may appear to occur out of the blue–great for me right?

According to DSM-5, a panic attack is characterized by four or more of the following symptoms:

  • Palpitations. In essence, a rapidly beating heart, which is what I had experienced.
  • Sweating
  • Trembling or shaking. Again, something else that incapacitated my body that day with the camera watching like Big Brother.
  • Shortness of breath or smothering. Yup that happened too.
  • A feeling of choking. That’s what it felt like when my tongue went numb.
  • Chest pain
  • Nausea or stomach pain
  • Dizziness or feeling like you might pass out. Check. That’s why I had to sit in that plastic chair, my body bent in half, my head below my knees.
  • Feelings of unreality (derealization) or being detached from oneself (depersonalization.) I’ll be honest, I don’t even know how you can classify that, it seems so subjective. But I definitely didn’t feel present in the moment; all I could think about were those cameras and everyone watching.
  • Fear of losing control or going crazy. I didn’t think I was going to go crazy. I just thought I was crazy.
  • Fear of dying. This is a big one. This is what a lot of people feel when they experience a panic attack. But I knew it was a panic attack. I knew I wasn’t going to die. I just didn’t know when it would end or if it would end.
  • Numbness or tingling sensations (paresthesias.) That too. My fingertips tingled and I couldn’t feel anything below my knees. Once the panic started to fade back into the shadows it felt like I had been walking on tiny little pinpricks, like walking on recently mowed grass.
  • Chills or hot flushes.

It’s important to note: the presence of fewer than four of the above symptoms may be considered a limited-symptom panic attack and agoraphobia (or social anxiety, which I’ll discuss in another post) now stands alone in a separate classification. I will share, though, that after I had experienced several panic attacks over the course of the few weeks following the initial attack I did develop agoraphobia. Who wouldn’t? I could never predict these attacks and the embarrassment that followed them made me want to hide in a darkened padded cell, locked from the inside and me with the key. After all, I was crazy. Wasn’t I? I must be.


What I went through to obtain treatment for these attacks was horrendous and only added to my anxiety. I did feel alone. No one–except that one classmate that one day–ever sympathized with me nor did any classmate ever open up to me about their struggles with mental illness (even when I found out secondhand or by a slip of their own tongue.) It was hush-hush. I felt like the only medical student in the world with panic disorder. But I later learned I wasn’t.


So the panic attacks turned into agoraphobia and they also congealed into depression. In future posts I will discuss the road I took to finding treatment and getting my panic attacks under control. I will also share with you the agoraphobia I experienced and, finally, the ever deepening, dark, cold, empty pit of depression I eventually fell in to and didn’t even want to find a way out of.


If you need help now, you probably already know the numbers to call. I’m going to spare you that pre-recorded sales pitch. But I will say: any reader can contact me anytime if you’d like to discuss anything you may be dealing with. You know the drill: “Menu” then “Contact Me.” There’s my email address: I’m always online. I’ll be the med school dropout non-MD consultant who will always listen.

HYPOCRISY AND THE HIPPOCRATIC OATH

MEDICAL ETHICS BY MEDICAL STUDENTS

Burgeoning young medical students, clad in pristinely starched, stiff, bleached white buttocks-length coats, almost blindingly white, clean lines from having just been unpacked from the manufacture from whence they came running the length of both sleeves, not a minuscule wrinkle to be found on the heavenly uniform, with either cursive embroidery identifying them by name while subliminally marking the area where the aorta of the heart bifurcates or, if you want to save $10, in place of embroidery hangs a neat rectangular with the same formality (but nevertheless locating like a pin on a cadaver the same important split of the heart’s main vessel,) all line up next to each other, their shoulders almost touching, looking like they are about to face a firing squad, on the first day of medical school orientation.

Looking back that’s exactly what we were doing: facing a firing squad. If we had been standing individually it would have been similar to waiting for the delivery of your sentence by the jury after a lengthy trial (or so I would imagine.) “We the jury find you worthy of attending our institution for $75,000 a year to become one of us, one of the best in the world, one of the top makers and leaders of society.” But first we had to take the oath. The Hippocratic Oath that all medical students must swear by during a ridiculously formal and large ceremony before even peaking at the inside of a textbook.


But those pristine white coats stood in stark contrast to the deeply aberrant and prejudiced views expressed by some of my former classmates over the course of the 3 years I endured medical school in Cincinnati.

It became apparent why medical schools took so much lecture time attempting to engender principles and an understanding of compassion, empathy, and human communication with patients: because many med students don’t know how to interact with others respectfully let alone “treat” patients as human beings not dissimilar to themselves. This realization seeded my brain during my first year and my experiences during the next two years led to a painful personal disillusionment and loss of faith in medicine.

And it all was rooted in disregard or inability to comprehend the obvious principles set forth in the Hippocratic Oath. To any compassionate human being, the Hippocratic Oath should be renamed “Common Sense.”


The Hippocratic Oath varies from medical school to medical school. Most medical schools set aside time for students to discuss among themselves which principles from the ancient text to discard and which to maintain. Then they re-write the Oath in their own words. The med school prints out the revised version in small booklets, hands them out to students, parents, and anyone else attending the celebrated White Coat Ceremony, and then instructs their students to read the modified Oath aloud and swear by it.

Below is an example of a modern-day Oath comprised of principles most med students in the US choose to keep. While the wording may vary, this is the gist of most Oaths in American medical schools:

I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.
I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University

Most important are the following two concepts the Oath mandates physicians to practice. These were constantly drilled into us with a bore.

  1. Non-Maleficence. Do no harm. Do not harm the patient or anyone else. I’d like to believe we are all born with this congenital principle. That it is our environment that causes us to deviate from this. But, either way–whether innate or acquired–this principle was definitely deeply implanted within my identity by age 5. I never had moral qualms with myself about whether or not I should harm someone else. I think for most people adherence to this concept comes naturally.
  2. Beneficence. Do good. Help others. Provide the best medical care possible to every patient. Again, I had no issues with this. In fact, isn’t this why we were all here in our starched white coats anyway? To help others? Did this even need to be pointed out to us?

The Hippocratic Oath. No one had even mentioned that this existed in medical schools–not my family practice physician father or my OB/GYN aunt. When I first read over the “principles” comprising the Oath my first thought was: really? You’re going to make us swear by these “rules” that are the most basic behavioral modes to interacting with other human beings respectfully? Like suddenly if one of us carried a skewed moral compass we’d freely walk off the stage, handing over our white coats to a faculty MD, and leave the auditorium in surprise that we were expected to treat others humanely. OF COURSE THESE PRINCIPLES SHOULD BE ADHERED TO. Again, what should this oath really be called? Common Sense. Is it that inconspicuous to anyone in my class to the extent that University of Cincinnati feels compelled to remind us all to be not just caring physicians but decent human beings? I guess that was the first Code Black I heard; but I buried my annoyance when it became apparent I was the only one annoyed.


I did challenge one of our professors about why so much time was being spent trying to teach us elementary behavior.

Why are we reciting this? Because it’s always been recited. Well how would just saying these words keep any future MD from doing the opposite? Well because they have to swear by it. So what? You think one of us will be confronted with a medical ethical dilemma and we will look up this set of guidelines in our notes and know immediately what the next course of action should be? No rational thinking involved? Well it’s just medical students have always been required to recite it. OK–I mean I see what the point was but I will say right away that I came to realize over the next three years that this “oath” was too frequently ignored and compliance was 50% at best. Guess it wasn’t common sense to some.


Historically, the Hippocratic Oath is one of the most widely known Greek medical texts. It is an oath taken by physicians spanning centuries. An oath requiring a new physician to swear, by a number of “healing gods” in the original Oath, to uphold specific ethical standards. Per Wikipedia, “The Oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today.”

The original version of the Hippocratic Oath contains some perplexing notions when read in modern-day contexts. In addition to requiring that physicians look to the Greek gods for guidance, “I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses,” it also asks doctors never to “give a woman a pessary to procure abortion,” and to abstain from euthanasia (“I will neither give a deadly drug to anybody who asked for it”). These 2,000-year-old statements are obviously omitted in modernized versions.


The Oath bothered me.

FIRST DO NO HARM. Pretty fucking obvious. Unless one of us was an undercover assassin who had used medical school as some lengthy, and inefficiently, roundabout, means of unleashing a mass casualty event, no shit. Why would we want to do harm to our patients. Well, it turns out “harm” is subjective. Very subjective. And while I interpreted this first principle as not violating the inherent rights of a patient, I soon learned many of my classmates held various different interpretations.

Actually, “Do No Harm” is not even found in the original oath but included as a rough translational interpretation. In its place are modernized oaths, which combine the idea of “do no harm” with vows to remember both the human beings on the other end of the stethoscope and their social, emotional, physical, and financial well-being when treating them.

SECOND, DO GOOD. This principle is a chimera, mirrored opposite, of the first: beneficence. Non-maleficence balanced by beneficence—or the promise to only promote the well-being of our patients. Again, seems pretty fucking straightforward.

“I will remember that I do not treat a fever chart, or a cancerous growth, but a sick human being,” medical students vow at the symbolic white coat ceremonies across the country, promising to practice ethically sound medicine as they embark on the journey towards MD. Anything confusing you yet?


I WANT TO BE CLEAR BEFORE I PROCEED: many, probably the majority, maybe 60% or 70%, do correctly interpret the oath and practice medicine according to its guidelines without conscious thought throughout long-lived careers. But not all. And for sure not enough of them.

The other issue is from the viewpoint of patients, most of whom have never heard of the Oath, let alone how it guides the medical treatment they receive. I feel they have a right to know these principles, especially given that too many physicians deviate from them.


So the lines are indeed not as distinct as I initially thought. They aren’t even minutely clear. They are a haze, a blur, and entangled in a confusing web of medical bureaucracy and industry and capitalism and politics and individual thought. The oath is like factually telling a child not to touch the stove without ever explaining how a stove works or what fire is or how it burns or what a burn is or how it sears the flesh and inflicts a persistent gnawing pain or, even to the extreme, can produce something called death. Just don’t touch it ok? Ok Mom.


That’s what medical school is at it’s core: a parental governing body to teach, instruct, mentor, guide, until its students are ready and prepared and equipped to leave the nest and cope with the ups and downs of life so as to successfully deal with it and survive.

BUT YOU CANNOT TEACH INDIVIDUALS WHO ARE 23, 24, 25 HOW TO BE ENGAGING, HUMBLE, THOUGHTFUL, SINCERE human beings. If they don’t already possess these traits, and most importantly consecrate them effortlessly, it’s absurd to expect them to. It’s not comparable to quizzing students on the jargon found in Netter’s Anatomy—ideas capable of being memorized and applied. These are deeply ingrained moral characteristics that are relatively permanent by the age of 18. It is rare for someone who was raised for 25 years to hold certain beliefs to suddenly disregard them in favor of a new set of taught ethical principles. Do you want your MD to continually refer to notes on how to interact with you or do you want his or her time to be spent researching any medical issues you may be experiencing?

There’s so much to learn in four short years (really two sets of distinctly different two years of absorbing then observing then trying independently.) There’s not much time to ensure everyone’s compass is pointing to True North before sending them out into the complex world of healthcare to lead and treat everyone else who never spend those years under a medical parenting unit. I guess this is how WebMD was born. A sense of distrust in the medical system and a lack of informative communication between patient and physician. Patients want that second opinion to reassure them that their provider’s moral and medical compass is indeed pointing to True North. But that’s a different subject for a different post.


Interestingly (to me at least,) a fraction of schools use an oath written by Lasagna (really.) “I will remember that there is art to medicine as well as science, and that warmth, sympathy and understanding may outweigh the surgeon’s knife or the chemist’s drug,” Lasagna’s oath reads. Lasagna’s version further calls on doctors to admit when they don’t know the answer; prevent diseases; and to take responsibility not just for the patient’s health, but for the way an illness affects a person’s “family and economic stability.” Heavy responsibility but that’s what the heavy paycheck is for right?

Lasagna…Hippocrates. Doesn’t really matter. The oaths are inherently the same.


An article published by the US News and World Report in May of this year urges medical students to practice some version of the Oath before they even graduate; wait, so the US News and World Report, as well as all med schools, expect us to be just, kind, rational, empathetic human beings? Mind-blowing ideas. Definitely the challenging and rigorous curriculum I was expecting from medical schools. The article goes on to remind students of 3 things:

1. Don’t be ashamed to say “I don’t know.” I don’t know, this seems like a pretty obvious expectation to have of medical students as well.

2. “Gladly share such knowledge as is mine with those who are to follow.” Ok doesn’t seem problematic.

3. “I will remember … that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.” The article states, “As a physician, you will swear to treat your patients with respect – respect for their privacy and respect for them as human beings. Your every interaction with patients, staff and colleagues requires mutual respect and consideration to create an optimal environment for health.” Further it explains, “Be more conscious of how you speak and interact with people in all walks of life. Use an on-campus job at the bookstore or dining hall as a learning lab, since people are routinely short on time and sometimes patience. Developing the ability to respond to uncivil behavior with compassionate behavior is an achievable skill that aids patient safety and quality of care.”

The last principle, from my personal medical school experience, is crucially lacking from the moral cores of many medical students. From discussions on how to treat Jehovah Witnesses who, based on their religion, object to blood transfusions (my response to this question on our Medical Ethics exam was that I would not force transfusion on the patient; when we had to discuss this in group meetings the following week I was shocked by the amount of students who said they would disregard the patients personal views in favor of imposing their own on the patient to guide their medical decisions,) to offhand comments made by my classmates (treating African Americans differently than Whites) revealed that this most crucial vow was the one most easily and frequently broken.


In future posts I will detail some of the successes and failures of practicing these essential medical principles that I witnessed while a medical student myself. I will discuss what I think the obstacles were and how these obstacles are prevalent in various subsets of the medical field. But, in short, I heard, witnessed, saw the highest levels of racism, prejudice, disregard of others’ religious views, narcissism, and selfishness from my med school class I’ve ever had the misfortune of experiencing from others within our modern-day society—it was shocking. I had never met individuals like this before.


To be fair, to this day, I can’t determine whether these views stemmed from where I went to medical school (Cincinnati—far from California where I was raised) or whether these were commonly held beliefs nationwide in American medical schools. Regardless, I was profoundly disillusioned and disturbed. I’m even more unsettled now by the fact that these former classmates of mine have graduated and are practicing MDs.


I INTEND NOT TO DENOUNCE MEDICAL SCHOOLS, including the one I attended. Rather I think it’s important that these deficiencies or failures on the part of too many medical students to understand THE PATIENT AS A HUMAN BEING should be discussed and addressed so the medical field can continue to improve and evolve and enroll students who have the innate ability to “tell right from wrong.” It’s not the medical school’s responsibility to correct the characters of its students. So let’s avoid further hypocrisies from occurring despite the insistence of the oath.


Many physicians refer to the Oath as the Hypocritic Oath.

“The original oath is redolent of a convenant, a solemn and binding treaty,” writes Dr. David Graham in an article from JAMA, the Journal of the American Medical Association, in December 2000. “By contrast, many modern oaths have a bland, generalized air of ‘best wishes’ about them, being near-meaningless formalities devoid of any influence on how medicine is truly practiced.”

Some physicians claim the “Hypocritic Oath” should be radically modified or abandoned altogether. I agree but only if we ensure these principles are still upheld by all medical students and physicians even if they aren’t being told outright to swear by them. How do we do this?


Medical schools should choose students who already know how to interact humanely with others and enroll these individuals to train as MDs. There are so many other issues within our modern day medical and healthcare systems that are crucial for medical students to discuss and learn about. American health insurance and national healthcare systems, abortion, euthanasia, global healthcare, human rights issues, how to detect if a patient is a victim of abuse or, in the extreme, human trafficking, mass shootings–these are all examples among an exhaustive list of contemporary medical issues that medical students should be expected to discuss and that test questions involving “Medical Ethics” should be composed of. Attempts aimed to transform self-involved students into empathetic human beings are attempts made in vain. You cannot teach a 25 year old how to be a decent human being.


Focusing on draining any stubbornly persistent abscesses afflicting a medical student’s integrity or core character is a waste of academic time and resources. It leads to ineffective, inattentive, indifferent physicians. A simple D&C will never drain students of deviant moral standards. Let’s discharge these students home without further expense wasted to remove these lesions and wish them the best in a career other than medicine.


[Stream of Consciousness]

Deflate-Gate: the Medical Field Versus the NFL

WHY THE MEDICAL COMMUNITY IS TRYING TO KICK THE NFL WHERE IT HURTS

CHRONIC TRAUMATIC ENCEPHALOPATHY: a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma (often athletes), including symptomatic concussions as well as asymptomatic subconcussive hits to the head that do not cause symptoms.

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THIS IS THE CASE AGAINST THE NFL:

Chronic Traumatic Encephalopathy is essentially a degenerative disease of the brain, just as dementia or Alzheimer’s Disease are diseases marked by brain degeneration. CTE, however, is diagnosed only after autopsy, mostly in brain sections of individuals with a history of multiple concussions or repetitive brain trauma, and not just a handful of blows to the head; patients must suffer hundreds or thousands of head impacts over the course of many years, whether playing contact sports or serving in the military. Also, this specific type of brain degeneration is found in the brains of individuals who have experienced, at some point in their lives, an acceleration and deceleration of the head on impact resulting in subsequent damage to axons (neurons or cells essential in information relay in the brain.) Think of a car accident and violent whiplash. Thus far, most reports have been from professional athletes–and not just football players. Ice hockey players and wrestlers have also been diagnosed with CTE  post-mortem (after death and upon autopsy examination.) Anyone else? Military veterans, individuals with a history of chronic seizures, and victims of domestic abuse have also been diagnosed with CTE after death (but of course the NFL and American football players are the main focus of the case for preventing CTE.)

Let me break this down for those who didn’t attend medical school or are confused by the medical jargon complicating documentaries (trust me I don’t blame you for being confused.) Upon autopsy, CTE is characterized by a reduction in the total weight of the brain (so loss of brain tissue just as a sponge shrinks without water.) One medical term to be familiar with is ATROPHY which is essentially what I described in the previous sentence: loss of brain tissue or matter. Atrophy is found in various forms of dementia and Alzheimer’s Disease. However, in CTE specifically, atrophy is found mostly in the areas of the brain that are instrumental in behavior, memory, speech, impulse control, emotions etc. You get the gist.

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This combination of photos provided by Boston University shows sections from a normal brain, left, and from the brain of former University of Texas football player Greg Ploetz, right, in stage IV of chronic traumatic encephalopathy. According to a report released on Tuesday, July 25, 2017 by the Journal of the American Medical Association, research on the brains of 202 former football players has confirmed what many feared in life _ evidence of chronic traumatic encephalopathy, or CTE, a devastating disease in nearly all the samples, from athletes in the NFL, college and even high school. (Dr. Ann McKee/BU via AP)

TAU PROTEIN: this is another medical term to remember. In layman’s terms, Tau protein is a specific type of protein identified by its structure and found only in a subset of brain disorders. Where the Tau protein is found, or deposited, within the brain is crucial: it helps differentiate one brain disorder from another. In CTE Tau protein is deposited in specific areas of the brain not found in other disorders. What does this all mean? It can’t be a coincidence that this protein is only found in certain areas of the brain in those who have suffered concussions or similar head injuries throughout their life. So, CTE is a definitive and unique brain disorder. Further, in CTE Tau proteins  form clumps that slowly spread throughout the brain, killing brain cells. While Tau proteins are seen in Alzheimer’s patients, they are not deposited in the same areas of the brain as those who have experienced head trauma (AKA in those with CTE.)

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Scientists use biomakers (basically a way to tag or highlight Tau proteins) to diagnose these patients after death. There is involvement of the individual’s immune system to these proteins resulting in auto-antibodies. You may or may not have learned or heard of antibodies at some point–whether it be in school or at the pharmacy or on TV or during one of your MD’s monotonous droning monologues. If not: antibodies are proteins that act as our main defense against infection. Think of them like our bodies’ soldiers who sit at base camp until told to get off their asses when there’s a threat of combat. Well, sometimes our bodies fuck up and produce antibodies that attack our own body, or proteins in our bodies, instead of fighting the enemies. This happens in CTE. These fighters attack our neurons (brain cells) in CTE and lead to neuronal death, thus essentially causing widespread death within the brain’s circuitry system.


So I said before that CTE can only be diagnosed after death because how could we remove the brains of living individuals and find these proteins? Well, scientists at UCLA have developed a way of identifying these proteins in living patients through PET SCANS (another medical term to store in your brain’s burgeoning filing cabinet of medical jargon; just know it is a type of scan, similar to an MRI or a CT scan–a way of imaging the brain.) Their studies found that ex-NFL players had a markedly higher level of Tau proteins deposited within their brains as compared to those who never even went for a jog in their life.


SO WHAT? What happens in patients who have CTE and don’t know it? Well: memory loss, anxiety, speech problems, Parkinson-like symptoms, confusion, impaired judgment, impulse control problems, aggression, depression, and progressive dementia. CTE affects a patient’s mood and behavior; they can become paranoid and have difficulty thinking along with confusion. Eventually they develop progressive dementia. But these symptoms do not generally appear until months to decades after the onset of trauma to the brain or head impacts.

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WHO HAS THIS HAPPENED TO?

In early 2010, Owen Thomas, a 21-year old junior lineman at University of Pennsylvania committed suicide. They did an autopsy. They found those tau proteins and early signs of CTE.

In late 2010, a 17-year old high school football player died hours after his homecoming game. He had a history of concussions and upon autopsy was found to have CTE. He is the youngest patient diagnosed with CTE to date.


WHAT IS THE HISTORY OF CTE AND THE CRUCIAL LINK TO THE NFL?

In 1928, CTE was first described by Dr. Harrison Martland when discussing symptoms seen in a group of boxers. He described the boxers as having “punch-drunk syndrome.” Over the following 75 years, many researchers reported similar findings in boxers and brain trauma victims.

In 2005, a pathologist named Bennet Omalu published the first evidence of CTE in an American football player: former Pittsburgh Steeler Mike Webster.

It didn’t take long for the sports world to respond: in 2008, the Sports Legacy Institute joined with Boston University School of Medicine and formed CSTE to study CTE. The Concussion Legacy Foundation also partnered with Boston University and the Veterans Administration to form the VA-BU-CLF Brain Bank. Thus far, more than 400 brains have been donated–250 have been found to have CTE.

In 2010, studies at CSTE showed that of the 51 confirmed cases of CTE, 90% were athletes. The most common symptoms found in football players: depression, dementia, paranoia, poor judgment, outbursts of anger or aggression, irritability, apathy, confusion, disturbances in concentration/attention, agitation. 4 out of 5 players experienced tragic deaths, specifically suicide.


LETS FOCUS NOW ON THE STORIES OF THE NFL PLAYERS WHO WERE FOUND TO HAVE CTE:

2011: Colt tight end John Mackey died after years of deepening symptoms of frontotemporal dementia (frontotemporal = behavior changes.) CSTE studies found CTE upon autopsy of his brain.

2012: Retired NFL player Junior Seau committed suicide. Autopsy performed by Dr. Bennet Omalu found CTE in Seau’s brain. Omalu’s participation in the autopsy was halted after Seau’s son revoked previously provided oral permission after receiving phone calls from NFL management denouncing Omalu’s professional ethics, qualifications, and motivation.

The autopsy performed on an anonymous retired NFL player with a history of chronic depression, suicide attempts, insomnia, paranoia, impaired memory which lead to his suicide showed signs of CTE on examination of the brain.

Here’s the list of NFL players who were found to have CTE upon autopsy (after their death):

  • Lew Carpenter
  • Lou Creekmur
  • Dave Duerson
  • Shane Dronett
  • Cookie Gilchrist
  • John Grimsley
  • Chris Henry
  • Terry Long
  • John Mackey
  • Ollie Matson
  • Tom McHale
  • Joe Perry
  • Junior Seau
  • Justin Strzelczyk
  • Andre Waters
  • Mike Webster

In fact, 33 former NFL players have been diagnosed with CTE on autopsy leading the medical community to declare CTE as a public health crisis.

OK so we know the case the medical community has made against the NFL regarding CTE. They’re the offensive players and the NFL is playing it’s best defensive players to tackle the issue.


SO WHAT PLAYS DID THE NFL CALL?

2010: NFL donated $1 Million for Brain Studies to CSTE. In fact, the NFL is the first professional sports league to financially support the center. More than 200 athletes have since committed to donating their brains after death to the center

2011: NFL changed its return-to-play rules. The number of contact practices was reduced (based on collective bargaining agreement.)


DESPITE THE NFL’S EFFORTS TO FORCE A FUMBLE AND REGAIN POSSESSION OF THE BALL:

In 2012 4,000 former NFL players brought civil lawsuits against the League. The NFLPA is an exclusive collective bargaining agent for all NFL players. They claimed that the NFL knew for decades the high risks involved but did nothing to protect players. They further alleged that the NFL glorified violence. 16 experts (including CSTE researchers) testified before the US House of Representatives Judiciary Committee against the NFL. In response, the NFL announced “radical changes” to its concussion management policies.

The League Commissioner for the NFL, Roger Goodell stated, “We obviously are very interested in the center’s research on the long-term effects of head trauma in athletes. It is our hope this research will lead to a better understanding of these effects and also to developing ways to help detect, prevent and treat these injuries.”

Dr. Thom Mayer, the NFLPA medical director, stated “We will encourage our players, both retired and current, to participate in this independent academic research at Boston University School of Medicine. In addition, this collaboration will allow us to educate our players on the findings as quickly as possible so that they can make informed decisions regarding their own health. Our goal is to protect our players to the fullest extent possible given the nature of the game of professional football.  This ongoing research is a critical piece of that effort.”


THE NFL THREW THE BALL INSTEAD OF RUNNING IT AND THE CSTE REGAINED POSSESSION:

The Co-director of the CSTE, Robert Stern, PhD, stated, “The new association with the NFLPA will facilitate our research tremendously, allowing us to discover the risk factors for CTE and methods of diagnosing and treating the disease.  This, in turn, will yield tremendous benefits for current and retired NFL players”

Robert Cantu, MD (neurosurgeon and CSTE co-director) stated, “The long-term consequences of repetitive brain trauma in sports are a tremendous public health problem.  CTE is the only fully preventable cause of dementia.  This research will allow us to make informed, research-based changes to the way contact sports are played, which will decrease the risk of CTE for professional athletes and for the millions of children who participate in youth sports.”

So with the score even, let’s look at the case of someone familiar to even those who despise American Football: Brett Favre.

In October 2013, Favre admitted to “scary” memory lapses.  He is quoted as saying, “I think after 20 years, God only knows the toll concussions took…I got a pretty good memory, and I have a tendency like we all do to say, ‘Where are my glasses?’ and they’re on your head. This was pretty shocking to me that I couldn’t remember my daughter playing youth soccer, just one summer, I think. I remember her playing basketball, I remember her playing volleyball, so I kind of think maybe she only played a game or two. I think she played eight. So that’s a little bit scary to me.”


Despite all this, is the NFL solely to blame? Let’s break the numbers down. CTE has been found in the brains of individuals whose primary exposure to head impacts was through:

  • Tackle football: 200+ cases
  • The military: 25+ cases
  • Hockey: 20+ cases
  • Boxing: 15+ cases (50+ globally)
  • Rugby: 5+ cases
  • Soccer: 5+ cases, 10+ globally
  • Pro-wrestling: 5+ cases
  • Baseball, basketball, intimate partner violence, and individuals with developmental disorders who engage in head banging behaviors: less than 3 cases each

CTE has been evidenced in every other contact sport. But, the NFL is America’s sport. It’s close to the status of our national anthem. Who should we target? The biggest organization in America: the NFL. Is CTE found mostly in football players or has the number of brains donated to CSTE been mostly from former NFL players? Despite head trauma impacts being far more detrimental in rugby or boxing, for instance, the medical community has targeted the biggest, highest-grossing professional sports team in the United States–to make a point. Is their point correct? Is CTE a public health concern? Absolutely. But what are other sports organizations doing to prevent CTE? How can we balance out the sample sizes? Only the NFL has made tremendous strides to reduce the rates of CTE in players–even before the lawsuits began.


My point is, instead of playing this out like a professional sporting event, why can’t the medical community work with not only the NFL but other professional sports organizations in developing ways to reduce the incidence of CTE. The NFL has been the only sporting organization to work with the CTSE in finding incidences of CTE in players. Why? Why would they do this to implicate themselves?

The problem: there is  still no consensus on how much trauma needs to occur for CTE to develop. Research needs to be targeted at answering this question and testing ways of preventing head trauma and concussions, such as improvement of helmets (wait, isn’t it rugby that doesn’t even require helmets?) Instead of this blame-game, let’s allow the NFL to work with the medical community in developing better ways to prevent head trauma.

Is NFL the most dangerous game, as quoted by Time Magazine? Most certainly not. Neither team will make it to the playoffs without joint cooperation.


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IMPORTANT LINKS:

CNN: CTE and the NFL

PBS: League of Denial

I GOT THE M BUT NOT THE D… HERE’S WHY I LEFT MED SCHOOL

WHY I DIDNT WANT “MD” TO DEFINE “ME”

PATHOLOGICAL…a term that, in medicine, is defined as: involving, caused by, or of the nature of a physical or mental disease. But taken apart, separate the Latin roots of the word, could be interpreted by an unknowledgeable pedestrian as “a reasonable way to go.”

That’s what went through my mind when I sent the email, at midnight, 6 hours before I was to start my first rotation of fourth year (anesthesiology,) to the Dean of University of Cincinnati: this was the rational choice to make. I wanted out. So the email was sent, my bags packed within 3 days, my apartment vacated, my gorgeous Siberian Husky adopted by a loving dog dad, and I literally fled with my black runt kitten back to the West Coast to Seattle.

In hindsight, all the signs and symptoms were there. At age 10 I was writing immature but time-consuming short stories and declaring to my family that I wanted  to grow up to become a writer, just like Platt or Poe–in my mind, heroes, legends. To me, authors were the greatest thing you could become. My father, a family practice physician, told my close relatives privately and me blatantly “my daughter isn’t going be some fucking writer. She’s going to be a fucking doctor.” Blunt but that’s how his dad was and probably his dad’s dad. To him, and the Normans, the medical field was the best professional field and if your interests didn’t align with it then too fucking bad because no one makes money by “following some fucking unrealistic dream.”

And so the tumor appeared and began to grow, very slowly at first but slow expansion turned to metastasis as quickly as a temperature drop in winter.

I fought it at first. I knew it was a tumor and I wanted it removed. At Berkeley I took courses in philosophy and legal studies. I argued with my father of course. My favorite course at Berkeley was a human rights course and I was obsessed with what I was learning–all the atrocities, all the injustices. He groaned, but it was more of a disgusted snarl, at the thought of me becoming a human rights lawyer. Let me be clear: the decision to go to medical school was my choice and mine alone. But, just as a tumor’s growth can be blocked by medication it can also grow from additional gene mutations. And that’s what happened. Over the course of four years, as the conversations piled up, the mutated genes multiplied and I was majoring in Molecular Biology and scored in the 95th percentile on the MCAT.

I’ll be honest. Ignoring the tumor had its advantages. My dad sent me money each month. He offered to pay for my sorority fees. He paid for my rent. As long as I was going to become a DOCTOR and nothing else he was “proud” and for me life was easy. I was excelling, I loved having the money to go out at night and blow off steam at Kips, and I was, after all, going to become a DOCTOR and with that came some bragging rights and some ego-inflation.

I loved seeing the looks on the faces of my peers at bars who couldn’t believe that the girl taking tequila shots and wearing some “slutty” outfit had the brains to maintain a 3.6 GPA with a major of Molecular Biology and, with a score of 34Q on the MCAT and an entire page of research experience, might be their healthcare provider in 4 years. I loved it. I was immature and naive but those were the best years of my life–thus far.

Right now I feel like I just got rolled out of the OR without any pain meds. I have debt that I probably won’t ever be able to pay off  and right now no job. But I don’t regret leaving medical school. I didn’t want to be some “FUCKING DOCTOR,” who could only talk about medicine and was so sleep-deprived that even with the MD they never got the D (and if they did they were probably half asleep anyway.) I didn’t want it to define ME.

This blog is my road out of this recovery room, away from a painful experience, and hopefully soon I’ll see the light of day again and find success, not just to prove THEM wrong (yeah that’ll be nice) but to prove to myself that I followed my gut, my instinct, and made my own choice to be happy doing something I love.

Don’t get me wrong–I love the subjects I learned in medical school and I love the topic of medicine and Molecular Biology. I just don’t like the medical system or its hierarchy or the things you never hear about if you don’t attend medical school.

So, I start the process of sharing some of my experiences and thoughts about the medical field. Whether you’re in it or just a WebMD-er I hope anyone can relate to these posts. Most importantly, I hope my posts stimulate some thought and discussion about issues in medicine or the medical field that are mostly ignored.