To Whomever It May Concern

Today we finished our ethics class in which we covered controversial topics like stem cell research, abortion, and physician-assisted suicide. I found the whole experience fairly intolerable, which surprised me until I found time to reflect on the reasons for my allergic reaction to learning ethics in med school.

First, I have found this year that I am really indignant when my school makes attendance of any class mandatory. So, of course, I was quite miserable every week during our mandatory discussion groups for the ethics course. I found this time, as well as the lectures, to be time that I wished was spent with my Robbins Pathology text or my microbiology notes. The "soft" courses in our curriculum (ethics, psych, clinical exam) have been deemed to be unworthy of my time by the academic defense mechanisms I have erected to cope with the insane amount of material which we are expected to master this year. Couple this ongoing anxiety with the impending doom of our Step 1 licensing exam this summer, and I find myself intolerant of any time wasted. Except time spent writing in this blog, of course!

The tendency of these courses to portray the "ideal" physician and putting forth the idea that said "ideal" physician can only act in certain ways is also a huge turn-off for me. I am sure there are plenty of great physicians that "feel their patient's pain" and "explore feelings and ever-changing goals of treatment" with their patients, but I am just as sure that there are physicians that simply don't have time to spend on these diversions that provide excellent care for their patients by focusing on other strengths. Medicine is far too complicated an endeavor to master simply by following a few "touchy-feely" rules, and I feel insulted when it is portrayed to us as such.

That being said, I think that a poem I wrote a few years ago touches on my conflicted feelings about ethics in medicine--in particular, that hazy line between aggressive treatment with the idea of curing an illness and palliative care in which the goal is to comfort the patient while they die naturally. I would love to hear what kind of reaction any of you have to this poem, or even your ideas about the role of the physician in the dying process and Western civilization's eternal fight against mortality. And, you know, if the poem is just way too obtuse for anyone but me to understand, feel free to let me know that too. No comment is unwelcome.

To Whomever It May Concern
Deaf men bang drums, bleeding hands
protest the primal rhythm.
The blind turn leaden eyes to the sky,
stone synapses flare to life.
An alcoholic, fire in his veins, defiant
stands before his essence, a genetic jury.
You wouldn’t understand.

You couldn’t understand
a fish joyfully embracing the sandy shore,
his best breath, his last.
Or the bulimic refusing herself from within.
A hunger artist painting a visceral desert.
The beauty of a falling eagle,
blanketed by warm vertigo.
That empyrean pull, fatal.

Not you,
you wrote the rules in blood.
You’ve got your millennial plan,
an ivory covenant delivered on death.
No, you couldn’t understand.