April 04, 2008

Education has a way of sneaking up on you...

So, it's official. I'm done with my second year as a medical student!

There's not much in that victory as the majority of my summer will be devoted to studying for Step 1. I've talked about it before here so I won't rehash all of the details of my particular situation. I have another story to share though.

After my 6 hour long multiple choice and essay question exam two weeks ago, I got a call from one of my friends living on the mainland now.
"Hey B, what's up?"
"Hey man, just landed on the island and I'm here with D. BTW, did you know that he's getting married this Saturday?"
Whoa, talk about last minute invites. Apparently D didn't have any of my contact info (or anyone in my circle of HS friends) so I made a few calls and found someone else to go with. I thought it would be a nice break from my board studies to go to the event. It was really nice; I got reacquainted with some of my old high school friends! J, my senior prom date (and a girl I had a crush on even when she was dating D), just graduated from acupuncture school and now she's working as a chiropractic assistant now. I made an effort to be open minded and ask her a little bit about her philosophy and practice and such. I was glad to hear that it really worked to help her with her pain after shoulder surgery (something that bummed me out about going to prom with her... the music really pained her having just had the surgery, so we only danced a few times.)

It's difficult for me to shut off that nagging factual scientific side of my brain that I use so much and approach things from a more nonjudgmental, holistic, cultural perspective (or what have you.)

Somehow, I opened a bag of worms by mentioning that I was in med school. After the polite round of "Oh, what kind of doctor do you want to be? (Family Medicine)" "Oh, that's nice (Yeah, I really want to be albe help all kinds of people)" One of the mothers on the table dove in for the kill.
So, I listen to this conspiracy radio talk show and they have some interesting topics. Yesterday they talked about vaccines, calling it the Vaccine Genocide. It's a shame how we have to vaccinate babies at birth! There's so many complications... How do you feel about it?
Obviously, a wedding table is no place to launch into a deep discussion about the pros and cons of vaccine administration, the benefits of herd immunity, the necessity for prophylaxis for diseases we don't have any other cures for... I was caught off guard by the sudden shift in subject matter, but I guess it was reasonable since I was inquiring about acupuncture just a few minutes earlier. How would I be respectful of her beliefs, challenge her assertions and not come off as angry, defensive, or patronizing as I do so?

"Yeah, I'm not a fan of genocide. I totally feel bad for all those all of these poor bacteria we're killing off!" I said jokingly. No one laughed. Not even a guffaw. Whoops. Time for a new tactic.

"We don't give vaccines to protect healthy people. Things like the the flu vaccine are given to protect people who are immunocompromised -- old people, young babies, diabetics, cancer patients, etc. I think a lot of people are forgetting what it's like to live in the days of infectious disease. In some ways, having vaccines makes it harder for us to understand why they are so important. Take the chicken pox vaccine for example...
"That vaccine is totally unnecessary. People who take it have a higher incidence of shingles!" retorted J, shaking her pretty blonde locks in disgust.

"Yeah, that's true," I conceded. "What I meant is this -- doctors don't even see patients with Chicken Pox anymore. Soon they'll forget what it looks like in person. I can only imagine what the general public will think."

Indeed, my personal philosophy about vaccines is somewhat cynical and harsh. In order to convince people of their necessity, they occasionally need to see the disease it would otherwise prevent... otherwise the adverse effects, no matter how rare or uncommon they may be, will be seen as PROOF that vaccines are harmful, even deadly, and doctors are killing babies. Perhaps I got through to her...

"What about the HepB vaccine?!? You give that to babies right at birth," the mother asserted.
"Yeah, the maternal antibodies protect the baby from HepB for a few months." J added.
Hm. This was an issue that required more finessing. I didn't want to tell them everything about HepB transmission, so I dropped the cancer bomb on them, a little something I had prepped a few years earlier on my blog.
"Did you know that HepB prevents cancer? Yep, that's right. We're vaccinating these children so they don't get HepB during the delivery from their mother so they don't get hepatocellular carcinoma."

I felt satisfied that I defended my profession. Still...

"A, what happened back there?" I said as we drove back from the beach house/wedding site. "You're a social worker, public health, natural disaster and all that business, I would've liked some support."
"You did a pretty good job," she said. "Thimerosal and autism? Where was she getting that stuff from? I thought it was disproven a long time ago."
Dang. A was right. Bush was right. Repeat something often enough, it becomes true to the American public, no matter what the facts are. Rather than submitting to this droning power of the collective, I will speak out! Hopefully in a nice and polite way that will help to put a good face on Medicine.


  1. Non medics just have no idea. I ignore such discussions all together. I used to defend and explain but sometimes the talk used to get a little nasty. The debate has no use if its going to cause hard feelings.

    You can listen to them and observe how people think and reason.

    No matter what, when they are ill, they will always seek a physician :)

  2. that was a good parting shot. hooray! some people just love shooting doctors down. tsktsk..

    i'm a med student too...and i have this auntie who's a huge alternative medicine fan. she's always quizzing me. i'm never converting, though.