So many who have had the luxury to nurture their social conscience have asked themselves the question, "Where can I make the biggest difference? How can I help the most?" And then other questions arise. What issues should I devote my time to? What causes should I fight for? Should I work from within the system or from without? Direct service? The non-profit sector? Grassroots organizing? Political organizing? Academia? Law school? For me, I came to choose medicine.
In my naive well-indoctrinated youth I thought the most efficient use of my talents for the benefit of humankind lay in biomedical research. What could serve the world better than the fabled cure for cancer? I did not know then that poverty--not cancer, not AIDS, not heart disease--was the number one killer in the world. There was just Democrat and Republican, liberal and conservative. Sure, both my parents were involved in the civil rights movement. I still have the photo on my wall of my mom being dragged away and arrested. I did picket Reagan's visit to our high school. I did skip class to protest the Gulf War. I did become vegetarian. This was all part of my identity, but it wasn't my life. That was politics; I was interested in science.
In college though, I learned a lot more than biology. Thanks to resources like Cornell's Alternatives Library, I started reading Noam Chomsky, Howard Zinn. I started to get more active. As I participated in basic science research myself, my idealistic notions started to change. I saw people spend decades in basements and ending up having some elegant elegans* enzyme named after them. And they would be proud; they had accomplished something.
* The latin name for some tiny worm that's become a favorite of researchers.
Famous biochemist Nobel Laureate Dr. Szent-Gyorgi, speaking in 1961 at an international medical congress, is quoted as saying 'The desire to alleviate suffering is of small value in research--such a person should be advised to work for charity. Research wants egoists, damned egoists, who seek their own pleasure and satisfaction, but find it in solving the puzzles of nature."
Couldn't I do both? In my first formulation, I thought I'd do it all. I could get a doctorate and do research and I could get an MD and do medicine on the side, working in some Guatamalan refugee camp, for example, a month out of the year and spend the rest of the time in the lab. And so I applied to dual degree MD/PhD programs.
I knew I had a long road ahead--12 more years of school at least, so I decided to make the summer count. I chose a school in Boston in part because of the city's reputation as a bastion of the old Left. Chomsky and Zinn were here. Organizations I had heard about like Food Not Bombs were active here too. And Tufts was in Chinatown, a half block away from my favorite veggie restaurant. So in the summer before medical school I arrived in Boston a few months early and started volunteering for social justice organizations--Food Not Bombs, Food First, the Lucy Parsons Center, Bread and Jams, Solutions at Work, the New England Anti-Vivisection Society. Soon I had my own handcuffed acts of civil disobedience on the wall. My intensifying activism was cut short, though; medical school loomed ahead.
As school started I still managed to skip a lot of classes and go feed people. Real medicine. It was in these lives I was touching that I started asking myself the uncomfortable questions. I knew my conscience wasn't going to let me get away with a month out the year. As Chomsky once said in an interview, "It's a matter of being able to look at oneself in the mirror everyday,"
So on October 28, 1995, I wrote a letter of resignation. I had been accepted into the Medical Scientist Training Program at Tufts--an all expenses paid trip through medical school and graduate school. I'd even get a stipend; they were going to pay me to go to what I hear is the second most expensive medical school in the country and throw in the PhD to boot. But I forfeited my spot to someone else. My vision for my future had changed. "I wish to withdraw from the combined degree program and pursue a straight MD," I wrote to the administration. I enclosed an letter of explanation.
I opened that letter with a question asked by Otto Rene Castillo in his famous poem Apolitical Intellectuals, Que hististeis cuando los pobres sufrian? (What did you do when the poor suffered?) I quoted Albert Schweitzer as he left his two professorships at Strasbourg, left all the compensations of "civilized" life and built his hospital in Lambarene in the name of justice and compassion. "The black man has suffered", he said, "from his supposed brother the white man long enough and if I feel this, I have an obligation to follow it out myself and not leave it to someone else."
I quoted Chomsky. "If we had the honesty and the moral courage , we would not let a day pass without hearing the cries of...[our] victims. We would turn on the radio in the morning and listen to the voices of the people who escaped the massacres in Quiche province and the Guazapa mountains, and the daily press would carry front-page pictures of children dying of malnutrition and disease in the countries where order reigns and crops and beef are exported to the American market with an explanation of why this is so. We would listen to the extensive and detailed record of terror and torture in our dependencies compiled by Amnesty International, Americas Watch..."
I talked about dead Iraqi children, our role in East Timor, our invasions, our assassinations, global poverty, animal rights. "If we were as interested in saving lives as we allude to in our grant applications," I wrote, "we would be in Bangladesh or would be organizing." I questioned their intellectual integrity. It was a rant of catharsis, a shedding of "liberal" middle class roots. "Research is a time intensive hobby; and there is work to be done." I can't imagine it was quite what the administration was expecting. I ended with a quote by 60's radical Abbie Hoffman: "I just want to do what has to be done so much. I'll never understand why everyone else doesn't feel this way."
So I decided the PhD was not for me. But why didn't I drop out completely? Why did I continue to pursue the MD? One could argue, of course, that medicine can be used as a vehicle for social change. The power this society affords physicians is obscene. I could imagine using that privilege, that power, those credentials to make a greater impact in whatever chose to do.
And isn't working for revolutionary social change what medicine should all be about? In 1985 the World Health Organization published a statement, "Without peace and social justice, without enough food and water, without education and decent housing, and without providing each and all with a useful role in society and an adequate income, there can be no health for the people...." Medical historical figure Rudolph Virchow wrote, "Politics is nothing more than medicine on a grand scale." Peace activist Daniel Berrigan wrote: "I'd like to see the peace movement to explore peacemaking from a metaphor of healing--that we are really trying to heal people, heal the culture, heal the Pentagon, and heal wherever we are."
I also envisioned medical school as a political education, learning more about The System. On a practical level, medicine has the potential to afford a degree of independence from authority. It could be a source of potentially nonexploitive income, kind of "MD as insurance policy," security for the radical.
During that summer before medschool, volunteer coordinators would ask, "What are your skills." Carpentry? Accounting? No; I couldn't even type very well. Medicine, I rationalized to myself, could be direct service as well. I could be bandaging heads split open at protests. Patch Adams offered the world a vision of the fusion of activism and medicine. Maybe I'll spend a few decades down there.
I am currently in internship, months out from medical school. Still in the grind. Could these years have been better spent? Isn't flashing the MD condoning this same sick system of credentials over substance in the first place? Isn't it justifying the same illegitimate authority I've railed against all my life, where it matters more how many letters you have after your name than if what you're saying is true? I can't help but wonder if my decision to remain in medical school was more ego and pride than compassion.
I have seven more months of the bleakness and savagery of internship. Then recovery, putting my life back together. A wedding. Susan and I made it through medical school. And then decisions, options, choices. A simplified life. Becoming social again, giving again. Becoming the me I knew before medical school, again.
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