culture · fellowship

Physician suicide

This week, the New England Journal published two articles on physician well-being, or the rather, the lack thereof. One, Kathryn, is the story of a fourth-year medical student who jumped out of her apartment window last August. The other, Breaking the Stigma, is about how the culture of medicine is one of ritual shaming, particularly when it comes to mental illness. [I think both are open access, but please let me know if they are paywalled.]

Tragic stories, both of them, and sadly common. There were no suicides in my medical school, but there was at least one almost. I’m glad that there is growing awareness — at least among medical educators, hopefully among the wider public too — of how severely we are failing each other. When one in ten medical students contemplate suicide, we are failing each other; we are failing our future.



I recently discovered Bramwell, a mid-90s show (now on Netflix) that has Jemma Redgrave as a doctor in 1890s London, who can’t get an appointment at Ye Olde Englysshe Hospitale — because she’s a woman, gasp! — so convinces a birdbrained lady philanthropist to give her money to start a charity hospital in the East End, which she very creatively names the Thrift. (Because her patients are poor. Get it?)

Don't mess with Dr. B.

I get the sense that the budget was all spent on period-appropriate costumes (because Jemma gets to wear some really awesome Victoriana, including a bike-friendly split skirt — like skorts, remember those?), because the supporting cast is hilariously bad. It’s like they called up the Royal Acting Academy for the Congenitally Monotone and asked for their middling-average students. Plus, the writers were intent on making every episode a Very Special, targeting issues like racism, sexual double-standards, and … the importance of a good cognac at dinner parties.

It’s basically Dr. Quinn in London instead of Frontiersville. Awful and awesome and I can’t stop watching. The fact that I’m trying to rework the stats on my thesis just might have something to do with the latter.

culture · health policy · infectious disease · narrative medicine · New York

The Normal Heart

Friday night, I went to see The Normal Heart, a revival of a 1985 play about the early days of AIDS. (Starring Lee Pace! And Jim Parsons! More on them later.) It was quite shocking to us, for whom HIV/AIDS has become … well, not a commonplace, but a fairly straightforward chronic disease. I was on the infectious diseases service last January, and it was one of the most difficult months of my life, but we knew was wrong with these patients. We knew it down to the molecular level. We had drugs to extend their lives. We couldn’t cure them, not quite yet, but we could do something. 

And so forgive my naivete, but it was a shock to step back nearly 30 years (the play is set 1981-1984) and see a time when that wasn’t possible. The Normal Heart is basically a rant against the people that twiddled their collective thumbs while young men died. It’s happened before, and it will happen again. It’s probably happening now, and I just don’t see it because of the New York bubble. The title comes from a poem by WH Auden, which you should all go read because it’s Auden, nuff said.

The didacticism and emotional manipulation did get a little heavy-handed at times, but there was enough nuance to just save it. The relationship between Ned and his conservative brother Ben, for instance — love, uncertainty, and depth. The City government and the NIH bear the brunt of Ned/Larry Kramer’s diatribe, probably fairly, but they do come across as straw men. I guess it’s easy to attack institutions, but I would have preferred to see the people within those institutions.

And fantastic acting all around. Lee Pace as a jerk (though hints of backstory suggest non-jerkish behavior)! And Jim Parsons — holy crap. He had very few lines, but he just commands the stage in this understated and powerful way. Everyone was amazing, but he was just on point.

I was thoroughly impressed and should probably read And the Band Played On at some point. Why don’t we talk about this stuff in medical school?