I began writing this entry at the end of last year and never quite got around to finishing it, so I didn’t make it “public” until now, but I think it’s a worthwhile – if rough – snapshot of where my mind was at the end of my first year in medical school. Much more to come as I continue the reentry process. My mood at this moment approaching second year is somewhat apprehensive as I realize how much I will need to learn in the next seven months, but it helped me a bit to reread this entry and remember why I’m doing this in the first place.

“Journalists and doctors tend to think modestly in terms of their own personal contribution to society, and consider the world at large to be a fascinating sea of untapped knowledge and possibility. Businessmen, entertainers, politicians and lawyers think modestly about the world at large and feel their own personal contributions to society are fascinating seas of untapped knowledge and possibility.”
–comment on “When Doctors Write”

You, reader, may or may not agree. The commenter did add: “(And if you can’t make a sweeping generalization in public every now and again, what’s the point of blogging?)” I do think though that the comment – in response to Stephen Dubner’s question “So why do these doctors write so well, and so much better…than other non-writers?” – taps into something very interesting. Do we bring to our profession a sense of wonder and curiosity that perhaps other people do not? And is the difference in us, the people who choose to become doctors, or is it in our subject matter itself?

Dubner continues eloquently, “Perhaps there are elements of doctoring that lie in harmony with writing: peeling back the layers to get to the core of an issue; confronting the obvious but being willing to look beyond it; learning where to “cut in,” of course; and, more than anything, recognizing that this object before you – in one case a human body, in the other a manuscript – is on a certain level a miraculous object with the power to astound, and on another level is a complex, dynamic system which can (and must be) reduced to a schematic, laid out on paper or x-ray film.”

I am going to claim the difficulty of the reduction of complex systems to schematics as an excuse for my lack of posting lately… Actually, life has just gotten busy as we approach the end of the year. Final projects and papers are done or soon due, and we have two more exams before we end on June 8. Along with and among the flurries of work have come a network of interrelated things-that-are-fascinating, any of which could be a post in itself, but I’ll try to address in a nutshell here for now.

Cluster one: AIDS, its sociocultural context, and narrative medicine, which by the end of the month will lead to a massive product encompassing the Casebook itself and four appendices, as this project will now have formed the basis for final products for five classes (Mentored Clinical Casebook Project, Mind-Body Medicine, Role of Discovery in Medicine, Introduction to Social Medicine, Patient-Doctor I). While I originally intended to be more broad in the subject matter for these various projects, and I regret missing the opportunities to do some other interesting work while recognizing that it was not feasible in terms of time and effort, working on my Casebook patient’s story from all these various aspects has been an incredibly rich experience (even beyond that of just learning his story in the first place). I am turning in and presenting tomorrow the narrative medicine piece for PD1; I advocate for the power and importance of narrative medicine, the application of narrative analysis techniques to patient stories, and do a first-pass analysis of my patient’s story. The social medicine piece has a long way to go yet, but I just finished reading the book And the Band Played On, a journalist’s contemporary account of the early years of the AIDS epidemic, and it opened my eyes to so much that seems like it should be long ago and far away (stigma, ignorance, hatred, prejudice…) but isn’t.

Cluster two: abortion, HPV, sex education, women’s health, ob-gyn, contraception, sexuality, sexual orientation. education and ignorance and prejudice. Outrage and sadness, and fear for the future of reproductive health. Also not entirely unrelated to cluster one. more on this soon, but one of these days I’m hoping to do something about it, in my own small way.

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