Friday, October 25, 2013

Why I Never Went To Med School

This has nothing to do with triathlon, athletics, nutrition, or fitness.
In all honestly, you may dislike me for this.
Read ahead if you can keep an open mind.

What follows is a dive into one of the reasons I veered away from medical school and opted for a Ph.D. program. 

How do I do this?  I'm not exactly sure how to go about this subject.  To be honest, I've only ever had this discussion with four people; a good friend of mine in college, my best friend, his girlfriend (also a good friend of mine) and my mother.  The first three loved the intellectual puzzle that it presented but continue to cordially disagree with me while the last, in not so many words, refuses to reproach the subject.  

I suspect that some of you will feel differently about me after reading this and I can't blame you.  I don't think my opinion is a popular one by any means, but I feel it's a viewpoint that has to be taken seriously at some point.  Despite that fact, I would implore you to simply be open to the idea even if you wholeheartedly disagree.  Think of this as a philosophical discussion meant to simply probe your thoughts and initiate a discussion.  

The idea I'm about to present has been on my mind ever since college and was borne out of mixing my science major and philosophy minor.  As the blog title states, it was one large factor as to why I never followed through with being pre-med and why I veered towards research instead.

I'm not sure how to state this, but here goes...

I feel that the field of medicine,
that being the act of attempting to save lives, cure diseases, and extend one's lifespan,
is, in part, in contrast to the best interest of the human species as a collective whole. 

Now, before you jump to conclusions on what that means, let me (attempt to) explain.  I apologize for the fact that I've found this hard to articulate in the past.  I will do my best to be brief and concise. 

I went to Boston University and earned a bachelor's degree in Biochemistry & Molecular Biology with a minor in Philosophy.  While I was there, my scientific studies spanned many subjects including evolution, many diseases; their causes and supposed "cures."  As a philosophy minor, I fondly recall countless debates that might have lasted for days if not restricted by class time.  These debates brought our very basic human beliefs, thoughts, and instincts to the surface and questioned them; an act I feel many people shy away from possibly because they fear finding that their beliefs are unfounded and unsupported. 

Throughout my time in Boston, I questioned many things.  Evolution for one.

Suffice it to say, I believe in Darwinian evolution.  I believe we came from monkeys, fish, and ultimately single-celled organisms at the bottom of the ocean.  I believe that given changes in our surroundings, many various species have come to 'life' and prospered, altering who they are very slowly on an atomic and microscopic level.  Given the principal of 'survival of the fittest' and 'natural selection' some of these changes have allowed species to flourish and continue to exist while others die off.  It's a very objective series of events.  Either change or don't.  If your status fits the environment, you pass on to the next round.  If not, goodbye!  And repeat!  There is no mulligan or handicap. 

Humans, or homo sapiens, arrived after a few million years (I lost count in there somewhere) and we've thus far continued to survive against the pressures of our environment; cold, heat, predators, weather, etc.  We even beat the Neanderthals.  Here we are, a conscious, sentient species evolved all the way from bits of atomic matter.  

During that time in Boston, I also learned to appreciate a lot of similarities between various subjects.  Disease, as many will agree, was simply a portion of evolution that was and continues to be on center stage.  Why?  Because our species has become intellectual enough to not only understand how the world works, but manipulate it.  To paraphrase a comparison I heard recently, 'Genetic engineering ourselves is no different than the cave man striking up a fire; it's our manipulation of the environment for our betterment.'  This is what I would term 'Modern Evolution' in order to differentiate between our conscious and knowing alterations of our environment and those changes that occur without our intervention (weather patterns, a predator, etc). 

I began to question our field of medicine in light of my knowledge of the evolutionary process.

As a species propagates itself in the wild over many generations, small changes occur providing that species with a range of characteristics in order to better fit possible changes in the environment.  A plant, after these changes, may find itself better suited than it's neighbor for drought conditions.  If a drought never comes, then it doesn't matter; they both survive as well as their species.  However, if a drought happens to come, then the neighbor dies off and guess who's grandbaby plants take over the field?, those who survived the drought.  This can also work in the opposite direction.  Instead of being more hardy in drought conditions, the same plant could find itself with less of an ability to battle a disease, an insect, or some other environmental factor.  Evolutionary changes don't necessarily confer beneficial traits.

Bringing this up a few levels on the evolutionary scale, how does this fit with humans?  Back in caveman times, what happened if someone got sick?  They may have eventually gotten better, but more often, they probably died.  That was the way in which nature "decided" how our species would survive.  If you were viable enough to make it to maturity, you had the opportunity to mate and propagate your DNA.  If you were born with a hindrance, your chance at survival was minimal.

Jumping even further ahead, medicine has now vastly improved the odds of those that may have died before.  We've provided many with the possibility of fruitful lives given preventative care, early detection, and/or the correct treatment.  However, stated in another way, we've alluded the clutches of what I call "natural" evolution, allowing a variety of traits that are non-beneficial to our species to propagate themselves.  We've actually thrown a wrench into the system that is supposed to better our species.

This is where I find myself questioning the benefits of medicine.  If members of our species are detrimentally susceptible to an environmental factor, what is the benefit to allowing that trait to continue existing?  Wouldn't it be more beneficial to wipe the trait out or let it die out rather than let it propagate and simply manage symptoms in each successive generation?

The purpose of life from a basic biological viewpoint is to reproduce and propagate the species.  That's why we have the natural urge to mate.  In the caveman days, if a member of the group was sick, injured, or deformed, it hindered the efficiency of the group.  The group either slowed down or the illness could spread and kill them all.  In those days, that person was gone and the group was improved, able to move on efficiently.  Today, we have such a large population that it's hard to see the similarities.  If a person is born with let's broadly say a genetic, long-term illness that thanks to medicine allows them to live to reach maturity, then we are allowing this anomaly to propagate in our species.  In effect, we're bringing down the efficiency of our collective group.  In STRICTLY an evolutionary viewpoint, I see an oddity in this.  We've altered the course of natural evolution and created modern evolution (the difference only pointed out here to indicate a change in the means, not the ends). 

Because of all of this bouncing around in my head, as I think you can understand now, I was unsure how I felt about pursuing a career that I felt I did not fully support.

Therefore, I never went to Medical school.

I did, however, go into research.  While yes, research pursues, in part, cures to the diseases I held in question, it allowed me to work on things strictly from a "Hey, this is cool" standpoint as opposed to that of "I want to cure the world."  I could work in research just because I think science is cool and offers so many astounding facts and revelations (like a kid staring at his first fireworks show or a magic trick) without having to care about the world and it's diseases.  I know that may sound cold, but if you've ever had a pure interest in something like puzzles, you'll understand where that comes from. 

And now I'll address the question I'm sure you've already formed...

Why bring this up now?

I recently read Inferno by Dan Brown and in the book, they bring up a similar idea.  The book focuses on the fact that due to our exponential population growth, humans have overgrown our ecosystem's balance and that our continued prosperity as a species will also be our extinction.  The book literally talks about how there are currently over 6 billion people on Earth and that the ecosystem can only handle 4 billion.

I am not saying that these numbers are correct - I haven't even tried to draw up my own numbers - but I admit that the basic premise is correct.  Our population continues to rise and if you talk to any populations biologist or ecologist, there is always a maximum at which a species out grows the current surroundings.

Going back to my long-stated point above, how many of the 6+ billion would not exist if we allowed diseases to run their course and wipe out populations?  If medicine did not interfere with natural selection, how much smaller would the overall population be?  I don't have an answer, but it's a puzzling question.  And the book itself proposes a few pieces of food for thought, ultimately deciding on the final outcome which I admit surprised me!  I won't ruin the book at all for you, but it brought quite a few of my pre-med thoughts and internal questions back to mind.

Are we doomed as a species
because of our pure desire to live?  

Are we too intellectually smart and not ethically sound enough to make a decision that would be very widely disapproved?  Are we willing to send our species off the cliff in order to avoid being the "bad guy"?  And I don't mean a comic book villan, a serial killer, or even Hitler.  This may mean telling the world that we need to make cut backs, not to salaries or jobs, but to life.  I don't know if there are people willing to do that.  But it's interesting to consider. 

Now let me touch briefly on a few side points that you might have thought of already...

1.  Medicine is not bad.
I am not saying that the field of medicine is useless.  What I've outlined above is a very focused point on one thing that medicine does.  I am not saying that doctors are bad in what they do, simply that this was one reason I did not look to becoming one myself; the same as to why I never looked into becoming a Nascar driver.  I just don't see the point.

2.  What is Modern Evolution?
 I must admit that the way in which evolution was taught to me (not that long ago), begs to be added to in that it does not even address modern evolution and the question of whether medicine or the like are considered evolutionary pressures or our own manipulation of the process.  This was left completely up to myself and my fellow classmates to question and ponder ourselves.  In the above write up, I have split medicine into "Modern Evolution" which is separate from "Natural Evolution" for convenience sake though there may be a separation in the literature that I am not aware of. 

3.  I am not unaffected by the theoretical outcome of these thoughts
Keep in mind, I do not write this as someone separated from the experiences of death, illness, and medicine.  I have a very close family member who spends more time than I'd like in the hospital and another who was born with SMA, lived a life we knew would be short, and died at a very young age.  I can't say I've been able to completely mesh the above views with my personal life, but as Immanuel Kant, one of the better known philosophers of ethics, once said (articulated to me by one of my philosophy professors)...

It's always different when it's your own mother.

And that it is.  If you showed me a button that when pressed would randomly kill off half of the world's population, without doubt curing the world of population pressures and saving our species as a whole, I would not be able to press it. 

Final Words
Please, don't hate me for what I've said or what I believe.  It's tough to think about and even harder (as you might have grasped) to write out in a succinct way.  I hope the above statements and descriptions make sense; not that they align with your beliefs, but that they allow for you to question yourself, me, and others in order to discover and explore your own belief. 

If anyone would like to discuss this or any related topic in more depth, I am MORE than willing to do so.  I miss philosophical debates and in depth conversations.  I also would love to explore this topic more, but a discussion with yourself only leads so far.


1.  Do you have any thoughts?

2.  Did you ever take a philosophy class?  Did you ever have similar debates?
My modern philosophy class was 90% in class discussions lead by the professor that were absolutely thrilling for me.  I wish I had recorded them or better yet, could go back and rejoin the class.

3.  Is anyone an ecologist or populations biologist?
If so, I would love to chat about any information or ideas you might have to address the status of the view I've stated here.


1 comment:

Anonymous said...

great post. one thought that came to my head while reading this was that individuals who might have "undesirable traits" or are "susceptible to disease" could contribute to the population or to society in their other merits (i.e. Steve Jobs had colon cancer but contributed to the world despite that trait).