Humanity in the Basic Sciences?

I have to admit that when I was sitting in my buddy Eran’s backyard at his beautiful Newton, Massachusetts home, I wasn’t exactly excited about my first week of biochemistry, which was to start the following day. You see, I was just trying to enjoy my Labor Day with a few friends, some great food, and even better conversation. I definitely did not want to think about school or how it was about to morph from the social and personal perspective of medicine, taught in ITP, to an extremely objective and scientific perspective, which is conveyed in MCM (Molecular and Cellular Basis of Medicine…what we call biochemistry, genetics, and cell bio). I just wanted to focus on devouring the perfectly executed Gorgonzola cheeseburger Eran had grilled and then placed in front of me. Although we definitely enjoyed ourselves and shared great laughs around that patio table, the event became somewhat imbrued by a general preoccupation with the arduous journey we were about to embark on – basic science medical education. This was especially hard because Eran and a few others were off to their segregated studies of the Harvard-MIT joint medical program called HST. This meant that I would no longer have classes with Eran or my other HST friends, which was also a source of sadness. Before we knew it, everyone “had to go;” the sun was not even close to setting. What kind of BBQ ends at five? Not one I’ve ever attended. Despite the veil of excuses, everyone knew what was going on here—it was time to gear up for medical school!

Ever since Abraham Flexner’s 1910 report on medical education in America, which called for the incorporation of more rigorous scientific education in medical curricula, the first couple of years of medical school have largely focused on biological and biochemical sciences and their fundamental basis in the field of human medicine. Like many others, this made me fearful that I would begin to lack empathy for patients by virtue of viewing them through a series of analytical prisms. Perhaps I would start to divorce these things from the human experience. I am terrified of becoming callus to the human suffering of which we make a commitment to help alleviate. As another HST friend of mine, David Gootenberg, so eloquently (and candidly) put it, “diseases and disorders aren’t interesting; they’re tragic.” (I must say that I could not have said it better myself, so I didn’t even try.) He’s exactly right! We hear this all of the time in the basic sciences—diseases and their processes are “interesting.” However, we rarely take the time to address the tragic nature of diseases: how they destroy families, how they wipe out entire populations, how they prey on the weak, etc. These “interesting” diseases have dire implications and cause immeasurable human suffering. As medical students and medical professionals, we must never divorce the idea of human suffering from the scientific aspects of disease. We must remember that we are here to help the sick and dying. We have a duty much bigger than biological science can account for, and medical education is finally starting to reflect those virtues again.

Today I completed my first full week of MCM, and I must say that I was pleasantly surprised by a few things. First, I get what people are talking about when they say that this biochemistry stuff is interesting! I was literally on the edge of my seat throughout the entire hemoglobin and RNA processing lectures. At first, I was shocked at how interested I became, but then I realized that I was interested because the lecturers consistently bridged the gap of context and relevance. This made this stuff real to me, whereas before it seemed more akin to wizardry or street magic. Furthermore, we have clinic days where real patients come to our classes so that we can see how these pathologies manifest themselves in human beings. What better way to correlate human suffering with these very tedious biochemical processes? As apprehensive as I was about delving into the multiple minutiae that biochem has to offer, it turns out it’s not so bad after all. The basic science aspect of medical education is quickly evolving into a more comprehensive type of education, and I think we’ll be better for it.  I’m truly excited about the things I’ll learn next week! Until then, take care my friends.