Change the World

http://www.flickr.com/photos/wallyg/2259592476/

Often in the thick of studying for a final exam, when medicine seems to be reduced to just memorizing long lists of diseases, anatomy, drugs and information – I think and ask, why am I in medicine?

I remember before starting university and still was wondering what direction my life would take, I wrote out what I thought were the top 3 most pressing problems in the world. They were in no particular order

  1. Environmental Damage – including Global Warming, Pollution, Species Extinction.
  2. Extreme Poverty.
  3. Overpopulation and Intolerance to Others – including terrorism, peace conflicts, racism, etc.

When I look forward, I frequently question that difference a doctor can make. I acknowledge that you get to see the rewards of your efforts. Your actions have quick and direct results. But I wonder how much influence a doctor can have in large lasting changes? At most, a doctor will directly interact and help around ten thousand patients over his or her lifetime. A small drop in our global population.

Furthermore, for most doctors practicing in North America, they are treating people who have lived “privileged” lives. No war, no poverty, no famine or epidemics. Although we are helping people who have serious illnesses, there is always this guilt within me that tells me that there are people out there who are more deserving of help. People who live on less than a dollar a day, people who have never had an education, people who struggle everyday just to live.

I wonder how my studies in medicine are making the world a better place. Am I helping preserve our natural environment? How am I addressing the economic struggles of billions of people?

That’s why I think policy and research are so important. Passing a health care bill can instantly provide health care to millions who did not have access before. Vaccines have saved millions of children all around the world from debilitating diseases.  As just a primary care physician, although you are helping many people directly, there is a limit to your abilities.

Everyone wants to change the world, few have the chance to, and fewer actually do. And often I wonder was  studying medicine and becoming a doctor the right path to take. I guess my future is still ahead of me and it’s a bit too early to tell what’s in store down the road.

7 Responses to Change the World

  1. Roojin says:

    Hi,

    I was very inspired by this post and your insight into the purpose of medicine. As a student currently studying a B.Sc and aiming for medicine, I also stop sometimes and ask “How can I contribute to the world?”. Again, like you, I have no answers. I know that I love to help people and make lives better/easier. But the medical profession often seems so ‘bounded’ and single-focused. I definitely agree that the wider, social aspects of the field i.e. policy, ethics should be explored!

  2. Jay says:

    Dear Medaholic,

    Thanks for your interesting post. The same questions that you posed have been on my mind for the past semester, as I sought for meaningful reasons to change undergraduate majors and questioned my motivations to pursue a medical career, that faraway light that so many of us are aiming for. Often times I have also wondered that if one can articulate problems, such as these, that affect enough people to be included as Millennium Development Goals, why not dive into a field that would give one the training and knowledge to address these issues directly, such as energy engineering, environmental law, economics, or policy studies? Then I feel guilty, because for me the answer has to do with risk and the unknown: medicine has a long, well-documented tradition, science is where I feel most comfortable, and I wish for the spiritual/moral security that being a doctor provides in knowing that you are helping someone everyday.

    I also don’t really have an answer to how doctors can also work towards the three widespread problems you identified, but I’ve heard of two stories/theories that give me hope. The story of how CFCs came to be banned shows how doctors can effect significant change through advocacy and education: although people did not really heed initial warnings from environmentalists, government quickly outlawed CFCs when doctors published projections of how the rate of skin cancer will increase if nothing is done. Perhaps doctors, being held in the public’s high esteem, can stimulate the same impetus to get people to take better care of the environment by showing how human health is closely tied with the well-being of life around us.

    The other story that shows how medicine may actually be very close to alleviating these widespread problems comes from a lecture by E.O. Wilson, “The Future of Life”, shown in my biology class. Your post reminded me of it because in his lecture E.O. Wilson relates and connects all of the problems that you identified. (I couldn’t find a link to the video online, but here is a relevant portion of the transcript:)

    “The immediate future can be usefully conceived as a bottleneck of overpopulation and inefficient resource allocation… Two collateral effects of the bottleneck phenomenon are worth especially our attention. The first is that the rich grow richer and the poor become poorer around the world… 800 million people still remain in what the United Nations classify as absolute poverty… Even if the income differential is dismissed as a humanitarian issue, it should be considered as a security issue, as upsetting [sic?] as I think we all understand, for resentment and fanaticism in the Middle East. The second collateral effect, interlocking with the first, is the accelerating destruction of the natural environment, leading to the mass extinction of species. The damage is already done, and will not be repaired within any period of time that is meaningful for the human mind… “Why,” future generations will ask, “by distinguishing the lives of so many species, did you so diminish our own?” The eradication of so many species will likely be the folly that our children will least likely forgive us.

    “To conclude, the central problem of the new century, in my opinion, that is, what is going to matter to our descendants, after our wars and economic problems are forgotten, is therefore how to raise the poor to an endurable quality of life while preserving as much of the natural world as possible. Both the poor and biological diversity concentrated in the developing countries, and the solution to the problem, must fall on the recognition that the poor, especially the one billion that are nearly destitute, have little chance to improve their lives in a devastated environment. Conversely the natural environment where most of the biodiversity hangs on cannot survive in the presence of land-hungry people who have nowhere else to go.

    “So I hope I have added to the conviction, shared by growing numbers of thoughtful people in all walks of life, that the problem can be solved. The resources to do so exist; those who control them have a lot of reason to do so, not the least for their own security. Biologists like ourselves must make themselves heard on these issues. At the end of the day the direction that we take will be a fact-based and ethical-based decision. A civilization able to envision God and an afterlife, to embark on the colonisation of space for heaven’s sake, will surely find a way to save the integrity of this magnificent planet and the life that it harbours.”

    With some imagination, I think medicine can be part of the answer “to raising the poor to an endurable quality of life while preserving as much of the natural world as possible.” The good thing about these big problems is that their scope allows virtually any one of any training to contribute. Maybe medicine is only another vehicle to effect that change; all we need to do is figure out how to make that link.

    (I apologize for this excessively long comment, but I was really intrigued by your post. I hope my thoughts may have contained some useful information. Your website is very helpful and I hope you find a way to make the meaningful contribution that you wish to.)

    • medaholic says:

      Thanks for your long thought out reply Jay, I definitely enjoyed reading it. I think at the time, I had finished reading Jeffrey Sachs “Common Wealth” which spurred a lot of critical thinking about my role in solving today’s big problems. Although I don’t have a real clue about how to go about this, I do know that if you pursue your passions and what interests you and do it well, you will be better off in the end, and likewise the people and community around you.

  3. Lydia says:

    I’m just curious… What are your thoughts now? It’s been three years, reflecting on your last paragraph, was being a doctor the right path to take (in your opinion)?

    • medaholic says:

      Hi Lydia,

      It was nice to re-read some of my thoughts from a few years ago. I can say that I still look for opportunities to make our world a better place, in my own life and in my workplace. I’m happy to say I find the work I do as a doctor extremely rewarding. There’s a lot of intrinsic happiness being able to help others achieve health. I love interacting with people everyday. Although some situations can be stressful or difficult (ie. call), overall I look forward to seeing patients and taking care of them.

      I’m still optimistic about changing the world, and I think as a physician have a lot of leverage and ability to do so, more so than in some other careers.

  4. Sparkles says:

    Dear Medaholic,
    I’ve read your blog and was very inspired by it (still am). And i have come up with a rather debatable conclusion.
    So we live on a dirty little circle we call “our world” being lured up in a vortex of hedonism, decadents , deveins, decadents, racism, destruction etc that’s corrupting its positive and pure nature. And as human beings, our job on this planet (called Earth) is to help one another. “So what renowned and prestigious yet highly rewardable way to do so then by being a physician?”, I thought.
    Until I discovered that natural sciences (doctors etc) are a completely different paradigm to natural sciences (humanity). I elaborate… if by being a doctor means experiments need to be conducted to justify a theory or hypothesis and everything is all factual and logic, while being a humanitarian is all about questionable motives that involves thought and emotion…., how do I combine the two? In other words, can I be both a pediatric surgeon and a revolutionist at the same time?
    Having been in the IB program for the last 4 years, I have learnt that nothing is impossible if you believe. Whilst human sciences debate between nature vs nurture;
    eg: Nature- we know what to predict based on actions shown in the present. eg. If we don’t stop hacking down tropical rain-forests, we are all going to die.
    Nurture- legislation needs to be introduced to ensure the government conduct their people in the right way because if it doesn’t change, we will all die.
    Doctors believe that the whole debate is fallacious because many genetic traits are dependent on the environment. (Mind=Blown!)
    Therefore, its clear to say that the difference between natural sciences and human sciences (in other terms, doctors and humanitarians/activists) are not very different afterall.
    Eg. Doctors get people to take better care of the environment by showing how health is closely tied with the well-being of life.
    Although a humanitarian/activist’s job has got to do with risk & unknown, a doctor’s actions have quick and direct effects. And there is that spiritual/moral security in knowing that I am helping someone everyday, by being a doctor.
    PS: i’m 17 and starting first year of med school in Jan. And also lead a Confluence to contribute to “our world” in other aspects besides health. We’re known as the “Xcape the Tempest”. I guess you could say “doctor by day, revolutionist by night.
    Lokoing forward to your next blog post. 🙂

Leave a Reply

Your email address will not be published.