For a while, I’ve been meaning to write about what an incredible change medical school has been, but I struggle to find words for the overwhelming gratitude I feel for it daily. It’s probably the best thing that ever happened to me.
It’s also hard to write about this without showing contempt of the many wonderful aspects of grad student life generally and the lab I work in specifically. But after being introduced to a field that places primary value on relationships and caring service for people and communities, I can’t see myself continuing my career in a field that is guided by the singular goal of individual achievement – defined by outcompeting your peers – any more than I can see myself becoming an Olympic athlete.
Despite being in the most supportive research environment I could imagine, I found the competitiveness of academic science soul-destroying, and didn’t fully realize the extent of it until this year. From talking to scientist colleagues in other fields, it seems that cancer research is particularly known for this. I still find it puzzling, given that nearly all the people I’ve worked with have been very collegial and collaborative and willing to share their expertise. But I don’t really want to talk about how this plays out for other people because those aren’t my stories to tell. I want to talk about the effect it had on me.
Having a publication accepted or advancing through the selection cycles of a scholarship competition felt really, really good. Maybe too good. Kind of addictive. I derived a good portion of my sense of self-worth by how I ranked against other applicants – not by how I treated people or based on how useful my work was likely to be to anyone except my own career. I also got a sinking feeling when people I perceived as rivals experienced similar success. I knew something was wrong when I realized I was envious even of my friends. These aren’t things I’m proud to admit, but they’re real and not altogether unanticipated consequences of the system of incentives set up for scientists today.
I was also getting really tired of the siloed thinking that so often permeates highly specialized fields, and of hearing that so many injustices staring us in the face “aren’t our problem” and having the conversation end there. While people have argued that scientists aren’t valued enough, the billions of dollars in research funding we receive, with almost no strings attached, testifies to the political clout we wield. And we don’t hesitate to use it to our own benefit, but we could do so much more. I would argue the least biomedical researchers can do is acknowledge the limitations of our own work and use the influence we have to amplify voices that are preferentially unheard (for example, those calling for dismantling systems of oppression as a way to support flourishing population health). Dr. Ruha Benjamin has some brilliant thoughts on how this might be achieved.
Last summer I attended a conference talk where a highly influential scientist in my field suggested that at least some of us in the audience should spend the rest of our lives on highly technical investigations of a rare type of cancer where the researcher:patient ratio is already close to 1:1. I felt like I was on another planet. While writing this post, a friend (who, obvs, knows me well) sent along a very relevant quote from Charlie Chaplin’s film The Great Dictator, which is very reminiscent of the thoughts that were running through my head then:
“We have developed speed, but we have shut ourselves in. Machinery that gives abundance has left us in want. Our knowledge has made us cynical. Our cleverness, hard and unkind. We think too much and feel too little. More than machinery we need humanity. More than cleverness we need kindness and gentleness. Without these qualities, life will be violent and all will be lost….”
I’ve got a long way to finishing my PhD, and who knows how I’ll feel in the 7+ years it’ll take to finish med school. But for now, I can’t imagine anything more fulfilling than this description of family medicine by a particularly inspiring doctor who spoke to us a few weeks ago:
“You see patients get better and walk with them along their journey.”
Garibaldi Park, Skwxwú7mesh and Lil’wat traditional territory