Saturday, February 3, 2007

Sextuplets - who's in charge?

Sextuplets born to devout Jehovah Witness couple in BC in need of blood transfusions

"The B.C. government got court orders in the past week to seize three of the surviving sextuplets born in Vancouver earlier in January and ensure they got blood transfusions if necessary. Two of the sextuplets have already died.
The babies were part of the group of of six born at B.C. Women's Hospital into a family of Jehovah's Witnesses, a religious group that prohibits blood transfusions."

-From B.C. intervened to save 3 sextuplets after 2 died

These are the kind of issues that really scare me. Makes me wish I had chosen my alternative career - doorman. That way I could still help people out, yet get much more reading done and not have to worry about such complex issues.

As a somewhat religious person myself, I am trying to be sympathetic to this couple. Yes, to me giving blood to these babies seems more of a gift than a violation, but can I not defend their position as well? Is mortal death really the worst thing that can happen? Obviously not - they could have aborted these babies days before birth, and may have been praised by some for protecting the mother's health and not biting off more than they could chew family size wise.

Learning to become a doctor (hopefully)...

I have a confession to make. I often find my pre-clerkship classes boring. I tell my parents it's interesting. I sit mid to near the front. I seldom sleep. Yet sometimes, sitting there listening to some phD drone on about another biochemical pathway I think to myself - how could this possibly help me help patients? Yet I continue on. I even memorize this stuff (not the concepts and their clinical significance, but rather ever minute detail). Why? Because it's on the next exam.

There are those in my class who are in denial, as if the slightest insinuation of boringness implies they faked their way in med school. They don't just lie to their parents, they lie to themselves. I imagine they will be the same people who will be in charge of the curriculum in the future, who will continue the rite of passage of having med students memorize laundry lists of facts void of clinical relevance.

I quite enjoyed That Med School Guy's soul searching post Somewhere Along the Line. He explores his apparent fixation on the test over preparing to help patients. He's pretty hard on himself. Below is my comment, where I discuss possible reasons for his test vs. patient centered mentality:

Great Post! I highly doubt you were one of those “who happen to fall through the cracks,” at least judging by the sincerity of your post (and blog in general). Can you blamed for studying for the test? That’s what ultimately got you into med school, how you’ve been hardwired over your premed years. You've been forced to develop an addiction that is hard to get rid of. What’s worse, that is also currently your main evaluatory measure of whether you’re doing well in medical school. At least from an evaluatory sense, you are being told the addition is still okay. Why is that? True, med students need to look past the multiple choice tests at the big picture, though why can’t the big picture and med students’ current reality be aligned? Sounds like it would make the Professors happier as well! [Reference to earlier comment by Med Prof. Dr. K]

I have an idea. Let’s deemphasize multiple choice tests asking us what enzyme is used in the 4th step of heme synthesis (uroporphyrinogen III synthase in case you are wondering). Let’s emphasize how we do in the scant time we get as preclerks with patients practicing clinical stuff. And let’s introduce a new evaluatory measure. Hold on to your seatbelts. Let’s ask the patients how we are doing. I know it sounds crazy – let’s ask the person we are trying to help if they have been helped. I enjoy the blog.