WEBVTT NOTE This file was generated by Descript 00:00:32.488 --> 00:00:35.548 Riley Behan-Bush: when I talk to undergrads who are pre-med, if they're in 00:00:35.548 --> 00:00:40.378 a major that is more obscure it's one of the first questions I'm asking them about. 00:00:40.428 --> 00:00:43.608 it's so interesting to talk to somebody who maybe went a little 00:00:43.608 --> 00:00:44.828 bit further off the beaten path. 00:00:44.938 --> 00:00:47.758 Madeline Cusimano: I came from a more conservative religious background. 00:00:47.826 --> 00:00:51.426 as a healthcare professional, you have an obligation to. 00:00:51.864 --> 00:00:53.664 The people who are in front of you 00:00:53.674 --> 00:00:57.214 every physician has a right to step away if it's something that 00:00:57.214 --> 00:00:58.534 they're not comfortable with. 00:00:58.954 --> 00:01:02.764 And I feel like if we lose that in medicine, we lose a lot of our ethics 00:01:02.814 --> 00:01:05.154 Dave Etler: welcome back to the short coat podcast. 00:01:05.184 --> 00:01:07.794 The show that gives you an honest look at medical school. 00:01:08.339 --> 00:01:10.929 this is a production of the university of Iowa Carver college of medicine. 00:01:10.929 --> 00:01:15.819 I'm Dave Etler with me today in the SEP studio, a veritable who's who of 00:01:15.819 --> 00:01:17.289 undergraduate medical education say. 00:01:18.214 --> 00:01:20.524 To Matt Anglican. 00:01:20.734 --> 00:01:21.214 Howdy. 00:01:21.331 --> 00:01:25.301 MD/PhD student Riley being Bush has arrived, over here. 00:01:25.301 --> 00:01:28.751 We've got, M D PhD, PhD soon to be MD. 00:01:28.751 --> 00:01:29.441 Is that right? 00:01:29.951 --> 00:01:30.251 Are you a 00:01:30.251 --> 00:01:31.091 Aline Sandouk: PhD? 00:01:31.571 --> 00:01:31.991 Not yet. 00:01:31.991 --> 00:01:34.121 I haven't defended yet. 00:01:34.121 --> 00:01:36.011 So PhD with an asterisk. 00:01:36.191 --> 00:01:36.821 Okay. 00:01:37.151 --> 00:01:37.421 Dave Etler: Yeah. 00:01:37.901 --> 00:01:43.991 And soon to be MD Elaine San duke, and four soon to be 00:01:44.141 --> 00:01:46.991 MD Madeline Cusumano is here 00:01:47.531 --> 00:01:49.991 Madeline Cusimano: countdown one week from today. 00:01:50.081 --> 00:01:50.831 I don't like it. 00:01:51.581 --> 00:01:51.811 I mean, 00:01:51.811 --> 00:01:52.841 Dave Etler: I like it for you. 00:01:53.561 --> 00:01:54.251 I like it for you. 00:01:54.251 --> 00:01:56.951 I don't like it for me that you're leaving Madeline. 00:01:57.611 --> 00:02:00.851 Madeline Cusimano: You know, I am very mixed feelings. 00:02:00.911 --> 00:02:04.091 I'm I dunno, I'm a very sentimental person. 00:02:04.091 --> 00:02:07.331 So I'm just like finding myself, driving around Iowa city and just being like, 00:02:07.361 --> 00:02:11.291 oh, I'm gonna miss this, or I'm gonna miss that person and you're going to 00:02:11.291 --> 00:02:11.711 Dave Etler: cry. 00:02:12.491 --> 00:02:13.481 You cry when you leave. 00:02:14.441 --> 00:02:17.681 Madeline Cusimano: I don't know if I'll cry at graduation. 00:02:17.681 --> 00:02:20.171 I feel like, I don't know. 00:02:20.171 --> 00:02:22.841 I cried alone in my car while driving through the cornfields 00:02:22.841 --> 00:02:24.011 of Iowa the other day. 00:02:24.011 --> 00:02:28.421 Cause I was just feeling sentimental about leaving this state, but that's fun. 00:02:28.421 --> 00:02:28.811 You cry. 00:02:28.871 --> 00:02:32.021 I'll probably cry when like I'm moving out, but maybe not at graduation. 00:02:32.021 --> 00:02:33.671 I feel like that'll be a joyous occasion. 00:02:34.121 --> 00:02:34.421 Do you have a 00:02:34.421 --> 00:02:35.711 Riley Behan-Bush: favorite thing about Iowa city? 00:02:35.861 --> 00:02:37.631 That you'll miss big Grove. 00:02:38.171 --> 00:02:38.501 That's a 00:02:38.501 --> 00:02:39.341 Madeline Cusimano: great place. 00:02:39.701 --> 00:02:42.281 Yeah, my husband and I just like played board games there, 00:02:42.281 --> 00:02:43.541 like all night, Wednesday night. 00:02:43.541 --> 00:02:45.791 It was it's one of my favorite places. 00:02:47.261 --> 00:02:47.531 Matt Engelken: It's a good 00:02:47.531 --> 00:02:47.891 Dave Etler: pick. 00:02:48.041 --> 00:02:49.121 Not a sponsor, but 00:02:49.481 --> 00:02:51.671 Matt Engelken: hashtag reach out, reach out. 00:02:52.121 --> 00:02:54.131 Not at all you out of state listeners. 00:02:54.461 --> 00:02:58.901 There's people here that think Iowa is in fact worthy of being sad about leaving. 00:03:01.031 --> 00:03:02.501 Riley Behan-Bush: I think that is that's noteworthy. 00:03:02.501 --> 00:03:02.741 Yeah. 00:03:06.461 --> 00:03:06.731 Dave Etler: Okay. 00:03:06.731 --> 00:03:12.311 Well, I guess I'll have to get used to this idea that, you know, after 19 years 00:03:12.311 --> 00:03:15.941 of working at the Carver college of medicine, I guess I'll, at some point I'll 00:03:15.941 --> 00:03:17.201 get used to the idea that people leave. 00:03:17.951 --> 00:03:18.251 Madeline Cusimano: Yeah. 00:03:19.271 --> 00:03:19.661 That's the 00:03:19.661 --> 00:03:20.441 Dave Etler: circle of life. 00:03:20.471 --> 00:03:20.921 Damn it. 00:03:21.641 --> 00:03:27.421 I also have one thing I have gotten used to is the fact that, and I don't know 00:03:27.421 --> 00:03:29.791 if I'll leave this in or not, but one thing I have gotten used to is the fact 00:03:29.791 --> 00:03:35.198 that, you know, to a certain extent, you am graduating in four is, are just so 00:03:35.198 --> 00:03:37.148 happy to put us in your rear view mirror. 00:03:40.178 --> 00:03:41.648 Madeline Cusimano: And that's why I said it's bittersweet. 00:03:41.648 --> 00:03:46.838 Like there's so much about medical school that I'm like ready to just move on from. 00:03:47.078 --> 00:03:50.978 But I mean, it's a very formative part of your life. 00:03:51.008 --> 00:03:55.448 A part of becoming a doctor, like all my first in the health care. 00:03:56.243 --> 00:03:57.893 Happened at this hospital. 00:03:57.893 --> 00:04:01.343 And some people are more sentimental about those things than others. 00:04:01.413 --> 00:04:07.111 I had, I would say on the scale of, one to 10, like my, the needle tips, 00:04:07.171 --> 00:04:10.801 way more positive experience at Carver college medicine specifically. 00:04:10.801 --> 00:04:12.241 So I think that's notable. 00:04:12.451 --> 00:04:16.051 Dave Etler: The, this was, you know, this, I was talking about this yesterday 00:04:16.621 --> 00:04:19.272 or the other day with Kate cause, you know, we, we, at this time of year, 00:04:19.272 --> 00:04:22.842 we, we put on all these ceremonies and all these little, little recognition 00:04:22.842 --> 00:04:25.512 things for our graduating seniors. 00:04:25.542 --> 00:04:30.882 And I always get the distinct impression that a group of them would be just 00:04:30.882 --> 00:04:32.245 as happy if we did not do that. 00:04:32.254 --> 00:04:34.054 I mean, they're happy to get the recognition and they're happy to 00:04:34.054 --> 00:04:36.364 get something on their, on their CV. 00:04:36.394 --> 00:04:41.644 They're happy to get recognition at graduation, but I think to 00:04:41.644 --> 00:04:44.674 some extent there's a group of people who is just like, you know 00:04:44.674 --> 00:04:49.294 what I I'm done with this place. 00:04:50.779 --> 00:04:51.409 I totally get it. 00:04:51.450 --> 00:04:56.251 so anyway to those people, it's cool. 00:04:57.961 --> 00:04:58.411 It's cool. 00:04:58.411 --> 00:04:59.251 Take care of yourselves. 00:04:59.461 --> 00:05:01.441 Love you forever. 00:05:01.441 --> 00:05:01.621 It. 00:05:01.662 --> 00:05:06.180 Michelina called the SEP listener line, seeking a little help 00:05:06.180 --> 00:05:08.430 on her path to medical school. 00:05:08.430 --> 00:05:10.440 Should we hear what Michelina has to say? 00:05:11.340 --> 00:05:11.700 Here we go. 00:05:11.970 --> 00:05:12.210 Come on. 00:05:12.210 --> 00:05:12.630 You guys. 00:05:12.660 --> 00:05:13.230 Let's do it. 00:05:13.290 --> 00:05:15.150 Madeline Cusimano: Yeah. 00:05:16.350 --> 00:05:16.440 Aline Sandouk: Hi, 00:05:16.440 --> 00:05:17.640 Michelina: my name is Nikolina. 00:05:17.970 --> 00:05:21.900 I am a student transferring in my junior year. 00:05:22.200 --> 00:05:28.860 I was a psych student, but I took a year and a half ish off because 00:05:28.860 --> 00:05:30.930 of COVID and being pregnant. 00:05:31.860 --> 00:05:40.230 And I struggled a lot to pass my classes that last semester before leaving school 00:05:40.470 --> 00:05:44.820 because of COVID and being pregnant, I. 00:05:46.090 --> 00:05:53.620 And switching the biology because it is faster, but I'm interested to know 00:05:53.680 --> 00:06:00.220 if, because I have a vested interest in pathology, it would be more worth 00:06:00.220 --> 00:06:07.030 it to do a degree in toxicology, which is also something I'm more interested 00:06:07.030 --> 00:06:12.070 in, or if it's worth it to just go through faster and finished the biology 00:06:12.070 --> 00:06:16.270 degree, because it's more applicable to the credits like currently have. 00:06:17.320 --> 00:06:21.820 I'm also curious to hear if anyone that you have on the show today worked full 00:06:21.820 --> 00:06:24.880 time while they were in medical school. 00:06:24.880 --> 00:06:31.660 As I work full time as an anesthesia tech, and my job will continue to 00:06:31.660 --> 00:06:36.370 pay for me to go to school so long as I continue to work there, which 00:06:36.370 --> 00:06:40.810 would mean that I would no have no further loans for my undergraduate. 00:06:41.620 --> 00:06:42.580 Thank you so much. 00:06:42.580 --> 00:06:43.000 And I love 00:06:43.000 --> 00:06:43.370 Dave Etler: the show. 00:06:43.383 --> 00:06:49.705 so let's start with I guess worries about, your, your last semester and COVID and 00:06:49.705 --> 00:06:50.935 your degree and all that kind of stuff. 00:06:50.935 --> 00:06:54.975 Cause I feel like there's a few questions there so first I did talk with our 00:06:55.095 --> 00:07:01.325 admissions expert, Rachel, Aaron, about this question Rachel has been on the show. 00:07:01.325 --> 00:07:01.974 a few times. 00:07:02.214 --> 00:07:06.104 So she says, first understand the schools like SeaComm are making allowances 00:07:06.464 --> 00:07:08.474 for dips and grades due to COVID. 00:07:08.624 --> 00:07:09.404 At least ours. 00:07:10.064 --> 00:07:12.530 Our school is, you know, they can see when you. 00:07:13.302 --> 00:07:16.662 You know what your, what your GPA was, what time of year. 00:07:16.662 --> 00:07:19.512 And they are aware that, you know, COVID messed with a lot of people's 00:07:19.512 --> 00:07:22.189 plans in many ways, including grades. 00:07:22.249 --> 00:07:29.375 So if you quote unquote just passed those that semester, you're probably cool. 00:07:29.466 --> 00:07:33.870 Um, also your pregnancy during that time is a factor that we 00:07:33.870 --> 00:07:36.060 would also be taking into account. 00:07:36.155 --> 00:07:38.885 I think third that, you know, you did struggle, you S you said, 00:07:38.885 --> 00:07:40.205 but you did pass those classes. 00:07:40.205 --> 00:07:41.351 So, well done. 00:07:41.351 --> 00:07:44.036 I think that's amazing given the circumstances you were in, you know, and 00:07:44.036 --> 00:07:47.878 your full-time job as an anesthesia tech is a huge plus, all those things should be 00:07:48.148 --> 00:07:49.948 and can be expressed in your application. 00:07:49.948 --> 00:07:51.411 They show, grit and determination. 00:07:51.921 --> 00:07:56.931 I think that's working full time being in school, being. 00:07:57.021 --> 00:07:59.841 I dunno if you were starting a family or if you already had a family, but 00:07:59.961 --> 00:08:04.394 either way, it's a lot going on there that, will be taken into account 00:08:06.224 --> 00:08:09.314 Madeline Cusimano: I think just based on the short summary that 00:08:09.314 --> 00:08:13.184 we got, like there's so much to be gleaned from all of that. 00:08:13.214 --> 00:08:18.584 Like, regardless of like how much she struggled at the time. 00:08:18.640 --> 00:08:22.350 I think really spinning that in a way to show grit and determination. 00:08:22.350 --> 00:08:27.254 Like you just said, Dave, is more than enough to, have a really positive 00:08:27.254 --> 00:08:29.004 like medical school application. 00:08:29.024 --> 00:08:33.421 and I think going to the like major thing, I think it just 00:08:33.421 --> 00:08:35.131 depends on what her goals are. 00:08:35.371 --> 00:08:40.141 Like if her goals are to get to medical school, as soon as possible, then maybe 00:08:40.411 --> 00:08:46.111 the biology degree is fine because as far as becoming a pathologist in the 00:08:46.111 --> 00:08:51.271 future, I think when you're applying to residency, I mean maybe the toxicology 00:08:51.271 --> 00:08:55.261 undergrad would distinguish you a little bit, but at that point they 00:08:55.261 --> 00:08:59.041 care more about what you do in medical school than what you did in undergrad. 00:08:59.041 --> 00:09:03.481 So if you're thinking about, oh my future career as a pathologist, then 00:09:03.481 --> 00:09:07.261 I think maybe you're looking a little bit too far ahead and you never know 00:09:07.261 --> 00:09:08.881 what's going to happen in medical school. 00:09:08.881 --> 00:09:11.641 You could find something else that strikes your interest. 00:09:12.271 --> 00:09:16.771 But if it's like, what's getting you through school now and something 00:09:16.771 --> 00:09:20.335 that you really want to add to your medical school application. 00:09:20.368 --> 00:09:25.798 I think the toxicology degree is fine, but as far as concerns for like 00:09:25.798 --> 00:09:28.768 finances and time, the biology degree. 00:09:29.503 --> 00:09:31.753 Especially with everything that they've told us about their 00:09:31.753 --> 00:09:33.943 application would be adequate. 00:09:34.153 --> 00:09:34.423 Dave Etler: Yeah. 00:09:34.423 --> 00:09:38.533 I mean, her, her job is, is paying for her undergraduate. 00:09:38.533 --> 00:09:42.373 So if she did switch to toxicology, my impression there is that 00:09:42.373 --> 00:09:43.692 that's not a problem, of money. 00:09:43.737 --> 00:09:45.567 but you just you're just time. 00:09:45.627 --> 00:09:45.957 Yeah. 00:09:46.077 --> 00:09:49.707 I mean, you're just, you know, putting off graduation maybe a little bit 00:09:50.517 --> 00:09:54.057 to, to get there, either of those paths seem totally cool to me. 00:09:54.057 --> 00:09:54.327 Yeah. 00:09:54.777 --> 00:09:55.047 I think I 00:09:55.047 --> 00:09:58.617 Riley Behan-Bush: would add as far as the toxicology goes, I think there's often 00:09:59.517 --> 00:10:03.177 the decision that pre-meds have to make, which is which major do you want to go to? 00:10:03.177 --> 00:10:08.037 And I know I didn't necessarily wrestle with this because I ended 00:10:08.037 --> 00:10:11.727 up choosing later in my college career, what I wanted to do. 00:10:11.727 --> 00:10:13.767 And I just stuck with the major that I was doing. 00:10:14.097 --> 00:10:18.387 But I do think there's something to be said about pursuing a passion of 00:10:18.387 --> 00:10:21.957 yours if she's really interested in toxicology, like I think there's a really. 00:10:23.352 --> 00:10:26.892 I guess good reason to pursue just something that brings you. 00:10:26.892 --> 00:10:30.162 Passion makes you interested in things like that. 00:10:30.222 --> 00:10:32.892 You're going to do much better in those classes than you would do learning 00:10:32.892 --> 00:10:34.512 about plants in your biology class. 00:10:34.692 --> 00:10:38.292 If you really feel like toxicology is more interesting to you. 00:10:38.292 --> 00:10:40.842 So I don't think the major is as important. 00:10:40.872 --> 00:10:42.042 However, time is money. 00:10:42.042 --> 00:10:46.992 You may have to add more credits and if you do have a child, now, that could 00:10:46.992 --> 00:10:51.642 be an issue based on the time that you want to be spending outside of school. 00:10:51.642 --> 00:10:55.902 So if you have to take extra credits to pursue this passion, then it might 00:10:55.902 --> 00:10:58.662 not actually be the best scenario. 00:10:58.662 --> 00:11:00.552 So I do think there's a lot of considerations. 00:11:00.552 --> 00:11:03.192 And like you had mentioned, like, what are her goals? 00:11:03.192 --> 00:11:06.222 If it's to get out as soon as possible, then maybe biology makes the most sense. 00:11:06.222 --> 00:11:10.632 But if you think that you might do better by taking classes, you're really 00:11:10.632 --> 00:11:15.552 passionate about, I am all for the path of choosing something that is outside 00:11:15.552 --> 00:11:21.162 the traditional biology or biomedical sciences or human physiology, I think. 00:11:22.077 --> 00:11:24.537 Looks really interesting on an application. 00:11:24.537 --> 00:11:27.237 It's something you can talk to everyone about on your interviews. 00:11:27.477 --> 00:11:31.227 And I think it just gives you a wider scope of knowledge because you're going 00:11:31.227 --> 00:11:34.317 to learn everything you need to know about biology once you get into medical school. 00:11:34.617 --> 00:11:37.767 So, absolutely that's my 2 cents, but good luck with the decision. 00:11:37.797 --> 00:11:39.417 I don't, that sounds like a difficult one. 00:11:39.627 --> 00:11:39.897 Matt Engelken: Yeah. 00:11:39.897 --> 00:11:44.184 I think going off of that a little bit, like depending on the major you go into, 00:11:44.184 --> 00:11:48.144 you might be a little bit further ahead just by having like a background in say 00:11:48.164 --> 00:11:51.114 pathology or a better biology background. 00:11:51.161 --> 00:11:54.181 I graduated in engineering, so my, knowledge base going 00:11:54.181 --> 00:11:55.401 into medical school was. 00:11:56.371 --> 00:11:57.011 Large. 00:11:57.011 --> 00:12:00.055 so it took a little bit of extra work to catch up to the point where 00:12:00.055 --> 00:12:01.765 I was, you know, passing exams. 00:12:01.765 --> 00:12:05.378 But at the end of the day, I still, had all of the information that I needed 00:12:05.378 --> 00:12:08.018 to learn given to me in medical school. 00:12:08.018 --> 00:12:12.188 So for me, it was a lot more like a rally set about choosing a major that 00:12:12.188 --> 00:12:16.118 I really like wanted to learn more about and wanting to go to classes 00:12:16.118 --> 00:12:21.338 and pass classes and like have a interesting and fun time in undergrad 00:12:21.338 --> 00:12:23.108 is fun as you can have at least. 00:12:23.152 --> 00:12:25.269 and yeah, everything that you'll need to know, especially like if you wanted 00:12:25.269 --> 00:12:29.229 to go into pathology or whatever down the line, you'll learn all that stuff. 00:12:29.229 --> 00:12:33.429 In medical school, we get an insane amount of pathology in our didactics. 00:12:33.479 --> 00:12:33.739 Dave Etler: Yeah. 00:12:33.749 --> 00:12:35.249 And, and I want to be clear. 00:12:36.899 --> 00:12:40.889 It does not matter what you, again, no, it does not matter 00:12:40.889 --> 00:12:42.119 what you study in undergrad. 00:12:42.839 --> 00:12:47.699 What matters is whether you enjoyed it. 00:12:48.749 --> 00:12:53.489 And whether you can talk about it in a way that indicates your passion for 00:12:53.489 --> 00:12:55.259 it or your, just your enjoyment of it. 00:12:55.315 --> 00:12:57.332 when you're doing your interviews 00:12:57.362 --> 00:13:00.062 Riley Behan-Bush: someday, I will anecdotally add that when I talk to 00:13:00.062 --> 00:13:05.492 undergrads who are pre-med, if they're in a major that maybe is more obscure 00:13:05.492 --> 00:13:09.332 in the pre-med track, it's one of the first questions I'm asking them about. 00:13:09.332 --> 00:13:11.672 If they say I'm, I'm majoring in. 00:13:13.142 --> 00:13:17.222 Let's just say toxicology, in this example, the first thing I would say is, 00:13:17.222 --> 00:13:19.472 wow, toxicology, how did you choose that? 00:13:19.922 --> 00:13:23.736 And that is always my first question when I'm meeting with, undergrads and I'm 00:13:23.736 --> 00:13:28.026 not even interviewing them, but I think as humans, that is, it's so interesting 00:13:28.026 --> 00:13:31.316 to talk to somebody who maybe went a little bit further off the beaten path. 00:13:31.426 --> 00:13:33.366 So that goes to Dave's point, 00:13:33.366 --> 00:13:35.466 Dave Etler: which is to say like our brains are used to picking 00:13:35.466 --> 00:13:37.026 out things that are different and 00:13:37.026 --> 00:13:38.616 Riley Behan-Bush: you might be able to speak with it, speak 00:13:38.616 --> 00:13:39.816 about it with more passion. 00:13:39.846 --> 00:13:45.336 I always found that was a huge plus of me having done a major that was kind of 00:13:45.726 --> 00:13:49.656 alternative to what other students had done is I was really passionate about it. 00:13:49.656 --> 00:13:50.616 I really enjoyed it. 00:13:50.646 --> 00:13:55.404 I had a great time, in my major in undergrad and I spoke with vigor about it. 00:13:55.404 --> 00:14:00.774 And I think people could sense that excitement because vigor, I think that's 00:14:00.774 --> 00:14:03.954 the point is they want to see that you're excited about that and you can take that 00:14:03.954 --> 00:14:05.094 excitement and apply it to medicine. 00:14:06.854 --> 00:14:08.397 Dave Etler: So, yeah, don't worry so much about which. 00:14:08.517 --> 00:14:10.968 do what fits best with your life, at this stage? 00:14:11.001 --> 00:14:11.692 it doesn't really matter. 00:14:11.692 --> 00:14:15.292 We have addressed working during medical school before on the show a few times. 00:14:15.305 --> 00:14:18.725 Madeline Cusimano: I'm wondering now that I re listened to that question, 00:14:18.725 --> 00:14:22.415 was she asking you about working while she's finishing out this degree? 00:14:22.805 --> 00:14:25.745 Dave Etler: So, I mean, she's going to, I think she's going to work 00:14:25.745 --> 00:14:26.945 while she finishes out the sticker. 00:14:26.945 --> 00:14:28.205 I think she's been doing that. 00:14:28.525 --> 00:14:29.735 She's been in anesthesia 00:14:29.735 --> 00:14:30.095 Riley Behan-Bush: tech. 00:14:30.455 --> 00:14:33.335 She get the anesthesia tech to also pay for her medical school. 00:14:33.335 --> 00:14:34.295 Is that I 00:14:34.355 --> 00:14:36.815 Dave Etler: think she wanted to know about working full-time during medical 00:14:36.815 --> 00:14:41.735 school, just because, or because she has a family and because I, you know, 00:14:41.735 --> 00:14:48.091 like maybe because she didn't want to take on more student loans, you know, 00:14:48.091 --> 00:14:52.171 she already, she already has this essentially, you know, quote unquote free. 00:14:53.356 --> 00:14:54.676 Undergrad experience. 00:14:54.759 --> 00:14:57.909 and she wants to know if she can sort of keep that going during medical 00:14:57.909 --> 00:15:05.349 school, working full time, having a young kid being in medical school. 00:15:06.414 --> 00:15:07.860 Sounds like, it sounds like a rough 00:15:07.860 --> 00:15:08.430 Aline Sandouk: road to me. 00:15:08.430 --> 00:15:11.070 It sounds like she already has a full-time job. 00:15:11.610 --> 00:15:12.150 I mean, 00:15:14.010 --> 00:15:14.400 Madeline Cusimano: full-time 00:15:14.400 --> 00:15:14.880 Aline Sandouk: jobs. 00:15:14.910 --> 00:15:15.300 Madeline Cusimano: What do you guys 00:15:15.300 --> 00:15:18.450 Dave Etler: think of this idea about working full-time and I think it's, 00:15:18.450 --> 00:15:21.180 Madeline Cusimano: I think that's one of the few things I say as a hard, no, 00:15:21.420 --> 00:15:23.790 in medical school is working full time. 00:15:24.120 --> 00:15:26.460 We've talked a lot about different creative ways that 00:15:26.460 --> 00:15:28.200 people can earn extra income. 00:15:28.500 --> 00:15:31.440 Dave Etler: People work, do work way more often than I thought. 00:15:31.590 --> 00:15:32.040 Madeline Cusimano: Yeah. 00:15:32.100 --> 00:15:36.837 I mean, I have a classmate who, was a sir, I can't, I might've even talked about this 00:15:36.837 --> 00:15:41.817 last time I was on the podcast, but who is a server at a local restaurant here? 00:15:42.357 --> 00:15:42.987 Undergrad. 00:15:43.497 --> 00:15:43.827 Yeah. 00:15:43.857 --> 00:15:44.427 She loved it. 00:15:44.427 --> 00:15:46.497 And she would just do Sunday nights only. 00:15:46.497 --> 00:15:47.337 They loved her. 00:15:47.337 --> 00:15:51.477 So, you know, it was way beyond the minimum that they would normally allow 00:15:51.537 --> 00:15:53.757 an employee just do Sunday night. 00:15:53.757 --> 00:15:57.267 She, she stopped kind of when things got really intense and 00:15:57.267 --> 00:16:01.385 then COVID happened so that, but then like fourth year slowed down. 00:16:01.385 --> 00:16:02.785 You don't have as much requirements. 00:16:04.085 --> 00:16:08.885 She's like probably working 25 hours a week at this point, because it's in 00:16:08.885 --> 00:16:10.505 four year and four years pretty chill 00:16:10.505 --> 00:16:10.745 Dave Etler: here. 00:16:11.075 --> 00:16:11.345 Yeah. 00:16:11.685 --> 00:16:17.145 Matt Engelken: I think another thing to mention is I know I'm obviously going to 00:16:17.145 --> 00:16:19.485 medical school for free would be awesome. 00:16:19.905 --> 00:16:23.511 We have a couple, MSTP students on the podcast right now that 00:16:23.541 --> 00:16:25.278 are having that experience. 00:16:25.331 --> 00:16:31.231 but also, it is a lot of work to work a full-time job and do medical school. 00:16:31.261 --> 00:16:34.211 I kind of agree with Madeline in saying it's nearly impossible. 00:16:34.211 --> 00:16:38.364 but also like loans can happen. 00:16:38.454 --> 00:16:43.284 And once you have like the physician salary, a lot of those problems 00:16:43.284 --> 00:16:47.484 will go away, but overworking yourself in medical school, it can 00:16:47.484 --> 00:16:49.314 just lead to burnout down the line. 00:16:50.349 --> 00:16:52.359 That's a scary thought to have. 00:16:52.999 --> 00:16:57.339 Dave Etler: There's a, I mean, the really important thing here is your kid, I think. 00:16:57.392 --> 00:17:01.002 and I mean, no judgment, in saying that you there, you know, why are you, 00:17:01.002 --> 00:17:02.142 why are you even considering this? 00:17:02.142 --> 00:17:02.712 You have a child. 00:17:02.712 --> 00:17:03.372 That's not what I mean. 00:17:03.402 --> 00:17:07.512 I just mean that, you know, if you work full time and you're going to 00:17:07.512 --> 00:17:10.182 medical school, I guarantee you that you're going to miss out on important. 00:17:11.622 --> 00:17:13.362 Aline Sandouk: And I wasn't even thinking about the child. 00:17:13.362 --> 00:17:17.712 I was just thinking about robbing yourself of the experience of going to med school. 00:17:18.132 --> 00:17:21.072 Like all the residents I talked to reflect back on their med school 00:17:21.072 --> 00:17:24.252 years as like one of the best times of their lives, you know, really 00:17:24.252 --> 00:17:27.552 bonding with their colleagues, like exploring their health interests, 00:17:27.552 --> 00:17:29.412 doing projects, stuff like that. 00:17:29.982 --> 00:17:31.452 And all of that. 00:17:31.542 --> 00:17:36.132 I don't think it would be possible if you were working and also raising what 00:17:36.132 --> 00:17:40.272 is, sounds like a very young child, not like a teenager that can clothe and feed 00:17:40.272 --> 00:17:42.582 itself, but needs constant attention. 00:17:43.062 --> 00:17:46.662 Madeline Cusimano: I think you can make some very smart, like I know it's like 00:17:46.692 --> 00:17:50.982 great to have goals of having almost no debt in like people from different 00:17:51.012 --> 00:17:55.512 socioeconomic background that might be more important than others, but there 00:17:55.512 --> 00:18:00.072 are ways, especially working very closely with your school's financial advisor. 00:18:00.072 --> 00:18:03.582 I'm a very big proponent of our school's financial. 00:18:03.618 --> 00:18:08.568 advisers, like there are ways that you can smartly navigate medical school to kind of 00:18:08.568 --> 00:18:12.858 minimize the amount that you're borrowing and then just making really good plans for 00:18:12.858 --> 00:18:16.038 repayment and all of that in the future. 00:18:16.038 --> 00:18:21.858 And I think, again, being more well, AKA having less things to juggle 00:18:21.888 --> 00:18:27.378 during medical school, you know, since family, the act of being in school. 00:18:27.378 --> 00:18:31.218 And I really liked what Elaine just said about being able to like, oh, 00:18:31.218 --> 00:18:32.958 there's this really interesting project. 00:18:32.958 --> 00:18:37.008 Like maybe an advocacy project that you get really passionate about 00:18:37.008 --> 00:18:41.598 and that might inform your future career or help your residency, 00:18:41.675 --> 00:18:43.205 application or, you know, what a. 00:18:43.940 --> 00:18:46.910 And I'll give you a little bit more freedom to balance all that, 00:18:47.000 --> 00:18:48.950 Riley Behan-Bush: and then argued to the medical students that 00:18:48.950 --> 00:18:53.210 seem to have the most enriching experience, see medical school as 00:18:53.210 --> 00:18:54.620 a full-time job in and of itself. 00:18:54.650 --> 00:18:58.640 They often see it as like, this is my purpose and this is what I'm 00:18:58.640 --> 00:19:02.480 doing, and I'm going to enrich it with extracurriculars in pursuing 00:19:02.480 --> 00:19:06.470 my interests and odds are, you're probably working 40 hours a week 00:19:06.470 --> 00:19:10.130 between attending lectures and studying and attending interest groups. 00:19:10.130 --> 00:19:12.830 I think you're probably working arguably more than 40 hours a 00:19:12.830 --> 00:19:16.550 week, a lot of the time, especially when you're in clinical rotations. 00:19:16.850 --> 00:19:19.580 So I think seeing it as that. 00:19:19.610 --> 00:19:24.230 So I do agree that that like the monitor aspect would be great. 00:19:24.230 --> 00:19:27.080 I think if we all could have jobs in a little extra income, 00:19:27.080 --> 00:19:28.430 I think a lot of us would do it. 00:19:28.468 --> 00:19:33.627 however, in order to kind of enrich your experience the most, like I would 00:19:33.627 --> 00:19:38.427 say, do all you can in the time that you will commit to medical school. 00:19:39.237 --> 00:19:42.537 Take that time off when you get to spend time with your children, when you 00:19:42.537 --> 00:19:47.397 get to spend time outside of medicine, I think that is arguably the most 00:19:47.397 --> 00:19:52.827 important part for me as a physician in training is I need adequate time 00:19:52.857 --> 00:19:58.407 outside of medicine to recoup, to relax, to decompress from the day. 00:19:58.707 --> 00:20:01.257 And that would be really difficult working. 00:20:01.257 --> 00:20:03.147 Full-time the entirety of medical school. 00:20:03.357 --> 00:20:08.277 I think you underestimate how much free time you need to decompress 00:20:08.277 --> 00:20:09.777 once you're in this field. 00:20:09.927 --> 00:20:10.047 Oh 00:20:10.047 --> 00:20:10.317 Madeline Cusimano: yeah. 00:20:10.317 --> 00:20:13.947 I, I know that not everyone has this luxury, but I highly enjoy 00:20:13.977 --> 00:20:17.757 my free time and pursuing my passion to the music and sports. 00:20:18.597 --> 00:20:23.484 Just hanging out, going to big Grove, being a person, um, bolding 00:20:23.484 --> 00:20:27.114 in my pocket is a check from the establishment, not just, 00:20:29.544 --> 00:20:29.694 Dave Etler: wow. 00:20:29.694 --> 00:20:33.534 That would be a lucrative sideline going on medical school podcasts 00:20:34.434 --> 00:20:37.914 Madeline Cusimano: to be promoting local restaurants, 00:20:38.184 --> 00:20:38.814 Dave Etler: telling Dave, 00:20:40.734 --> 00:20:44.304 Aline Sandouk: I want to add something like to the already great points. 00:20:44.304 --> 00:20:47.694 I think everyone made, I want to piggyback on something Madeline said, 00:20:47.783 --> 00:20:54.203 about curating an application that makes you really competitive for residency. 00:20:54.203 --> 00:20:55.133 That's something I didn't think of. 00:20:55.133 --> 00:20:58.553 I was just thinking of like, like from the selfish perspective of like enjoy, 00:20:58.583 --> 00:21:01.463 you know, the experience like really immerse yourself, which is also valuable, 00:21:01.463 --> 00:21:06.593 but when you have diverse experiences in med school, you're generating 00:21:06.593 --> 00:21:09.113 currency of a different kind, your. 00:21:10.568 --> 00:21:12.938 You're going to look so much more interesting. 00:21:12.968 --> 00:21:16.148 Cause like the thing I hear about applying to residencies, 00:21:16.148 --> 00:21:17.678 I like everyone's qualified. 00:21:17.678 --> 00:21:20.468 Everyone's a great candidate school, right? 00:21:20.468 --> 00:21:21.578 They all got good grades. 00:21:21.608 --> 00:21:25.238 They, you know, they're, they're all by all indications, adequately 00:21:25.238 --> 00:21:26.318 prepared to be good doctors. 00:21:26.318 --> 00:21:28.778 It really comes down to like, do we like this person? 00:21:28.808 --> 00:21:32.648 Like, do we want to hang out in the middle of the night on Saturday with this person? 00:21:32.648 --> 00:21:33.788 Can we stand with them? 00:21:34.298 --> 00:21:39.068 And I think the way that they gleaned that is from, you know, from an interview, but 00:21:39.068 --> 00:21:43.178 before getting to the interviews, just like your application and if all your 00:21:43.178 --> 00:21:46.388 application contains is I went to school. 00:21:47.558 --> 00:21:50.528 It's not to say that you don't deserve a spot, but it's going to be a lot harder, 00:21:50.528 --> 00:21:54.158 I think for residencies to pick you, because they're just not going to get 00:21:54.158 --> 00:21:55.718 a sense of who you are as a person and 00:21:55.718 --> 00:21:58.778 Madeline Cusimano: say, you know, her interests change in medical school. 00:21:58.778 --> 00:22:02.108 Like she no longer, you know, like is interested in pathology. 00:22:02.108 --> 00:22:02.918 It's something else. 00:22:02.948 --> 00:22:07.658 Then it's like, I mean, that, that was so stressful about picking a. 00:22:08.918 --> 00:22:09.488 Specialty. 00:22:09.488 --> 00:22:12.008 You was like, oh, well, I've done all these things for this. 00:22:12.008 --> 00:22:14.717 And now I, you know, and, a lot of it should apply. 00:22:14.717 --> 00:22:18.827 Cause again, most physicians that I meet, like don't expect you to have, 00:22:19.457 --> 00:22:23.117 have your specialty picked by the first or second year, but then there 00:22:23.117 --> 00:22:27.107 are some specialties that kind of double standard you and expect that. 00:22:27.467 --> 00:22:33.017 So it's, it's, there's just a lot of mental energy that goes into kind of 00:22:33.377 --> 00:22:39.317 choosing your life forward and to have a little bit more freedom to kind of adjust 00:22:39.317 --> 00:22:43.697 and pivot and diversify your medical school experience is going to be better 00:22:43.697 --> 00:22:46.377 for an application overall and, and 00:22:46.397 --> 00:22:48.767 Aline Sandouk: do a lot of soul searching at the same time. 00:22:48.797 --> 00:22:50.477 Like that takes time. 00:22:51.107 --> 00:22:56.267 Dave Etler: There is one aspect of this that I don't think we address 00:22:56.267 --> 00:23:02.717 enough on the show, which is the risk involved in, in entering medical school. 00:23:05.147 --> 00:23:06.857 I don't know how often this happens. 00:23:06.884 --> 00:23:12.898 but some people, you know, spend a year and a half, two years, maybe even two 00:23:12.898 --> 00:23:19.078 and a half, three years and realize I can't do this, this isn't for me. 00:23:19.588 --> 00:23:24.328 And then, you know, it's not like there's no, there's no money back 00:23:24.328 --> 00:23:27.378 guarantee, unfortunately, with this path. 00:23:27.858 --> 00:23:31.668 And so now you're maybe, you know, a hundred and something thousand 00:23:31.668 --> 00:23:32.238 Aline Sandouk: dollars a day. 00:23:32.278 --> 00:23:35.368 I don't hear enough from people who started and then stopped and 00:23:35.368 --> 00:23:36.898 then what they did with that. 00:23:36.898 --> 00:23:39.718 Cause it doesn't happen often, but it does have, it does happen. 00:23:39.748 --> 00:23:45.083 Dave Etler: And, and so maybe if I had to sort of extend my, my 00:23:45.083 --> 00:23:48.713 understanding or I, if I had to, if I had to prognosticate what the, what 00:23:48.713 --> 00:23:54.203 the actual basis of this question is maybe that fear that I'm going to get 00:23:54.203 --> 00:23:55.793 into this and realize it's not for me. 00:23:55.793 --> 00:23:57.263 And then I'll have sunk a whole bunch of money. 00:23:58.693 --> 00:24:03.223 Into into this that I can't repay at, or at least can't repay easily. 00:24:03.523 --> 00:24:04.856 I don't have an easy answer for that. 00:24:04.857 --> 00:24:05.067 that's 00:24:05.067 --> 00:24:05.577 Madeline Cusimano: a tough, 00:24:07.737 --> 00:24:10.467 Aline Sandouk: we live in a society that's driven by debt. 00:24:10.497 --> 00:24:11.187 Like, I don't know. 00:24:11.487 --> 00:24:14.247 There's just not a lot of people out there that don't have any debt. 00:24:14.277 --> 00:24:15.657 Everything in this country is. 00:24:16.392 --> 00:24:20.712 Supremely expensive from cars, anything worth having, you're 00:24:21.212 --> 00:24:22.332 only getting more expensive. 00:24:22.332 --> 00:24:24.492 You're going to have to borrow some amount of money. 00:24:24.972 --> 00:24:28.272 And she's in fact, like it's mind blowing that she's not 00:24:28.272 --> 00:24:29.262 going to have any college debt. 00:24:29.292 --> 00:24:31.392 There's a lot of people who come to med school. 00:24:31.812 --> 00:24:32.082 That's a 00:24:32.082 --> 00:24:33.012 Dave Etler: big, that's a big, 00:24:34.242 --> 00:24:35.052 Aline Sandouk: huge one. 00:24:35.052 --> 00:24:37.032 Like sh that's already a dramatic advantage. 00:24:37.062 --> 00:24:41.202 I think over her colleagues, but like a lot of people in the MSTP really 00:24:41.202 --> 00:24:44.232 worry about that because a lot of them went to like very expensive schools 00:24:44.232 --> 00:24:47.802 and like, yeah, they're not paying for med school, but now their college debt 00:24:47.802 --> 00:24:50.022 is just climbing and climbing climate. 00:24:50.022 --> 00:24:52.932 And they're not doing anything about it, you know, and they're freaked out. 00:24:52.932 --> 00:24:57.582 So she's already, she may not realize it, but she's already in a 00:24:58.062 --> 00:25:00.192 vastly better spot than I think most 00:25:00.912 --> 00:25:01.812 Dave Etler: matriculants. 00:25:02.082 --> 00:25:05.712 I don't think it's, you know, I'm, I'm not going to claim that, you know, 00:25:05.712 --> 00:25:06.912 it's not something to think about. 00:25:07.572 --> 00:25:09.312 I think another, cause that's, that's. 00:25:10.467 --> 00:25:11.847 Yeah, you got to think about it. 00:25:12.867 --> 00:25:15.687 Matt Engelken: I think another thing that we could mention is there are a 00:25:15.687 --> 00:25:19.797 lot of people, it sounds like you're in your junior year, so you've probably 00:25:20.187 --> 00:25:23.787 already decided that you are planning on going to med school, but there's a lot 00:25:23.787 --> 00:25:27.910 of people that want to go to med school and then decide not to down the line. 00:25:27.979 --> 00:25:30.799 and so also choosing a major based on something that you 00:25:30.799 --> 00:25:32.209 could see yourself doing forever. 00:25:33.139 --> 00:25:36.859 Is a good thing to have in the back pocket. 00:25:36.979 --> 00:25:41.571 Like I know, I always thought that I was going to go to medical school, but at 00:25:41.571 --> 00:25:44.811 the same time I knew that it down the line, if I decided I didn't want to go 00:25:44.811 --> 00:25:49.229 to medical school, I had a lot of options with my major and I had a lot of different 00:25:49.229 --> 00:25:51.029 career paths I could choose and love. 00:25:51.090 --> 00:25:55.109 and so that was also a big part of it, which is like, if I either like don't 00:25:55.109 --> 00:25:58.439 get into medical school or like decide, I don't want to go to medical school 00:25:58.439 --> 00:26:02.598 or be a doctor anymore, will I be happy with the life I've made for myself? 00:26:02.663 --> 00:26:05.273 so it's kind of both ways where if you want to go to medical 00:26:05.273 --> 00:26:09.023 school, as soon as possible, then biology sounds like a great option. 00:26:09.743 --> 00:26:14.483 But if you think that toxicology will be great, both for, like we said earlier, 00:26:14.483 --> 00:26:18.053 like just caring about your classes and loving your undergrad experience. 00:26:18.082 --> 00:26:21.082 or also just like, if you could see yourself getting a job that features 00:26:21.082 --> 00:26:24.772 toxicology, if you decide that medical school is not for you, then it's a 00:26:24.772 --> 00:26:27.412 really great choice to choose toxicology. 00:26:27.412 --> 00:26:29.032 Even if it takes a little longer. 00:26:29.632 --> 00:26:30.532 Riley Behan-Bush: I think that's a great point. 00:26:30.562 --> 00:26:34.802 And one that I often emphasize to a lot of people, I don't think it's a catch all. 00:26:34.802 --> 00:26:37.280 I guess it's not the catch all answer because I wouldn't recommend, 00:26:37.280 --> 00:26:38.630 like we both did engineering. 00:26:38.630 --> 00:26:42.579 I wouldn't recommend that for every pre-med because it's, it's hard. 00:26:42.909 --> 00:26:44.289 If you haven't heard, it's very difficult. 00:26:44.559 --> 00:26:45.589 It's very difficult. 00:26:45.589 --> 00:26:50.643 but you come out with skills that are greatly sought after problem 00:26:50.643 --> 00:26:55.196 solving, and it's widely applicable to different markets to different jobs. 00:26:55.196 --> 00:26:59.036 And that was the advice that I got from my parents in high school when I was 00:26:59.036 --> 00:27:00.476 thinking, oh, I might want to do this. 00:27:00.476 --> 00:27:00.896 Pre-med. 00:27:01.991 --> 00:27:05.591 I had a dad who was like, maybe you, I don't feel like you feel 00:27:05.591 --> 00:27:06.881 strongly enough about this. 00:27:07.451 --> 00:27:09.821 And you feel really strongly about this engineering thing. 00:27:09.821 --> 00:27:11.861 Let's do that because you could do both of them. 00:27:12.311 --> 00:27:15.101 So this is advice to maybe someone out there who's thinking 00:27:15.101 --> 00:27:16.421 about what they want to do. 00:27:16.871 --> 00:27:21.731 Choose based on, you could consider, I don't want to say choose based solely on 00:27:21.731 --> 00:27:25.271 what will give you the best job because medical school is also super exciting 00:27:25.271 --> 00:27:28.601 and you might want to get through as fast as possible, but if you're not so 00:27:28.601 --> 00:27:35.741 sure consider which major might give you the widest net that you could apply to 00:27:35.741 --> 00:27:40.241 future jobs, that doesn't make you a bad pre-med that just makes you a practical 00:27:40.241 --> 00:27:44.741 human in their twenties, trying to make sure they have all their bases covered. 00:27:44.921 --> 00:27:47.671 So just remember that it might help some people, it might not. 00:27:48.401 --> 00:27:51.311 Others who just feel really strongly about exactly what they want to do. 00:27:51.341 --> 00:27:52.661 I was not one of them here. 00:27:52.661 --> 00:27:53.964 I am feel strongly now. 00:27:53.964 --> 00:27:56.686 however, I don't know what residents you want to go into, 00:27:56.686 --> 00:27:58.726 so therefore I am back to zero. 00:27:59.326 --> 00:28:01.936 Matt Engelken: I think another thing kind of on that as well, is 00:28:01.936 --> 00:28:03.392 that a lot of your non-traditional. 00:28:03.392 --> 00:28:06.436 Um, paths for like majors will give you really unique 00:28:06.436 --> 00:28:08.566 experiences and unique skillsets. 00:28:08.956 --> 00:28:12.136 Like I know Raleigh brought up problem solving and like critical thinking is 00:28:12.136 --> 00:28:15.976 a huge thing that I know I'm looking forward to using in like clinics. 00:28:15.976 --> 00:28:19.402 And once I become a physician, but there's other things like, in a lot 00:28:19.402 --> 00:28:23.358 of like the fine arts or the visual arts, you have your, like creativity 00:28:23.688 --> 00:28:27.918 and you're thinking outside the box and like others, I know that there's a few 00:28:27.918 --> 00:28:29.688 business students and things that have. 00:28:30.383 --> 00:28:34.541 Kind of mindsets, that come in and are just as applicable as maybe knowing 00:28:34.541 --> 00:28:36.101 the Krebs cycle a little bit better, 00:28:37.661 --> 00:28:38.741 Aline Sandouk: it's worth emphasizing. 00:28:38.741 --> 00:28:40.211 And what Raleigh said, which is like 00:28:42.521 --> 00:28:46.361 Dave Etler: the cycle gets so much shit on the show and in general from med students, 00:28:46.571 --> 00:28:48.131 Madeline Cusimano: cause it's just the freaking worse 00:28:49.901 --> 00:28:50.291 Aline Sandouk: done. 00:28:50.291 --> 00:28:52.841 Dave Etler: So I have looked at this diagram before and 00:28:52.901 --> 00:28:54.071 it's made my eyes cross. 00:28:54.911 --> 00:28:55.421 I get it. 00:28:55.532 --> 00:28:58.952 Madeline Cusimano: So as the resident biology major 00:28:58.982 --> 00:29:01.735 here, I reckon loved biology. 00:29:01.765 --> 00:29:06.535 I did not really have a plan B if I didn't go to medical school because 00:29:06.835 --> 00:29:12.724 all my career options were a physical therapist, PA physician, potentially 00:29:12.724 --> 00:29:17.393 nursing, So I was just like, all right, I'm just going down this path, you know? 00:29:17.398 --> 00:29:20.128 I thought maybe it'd be like a high school, like get my teaching. 00:29:20.158 --> 00:29:23.038 Master's in teaching, be like a high school biology teacher. 00:29:23.578 --> 00:29:29.368 But, also if you really love biology, a big fear of mine was like, I hated 00:29:29.368 --> 00:29:35.175 that I was just the classic major, pre-med student, but I just made sure 00:29:35.175 --> 00:29:39.205 to highlight like my passion for it, but also highlight my other interests too. 00:29:39.255 --> 00:29:43.005 because I knew that I was like the most common major applying to medical 00:29:43.005 --> 00:29:47.115 school and that made me a little bit nervous, but it did make my life easier 00:29:47.115 --> 00:29:51.775 because, I had a lot more time, like I did not, like, I don't know, I didn't 00:29:51.775 --> 00:29:54.355 carry like huge loads in undergrad. 00:29:54.505 --> 00:29:58.555 I saved a lot of time for my extracurriculars, which I feel like 00:29:58.705 --> 00:30:00.685 really shown through a may application. 00:30:01.555 --> 00:30:03.055 That's kind of been my philosophy. 00:30:03.055 --> 00:30:03.385 I think. 00:30:04.195 --> 00:30:08.385 A common thread was just spend as little time on academics as possible 00:30:08.395 --> 00:30:12.085 and diversify my extracurriculars. 00:30:12.085 --> 00:30:12.985 Matt Engelken: So, yeah. 00:30:12.985 --> 00:30:16.915 And I think kind of going off of that, like what you said, even like biology 00:30:16.915 --> 00:30:20.965 is a standard thing to get into medical school, but showing that you chose the 00:30:20.965 --> 00:30:24.085 major for something that wasn't just, oh, so I can get into medical school. 00:30:24.085 --> 00:30:28.495 Like, because that is a very boring answer for the admissions committees. 00:30:28.525 --> 00:30:32.815 But like, if you love your major and love what you do, then that comes across in 00:30:32.815 --> 00:30:37.315 applications and interviews and that's, those are things you can't like lie about. 00:30:37.315 --> 00:30:40.615 And they're things that make you somebody that's appealing to the 00:30:40.615 --> 00:30:41.905 admissions committees as well. 00:30:43.805 --> 00:30:45.665 Aline Sandouk: you know, someone, we talk about a lot on the show is 00:30:45.665 --> 00:30:49.175 that when you're applying, like what anybody would see, calm really values 00:30:49.205 --> 00:30:52.355 is authenticity and passion and. 00:30:53.465 --> 00:30:59.335 Picking biology because it'll be done faster and it'll be cheaper, I think is, 00:30:59.335 --> 00:31:01.779 it's, it's a streak for practicality. 00:31:01.779 --> 00:31:05.499 That's going to come across really negatively to admissions 00:31:05.499 --> 00:31:07.269 committees, like right at the outset. 00:31:07.269 --> 00:31:08.619 You're already thinking about money. 00:31:08.769 --> 00:31:09.999 You're probably not right 00:31:09.999 --> 00:31:10.479 Dave Etler: for this. 00:31:10.779 --> 00:31:11.019 Yeah. 00:31:11.019 --> 00:31:14.182 But I think she's got so many different, I think she's got a different, and I 00:31:14.182 --> 00:31:14.392 don't 00:31:14.392 --> 00:31:17.392 Madeline Cusimano: think necessarily that she hates biology too. 00:31:17.392 --> 00:31:20.032 Like we didn't necessarily get that from the question. 00:31:20.062 --> 00:31:20.152 Okay. 00:31:20.212 --> 00:31:22.522 Dave Etler: Also I was going to say, I mean, she's got such a different life 00:31:22.552 --> 00:31:24.772 than some other kinds of medical students 00:31:25.672 --> 00:31:25.912 Madeline Cusimano: and 00:31:27.372 --> 00:31:27.822 Dave Etler: parents. 00:31:27.832 --> 00:31:31.462 I mean, that's just, it's, it's got, it's got to all 00:31:31.462 --> 00:31:31.552 Madeline Cusimano: be 00:31:31.552 --> 00:31:34.462 Riley Behan-Bush: taken into spot on the med school application 00:31:34.462 --> 00:31:35.902 of like ours parenting. 00:31:36.022 --> 00:31:39.202 Like that's like, like, you know how you put in your jobs and it's like hours 00:31:39.202 --> 00:31:45.392 done that time off, in my opinion, that should be like in 20, 24, 7 do the days. 00:31:46.327 --> 00:31:49.177 Had the child and then, yeah, you should just be able to put that 00:31:49.177 --> 00:31:49.987 on the med school application. 00:31:50.707 --> 00:31:51.097 I'd argue. 00:31:51.117 --> 00:31:51.607 That would be the 00:31:51.607 --> 00:31:52.087 Matt Engelken: hardest. 00:31:52.207 --> 00:31:55.177 Did they do have, like, is this like, is there anything else that 00:31:55.177 --> 00:31:57.877 you, we need to know about you, they put that on all the secondaries. 00:31:57.907 --> 00:31:58.087 Yeah. 00:31:58.267 --> 00:32:04.057 So really I would recommend highlighting that you're a parent and like the joys and 00:32:04.057 --> 00:32:07.790 benefits and like the things you get out of parenting, not as I'm like, oh, Boomi. 00:32:07.790 --> 00:32:09.620 I have to spend a lot of time with my kid. 00:32:09.749 --> 00:32:13.679 but in like a, these are ways that makes me an individual applicant or the 00:32:13.679 --> 00:32:15.119 Madeline Cusimano: struggles that have made you better. 00:32:15.179 --> 00:32:15.839 Exactly. 00:32:15.839 --> 00:32:16.139 Yeah. 00:32:16.619 --> 00:32:18.689 Riley Behan-Bush: Or what you've recognized about taking care of 00:32:18.689 --> 00:32:22.259 another human being that is both difficult and highly rewarding. 00:32:22.869 --> 00:32:25.799 Seems like it'd be a great thread to go into medicine with. 00:32:25.829 --> 00:32:26.489 Yeah, I 00:32:26.489 --> 00:32:26.909 Matt Engelken: agreed. 00:32:29.309 --> 00:32:31.250 Dave Etler: So, yeah, let us know how it goes. 00:32:31.321 --> 00:32:31.591 Aline Sandouk: Damn. 00:32:31.591 --> 00:32:32.281 We're awesome. 00:32:32.281 --> 00:32:33.811 That was all really good advice. 00:32:35.221 --> 00:32:36.871 Madeline Cusimano: She had a lot of questions we've 00:32:36.871 --> 00:32:38.101 been there that we had done. 00:32:38.551 --> 00:32:40.681 Dave Etler: Wait a minute to pat ourselves on the back. 00:32:41.221 --> 00:32:42.671 There we go. 00:32:42.671 --> 00:32:42.864 yeah. 00:32:42.894 --> 00:32:44.064 Th let us know how it goes. 00:32:44.064 --> 00:32:46.284 I'd love to hear more about your journey someday. 00:32:46.284 --> 00:32:48.580 If you have other questions, which you probably will. 00:32:49.600 --> 00:32:49.690 Madeline Cusimano: Okay. 00:32:49.760 --> 00:32:53.530 If you come to see calm, we have an anesthesia externship where you can 00:32:53.530 --> 00:32:56.320 work as an anesthesia tech and get paid. 00:32:57.720 --> 00:32:58.630 Riley Behan-Bush: Did not know that 00:32:59.260 --> 00:33:00.130 Dave Etler: that's right. 00:33:16.221 --> 00:33:20.361 We are in the midst of our spring, 2022 listener drive. 00:33:20.361 --> 00:33:23.211 We want to bring our message to new people, to encourage them during their 00:33:23.211 --> 00:33:27.402 medical school journey while acknowledging the triumphs and trials, to that end. 00:33:27.402 --> 00:33:29.979 I hope you'll share the show with your friends and colleagues. 00:33:30.015 --> 00:33:33.255 if you do a small token of my thanks, I'll send you one of these, 00:33:33.345 --> 00:33:36.895 acrylic pins I made for you, short coats, and there are three ways. 00:33:38.215 --> 00:33:38.995 You can get yours. 00:33:39.265 --> 00:33:42.805 Two of them are free just for sharing, or you can buy it for 00:33:42.805 --> 00:33:45.685 the special reduced price of $3. 00:33:45.895 --> 00:33:46.165 Wow. 00:33:46.165 --> 00:33:47.785 Matt Engelken: Only $3, three. 00:33:48.085 --> 00:33:50.155 Dave Etler: Great pen, $3. 00:33:50.575 --> 00:33:53.065 Who hasn't, which, which of you hasn't seen these pins yet? 00:33:54.025 --> 00:33:55.285 You've all seen these pins. 00:33:55.465 --> 00:33:57.685 Matt Engelken: I have my pen at home on a bulletin board. 00:33:57.685 --> 00:33:57.835 There 00:33:57.835 --> 00:33:58.315 Dave Etler: you go. 00:33:58.353 --> 00:34:01.466 yeah, head on over to the short code.com/pin to learn how to get yours. 00:34:01.466 --> 00:34:04.766 I'm so grateful for you out there, listening Short Coats and for your 00:34:04.766 --> 00:34:05.816 support of the show and our goal. 00:34:06.551 --> 00:34:09.551 To bring the truth about medical school, into ear holes everywhere. 00:34:09.551 --> 00:34:09.971 Thank you. 00:34:11.387 --> 00:34:11.887 Aline Sandouk: Ear holes. 00:34:11.887 --> 00:34:12.971 That's a technical term. 00:34:14.201 --> 00:34:14.931 Riley Behan-Bush: The medical term 00:34:14.961 --> 00:34:15.091 Aline Sandouk: That's 00:34:15.131 --> 00:34:15.701 right. 00:34:16.180 --> 00:34:16.841 Riley Behan-Bush: Ear hole docs, 00:34:19.218 --> 00:34:21.221 Madeline Cusimano: Ear hole docs, ear orifices. 00:34:22.721 --> 00:34:23.291 I don't know why 00:34:25.361 --> 00:34:25.701 Aline Sandouk: God 00:34:26.741 --> 00:34:28.191 Dave Etler: Is it an orifice or a foramen 00:34:29.371 --> 00:34:29.491 Madeline Cusimano: No, 00:34:29.491 --> 00:34:31.771 Aline Sandouk: it's a meatus actually isn't it. 00:34:32.591 --> 00:34:33.821 Madeline Cusimano: Well, there's a meatus 00:34:34.311 --> 00:34:35.711 Aline Sandouk: Or is meatus the opening 00:34:35.711 --> 00:34:36.461 itself. 00:34:36.511 --> 00:34:39.901 Madeline Cusimano: foramen is like, I feel like it has to go through it's. 00:34:39.931 --> 00:34:40.231 Yeah. 00:34:40.231 --> 00:34:41.881 It's like a ring that you go through. 00:34:42.421 --> 00:34:43.261 There's no exit. 00:34:45.391 --> 00:34:49.751 As soon as I did that, I was like, I hate--abort 00:34:51.591 --> 00:34:52.251 Aline Sandouk: abort 00:34:52.271 --> 00:34:52.711 Madeline Cusimano: I was like, 00:34:52.711 --> 00:34:53.641 no, visuals. 00:34:53.971 --> 00:34:54.761 This is a podcast. 00:34:54.781 --> 00:34:55.451 podcast 00:34:55.561 --> 00:34:56.861 Aline Sandouk: Use your imagination. 00:34:57.191 --> 00:34:57.311 guys 00:34:59.221 --> 00:35:01.139 Dave Etler: We're okay, so I want to talk, the other thing 00:35:01.139 --> 00:35:04.709 I want to talk about today is. 00:35:05.894 --> 00:35:09.054 About the role of discomfort in learning. 00:35:09.054 --> 00:35:11.790 one of the things, this is one of the things that we are thinking about in 00:35:11.790 --> 00:35:15.470 the writing and humanities program lately, how, on any topic you'd 00:35:15.470 --> 00:35:18.320 care to name at the intersections of medicine and society, especially 00:35:18.320 --> 00:35:22.004 there can be discomfort about the information that you're being presented. 00:35:22.004 --> 00:35:27.567 the obvious examples lately are things like how race affects health, termination 00:35:27.567 --> 00:35:29.547 of pregnancy, transgender medicine. 00:35:29.637 --> 00:35:31.087 A lot of these things are in the news lately. 00:35:31.157 --> 00:35:37.547 and I sense, I feel a lot of discomfort lately about these topics. 00:35:37.582 --> 00:35:39.574 but there are probably others that aren't as well known. 00:35:39.593 --> 00:35:42.113 like how people who are convicted are suspected of a crime should 00:35:42.113 --> 00:35:43.013 be treated in healthcare. 00:35:43.013 --> 00:35:43.613 Things like that. 00:35:45.413 --> 00:35:50.783 My question to you guys, in the studio and to you in the audience, if you 00:35:50.783 --> 00:35:54.863 want to reach out to us is how do you respond when you feel uncomfortable 00:35:54.893 --> 00:35:56.603 about what you're being taught? 00:35:59.693 --> 00:36:00.833 Riley Behan-Bush: This is a really good question. 00:36:00.893 --> 00:36:06.683 And one, we were just discussing in our lab the other day, in regards to histories 00:36:06.683 --> 00:36:13.223 of medicine that shed light on really terrible things, or why, or like certain 00:36:13.223 --> 00:36:17.123 things in medicine, we've only discovered because terrible things have happened. 00:36:17.153 --> 00:36:20.363 The common example is the Tuskegee syphilis experiment that we talk 00:36:20.363 --> 00:36:21.503 a lot about in medical school. 00:36:21.594 --> 00:36:32.004 and it's really hard as a person in medicine to recognize the evil past with 00:36:32.004 --> 00:36:35.394 which things we learn about came about. 00:36:35.634 --> 00:36:43.524 And I think that's where I feel this like intense discomfort of, oh, I'm I 00:36:43.524 --> 00:36:47.874 didn't take a part in that, but like, you have to acknowledge that as a medical 00:36:47.874 --> 00:36:52.794 system that I am now taking a part in, it comes from that place, therefore 00:36:52.794 --> 00:36:56.124 to say the kind of infrastructure in. 00:36:57.369 --> 00:37:01.629 Those experiments could happen still persists. 00:37:01.899 --> 00:37:07.779 And I, you almost have to take it and digest it and say, there 00:37:07.839 --> 00:37:12.249 is probably some of that still in society, in our medical system. 00:37:12.519 --> 00:37:19.089 And then I become overwhelmed by, oh my gosh, that is probably there. 00:37:19.119 --> 00:37:21.609 I have no idea what to do with that information. 00:37:21.909 --> 00:37:26.859 So that's the feeling I often end up with in going through these conversations 00:37:26.859 --> 00:37:29.709 of really tough and challenging things. 00:37:29.709 --> 00:37:33.849 And often again, I'm from my own example of talking about just 00:37:33.879 --> 00:37:35.859 kind of the evil pass of medicine. 00:37:35.859 --> 00:37:39.729 Like if you ever think about how we got anatomy textbooks, like had 00:37:39.729 --> 00:37:40.749 Madeline Cusimano: to come from somewhere, there's 00:37:40.749 --> 00:37:42.399 Dave Etler: a lot of really screwed up stuff in there from the 00:37:42.399 --> 00:37:45.699 perspective of our current society. 00:37:46.359 --> 00:37:46.619 Riley Behan-Bush: Yeah. 00:37:46.659 --> 00:37:49.359 So we've gotten a lot of knowledge from really messed up things. 00:37:49.359 --> 00:37:51.669 And how do you take that and sit with it? 00:37:52.149 --> 00:37:52.959 And then what do you do with. 00:37:53.679 --> 00:37:54.759 That's where I get stuck. 00:37:54.999 --> 00:37:55.929 What do you do with it 00:37:59.979 --> 00:38:01.779 Matt Engelken: kind of going off of that as well? 00:38:01.809 --> 00:38:05.962 I know right now a lot of medical schools are trying to, are trying their best to 00:38:05.962 --> 00:38:11.032 move away from some of those stereotypes, like trying to figure out which diseases 00:38:11.062 --> 00:38:16.672 are linked by, you know, heritage and ancestry rather than just like race. 00:38:16.693 --> 00:38:19.826 and trying to figure out like, if certain populations have a higher risk 00:38:19.826 --> 00:38:24.276 of disease because of socioeconomic status or if there's actual, genetic, 00:38:24.306 --> 00:38:29.614 genetic like differences, and like people that grew up in different areas. 00:38:29.614 --> 00:38:30.064 And so, 00:38:30.554 --> 00:38:32.914 Dave Etler: and at one time race was a blunt instrument. 00:38:33.094 --> 00:38:33.683 Yes. 00:38:33.684 --> 00:38:38.754 for figuring out like what people are more susceptible to than others. 00:38:38.754 --> 00:38:39.924 Cause it's basically all we have. 00:38:40.134 --> 00:38:40.794 And I think that. 00:38:41.694 --> 00:38:44.484 My guess is that, and, you know, it was kind of the best. 00:38:44.514 --> 00:38:47.364 Maybe, maybe it was the best information we had at the 00:38:47.364 --> 00:38:47.664 Madeline Cusimano: time. 00:38:48.034 --> 00:38:53.136 It's this balance of, not being like racially discriminatory, but also not 00:38:53.136 --> 00:38:54.666 being colorblind at the same time. 00:38:55.086 --> 00:39:01.026 So, you know, recognizing that like unique populations are more at risk. 00:39:01.026 --> 00:39:05.791 So like, whether it's to correct past wrongs or just to be particularly, 00:39:05.869 --> 00:39:11.209 paying attention to certain details while also not profiling people for any 00:39:11.209 --> 00:39:18.190 reason, whether it's religion, race, socioeconomic status, gender, all of that. 00:39:18.520 --> 00:39:18.790 It is 00:39:18.790 --> 00:39:21.880 Riley Behan-Bush: interesting though, when you go through studying for 00:39:21.880 --> 00:39:26.350 step one and step two and you can't help, but answer those questions 00:39:26.350 --> 00:39:28.720 that, you know, You know what it is. 00:39:28.720 --> 00:39:31.810 We've got an eight year old African-American boy who has 00:39:31.810 --> 00:39:33.160 sickling of his red blood cells. 00:39:33.160 --> 00:39:35.410 You can't like, they always add it. 00:39:35.770 --> 00:39:39.970 It's always a parameter in, we teach these as buzzwords. 00:39:39.970 --> 00:39:44.380 Like this race aspect is a buzzword for you to get this question. 00:39:44.380 --> 00:39:44.950 Correct. 00:39:45.340 --> 00:39:49.210 In going through tutoring, I was a tutor for the MSTP students who had 00:39:49.210 --> 00:39:50.530 just recently gone through step one. 00:39:50.530 --> 00:39:56.020 And a lot of the times we had to acknowledge these are step one questions. 00:39:56.020 --> 00:40:01.000 These are, these are not reflective of the actual world of medicine, just 00:40:01.000 --> 00:40:06.340 because race is a quick identifier on an exam question doesn't necessarily 00:40:06.340 --> 00:40:09.730 mean that it will be the quick identifier when you're in the clinics. 00:40:09.760 --> 00:40:14.680 And that was what struck me the most is as I'm doing these questions, I'm the tutor. 00:40:14.680 --> 00:40:18.730 And I want to emphasize this race portion in that was so hard. 00:40:18.730 --> 00:40:18.970 Cause it was. 00:40:19.675 --> 00:40:20.395 Oh, my God. 00:40:20.455 --> 00:40:25.645 It is a vital part of what they want me to understand is important 00:40:25.645 --> 00:40:27.415 that this question yet it feels 00:40:27.415 --> 00:40:27.835 Madeline Cusimano: so 00:40:28.525 --> 00:40:31.105 Aline Sandouk: race is a social construct. 00:40:31.195 --> 00:40:34.675 It is even more of a social construct than any of the other. 00:40:34.945 --> 00:40:38.425 There are truly no genetic differences between the races. 00:40:38.755 --> 00:40:39.565 Heritage. 00:40:39.595 --> 00:40:41.365 I think like Matt said is exactly right. 00:40:41.905 --> 00:40:47.152 People who have a longer, you know, lineage, originating in Africa are 00:40:47.152 --> 00:40:52.252 going to have, you know, I'm trying to remember the like more resistance to 00:40:52.252 --> 00:40:56.842 malaria because malaria was more prevalent in that region than in north America. 00:40:57.232 --> 00:40:59.632 But race is like, that's what we're talking about. 00:40:59.662 --> 00:41:03.772 It, it has no relationship or at least there's a relationship 00:41:03.772 --> 00:41:07.732 that we just didn't do a good job of a chore into something else. 00:41:08.542 --> 00:41:09.112 Right, 00:41:09.172 --> 00:41:09.772 Dave Etler: exactly. 00:41:10.882 --> 00:41:11.272 Yeah. 00:41:12.472 --> 00:41:16.282 Matt Engelken: Going back to Riley's point, I think medicine does. 00:41:17.642 --> 00:41:23.612 I think a poor job with writing questions because it's like, obviously racism is, 00:41:23.718 --> 00:41:27.558 like it's in a lot of questions stems, but there's also a lot of questions 00:41:27.558 --> 00:41:32.478 stems that will highlight things like obesity and type two diabetes and 00:41:32.478 --> 00:41:35.778 like IV drug users that are supposed to be these buzzwords for certain 00:41:35.778 --> 00:41:37.788 diseases and certain presentations. 00:41:37.794 --> 00:41:41.240 and to remember that, like not everybody that uses drugs becomes addicted 00:41:41.240 --> 00:41:43.010 to drugs or presents a certain way. 00:41:43.010 --> 00:41:46.160 And not everybody with diabetes has these exact same things. 00:41:46.160 --> 00:41:46.310 Sure. 00:41:46.310 --> 00:41:49.610 It's a higher prevalence in them, but they really like to give us 00:41:49.610 --> 00:41:54.350 those buzzwords to quickly correlate, certain populations with some diseases. 00:41:54.350 --> 00:41:58.790 But when we go into the field, that's really not how everyone presents and 00:41:58.790 --> 00:42:03.298 we can go in with, biases based on the question stems that are presented to us. 00:42:03.838 --> 00:42:04.198 So let's 00:42:04.198 --> 00:42:05.984 Dave Etler: talk though more about the discomfort part. 00:42:05.988 --> 00:42:07.158 has any of you ever. 00:42:08.483 --> 00:42:13.587 In class or in clerkships, felt the sense of like, I don't like 00:42:13.887 --> 00:42:15.897 what I'm hearing or seeing. 00:42:16.377 --> 00:42:17.937 I think, what did you do with that? 00:42:18.357 --> 00:42:19.587 Aline Sandouk: I'm going to go first on this. 00:42:19.617 --> 00:42:23.885 The thing that came to mind immediately is, and I'm not trying 00:42:23.885 --> 00:42:28.085 to sing, but seeing, as you said, the word, it got me thinking, the 00:42:28.085 --> 00:42:30.905 very casual use of the word racism. 00:42:31.115 --> 00:42:38.555 And Nazi-ism recently is something that I struggle with because Nazi-ism refers 00:42:38.555 --> 00:42:43.295 to like a very specific ideology of a very specific time period, targeting 00:42:43.295 --> 00:42:45.155 a very specific group of people. 00:42:45.785 --> 00:42:50.765 And I don't mean to say that it wasn't wrong obviously, but the problem is 00:42:50.765 --> 00:42:56.315 that when you call something Nazi-ism, that's not Nazi-ism you trivialize the 00:42:56.315 --> 00:43:01.235 Holocaust and you normalize Nazi-ism and that's something I'm seeing a lot. 00:43:01.940 --> 00:43:02.840 With racism. 00:43:02.870 --> 00:43:05.120 It's not racist to say. 00:43:06.410 --> 00:43:09.350 Cause you know, some of the things that they teach us are true, right? 00:43:09.620 --> 00:43:15.350 Some not related to race, but so that's the thing. 00:43:15.350 --> 00:43:16.220 It's complicated. 00:43:16.220 --> 00:43:19.820 Someone's heritage or someone's background or the socioeconomic 00:43:19.820 --> 00:43:20.960 situation they grew up in. 00:43:21.650 --> 00:43:23.030 There can be a relationship. 00:43:23.060 --> 00:43:26.660 But I appreciate what Matt is saying, which is maybe to like, keep an open 00:43:26.660 --> 00:43:29.960 mind that like that's not 100% of the thing that's going to be right. 00:43:29.960 --> 00:43:33.920 Like be open to the possibility that like, this is a pie. 00:43:34.010 --> 00:43:36.290 This could be it, but there's a lot of other things. 00:43:36.950 --> 00:43:43.040 But I think the quickness with which people jump to calling something 00:43:43.040 --> 00:43:45.530 racist is detrimental to people. 00:43:45.530 --> 00:43:47.330 Who've actually suffered from racism. 00:43:47.690 --> 00:43:49.490 And I, and not everyone agrees with that. 00:43:49.520 --> 00:43:52.130 And I, and I hesitate to say that I'm sure I'm gonna get a lot of hate 00:43:52.130 --> 00:43:53.420 mail tomorrow, but the thing is. 00:43:56.045 --> 00:44:00.295 It's if you're not saying that person is good or bad because of 00:44:00.305 --> 00:44:04.625 the, if you're merely making an observation, I don't find that racist, 00:44:04.985 --> 00:44:12.313 Dave Etler: but what if that observation leads to, errors in, I don't remember 00:44:12.313 --> 00:44:18.733 what type of error, but negative outcome, a negative outcome, because yeah. 00:44:18.973 --> 00:44:21.343 Well, how do you, I mean, how, when you're making that, when 00:44:21.343 --> 00:44:22.813 you're making that, I mean, 00:44:22.813 --> 00:44:25.903 Madeline Cusimano: you have different definitions, you have bias, you have 00:44:25.933 --> 00:44:27.703 discrimination, you have racism. 00:44:27.733 --> 00:44:32.443 And like, I don't know exactly if that exactly fits into what you're 00:44:32.443 --> 00:44:36.716 saying, but, I think bias can lead to racism and all of that. 00:44:36.716 --> 00:44:40.961 So there's, there's narrow-mindedness and, you know, I think maybe that's kind of 00:44:40.961 --> 00:44:43.421 the jet, the direction you are leaning. 00:44:43.451 --> 00:44:43.901 Yeah. 00:44:43.991 --> 00:44:48.371 Aline Sandouk: Nuance kind of, and have hard you wants is really hard. 00:44:48.401 --> 00:44:52.721 So like the example I was thinking of and the person who said it told me 00:44:52.721 --> 00:44:53.741 this story would, might be listening. 00:44:53.741 --> 00:44:55.901 So I would have to be really careful about what I say about it. 00:44:55.931 --> 00:44:57.895 But, they were like on route. 00:44:57.935 --> 00:44:59.825 So they were telling me a story about being on rounds. 00:44:59.855 --> 00:45:02.945 And one of the people on the team being like, I don't think 00:45:02.945 --> 00:45:03.935 this person's from this country. 00:45:03.935 --> 00:45:05.345 I think we should get an interpreter. 00:45:05.795 --> 00:45:08.105 And that person felt that was racist. 00:45:08.135 --> 00:45:13.805 And I was like, so the alternative is to not get an interpreter and then put that 00:45:13.805 --> 00:45:15.515 person at risk for getting worst case. 00:45:16.235 --> 00:45:19.445 To avoid the mere appearance of seeming racist. 00:45:19.775 --> 00:45:24.725 Like maybe that's not how I would have said it, but that person wasn't saying the 00:45:24.725 --> 00:45:26.555 stupid immigrant doesn't speak English. 00:45:26.585 --> 00:45:27.815 We should get an interpreter. 00:45:27.845 --> 00:45:29.975 Like they weren't making a value judgment. 00:45:30.005 --> 00:45:33.635 They were raising the possibility that this person wasn't understanding 00:45:33.785 --> 00:45:36.785 all of the complex information that was being relayed to them. 00:45:37.175 --> 00:45:41.285 Therefore we should preclude the possibility that they'd be harmed by not 00:45:41.285 --> 00:45:44.675 understanding by making sure that there's someone in the room who understands. 00:45:45.155 --> 00:45:48.425 Riley Behan-Bush: I think what you bring up is often where my 00:45:48.425 --> 00:45:54.155 emotion ends up lying, which is I want so badly to be empathetic 00:45:54.155 --> 00:45:56.075 toward every patient I ever see. 00:45:56.315 --> 00:46:00.185 And so I would be so fearful that I am doing the wrong 00:46:00.185 --> 00:46:02.045 thing by that specific patient. 00:46:02.405 --> 00:46:05.615 And I'd be so fearful then that by me wanting to do the right 00:46:05.615 --> 00:46:07.595 thing, it comes off the wrong way. 00:46:07.595 --> 00:46:12.155 I was in my clerkship, treating a patient who identified as a transgender. 00:46:13.265 --> 00:46:16.625 And had recently undergone transition later in life. 00:46:17.105 --> 00:46:20.735 And I was so worried every time I would step into a room that I 00:46:20.735 --> 00:46:24.125 would mis-gender or misidentify. 00:46:24.155 --> 00:46:29.255 And a lot of it stemmed from the fact that this person's records 00:46:29.255 --> 00:46:32.315 had not reflected the change yet. 00:46:34.535 --> 00:46:41.045 And I was filled with anxiety because I wanted to both respect this patient 00:46:41.045 --> 00:46:47.195 and also filled with anxiety because I felt unequipped with how to relay it 00:46:47.195 --> 00:46:53.525 to my team, felt unequipped with the language by which I should use talking 00:46:53.525 --> 00:46:59.285 about this patient who for all intents and purposes has a new identity that 00:46:59.285 --> 00:47:02.795 is not reflected within their chart. 00:47:03.305 --> 00:47:10.475 And I wanted so badly to make sure I respected this person's identity and. 00:47:11.210 --> 00:47:14.450 Was filled with fear that I would do the wrong thing. 00:47:14.450 --> 00:47:17.960 And I know that if I did and I would apologize and this person would 00:47:17.960 --> 00:47:22.850 likely be very forgiving, but I do think that I almost feel like I'm 00:47:22.850 --> 00:47:27.380 not, I want more to be more equipped with how to have conversations with 00:47:27.410 --> 00:47:30.860 immigrants, with people who identify as transgender with people who identify 00:47:31.040 --> 00:47:34.040 with any identification that they deem. 00:47:34.040 --> 00:47:37.880 And I just want to make them feel welcome in this world. 00:47:37.910 --> 00:47:38.000 Yeah, 00:47:38.060 --> 00:47:43.850 Dave Etler: no, I think that that discomfort that you felt it, you know, 00:47:43.850 --> 00:47:45.440 I think discomfort is a lot like pain. 00:47:47.620 --> 00:47:48.400 It is a tree. 00:47:48.460 --> 00:47:52.930 It is, it should be a sign of something that you need to pay attention to. 00:47:53.500 --> 00:47:53.860 Right. 00:47:56.140 --> 00:48:00.610 And I, and so what you were doing there was exactly that, you know, 00:48:00.610 --> 00:48:05.356 you, you felt a certain, discomfort with what you knew and what you 00:48:05.506 --> 00:48:09.076 understood and what you were seeing. 00:48:10.421 --> 00:48:11.771 And you paid attention to it. 00:48:11.887 --> 00:48:16.867 I don't think that implies that you are there for now perfect about how 00:48:16.867 --> 00:48:20.527 you deal with the world or how you see the world or anything like that. 00:48:20.527 --> 00:48:23.137 And I think that's also something to pay attention to, you know, you're, you're 00:48:23.137 --> 00:48:24.427 never going to be perfect about that. 00:48:24.457 --> 00:48:24.667 Yeah. 00:48:24.736 --> 00:48:27.646 Riley Behan-Bush: I think I come from a place too that like, I 00:48:27.646 --> 00:48:29.326 want to recognize those things. 00:48:29.326 --> 00:48:33.736 I, I I'm learning and I'm, I try to remind myself I am in the process of learning 00:48:33.946 --> 00:48:36.676 to be, it did, and I always will be. 00:48:36.676 --> 00:48:39.676 And I seek out learning. 00:48:39.676 --> 00:48:43.276 What is the best communication for all types of people. 00:48:43.276 --> 00:48:44.066 I seek that out. 00:48:44.946 --> 00:48:51.112 And I, I guess I hope for kind of in that, example of maybe the person asking 00:48:51.112 --> 00:48:56.812 for the interpreter, I asked for maybe compassion when I do say the wrong thing. 00:48:56.812 --> 00:48:59.812 And I think it makes a lot of people fearful and you just want 00:48:59.812 --> 00:49:02.812 to make sure that we are doing the best by every group of people. 00:49:02.812 --> 00:49:08.542 Like I genuinely wanted this patient to feel so welcomed by me as a 00:49:08.542 --> 00:49:13.162 student, in a system that has been inherently unwelcoming to her. 00:49:13.792 --> 00:49:21.412 And I felt like I didn't know how to make her feel as welcomed as she could, because 00:49:21.412 --> 00:49:24.802 it ended up being a systemic issue that like I couldn't handle as an actress. 00:49:24.862 --> 00:49:26.512 Dave Etler: There's nothing you can do about the fact that the chart 00:49:26.512 --> 00:49:30.112 doesn't include all the necessary details of this person, who that 00:49:30.112 --> 00:49:31.192 might be medically relevant. 00:49:31.792 --> 00:49:34.092 Madeline Cusimano: I think a lot of these, kind of themes that we're 00:49:34.092 --> 00:49:37.152 talking about could be mitigated by. 00:49:37.902 --> 00:49:42.222 Just being open to making mistakes and apologizing when you do, like, I had 00:49:42.222 --> 00:49:46.965 a situation where, I was being like very intentional with my language. 00:49:47.073 --> 00:49:51.513 when talking about someone who identified as non-binary and used 00:49:51.513 --> 00:49:57.158 pronouns, they, them and I, in a text message accidentally mis-gendered. 00:49:57.158 --> 00:50:04.508 So like in auditory conversations and all of that, like I felt like I was, 00:50:04.838 --> 00:50:06.848 you know, being appropriate and whatnot. 00:50:06.848 --> 00:50:09.398 And then it was just like a quick text that I sent out. 00:50:09.548 --> 00:50:13.328 Dave Etler: It's those quick interactions for gender that I have a big. 00:50:14.153 --> 00:50:14.723 Yeah, 00:50:15.263 --> 00:50:15.653 problem 00:50:16.373 --> 00:50:22.223 Madeline Cusimano: and not a crime and all literally, you know, I started having 00:50:22.223 --> 00:50:26.213 all this guilt and, and then, and I was just like, all I needed to do is just 00:50:26.213 --> 00:50:32.543 say also, I'm sorry that I mis-gendered your friend and my previous text message. 00:50:32.723 --> 00:50:34.823 I have attempted to be very intentional. 00:50:35.303 --> 00:50:36.413 This was a slip-up. 00:50:36.953 --> 00:50:37.313 Aline Sandouk: Yeah. 00:50:37.433 --> 00:50:38.003 Oops. 00:50:38.273 --> 00:50:38.453 Yeah. 00:50:38.473 --> 00:50:43.463 I mean, they is completely the vast majority of people that I find 00:50:43.463 --> 00:50:46.763 myself in situations like that, where they're like, Hey, thank you so much. 00:50:46.793 --> 00:50:49.553 Most people don't even recognize that they said the wrong thing. 00:50:49.583 --> 00:50:49.733 Dave Etler: Yeah. 00:50:49.913 --> 00:50:56.483 I think when I think I am more upset when I realized later and have no opportunity 00:50:56.483 --> 00:50:59.723 to have no now have no recourse because I can't go back to that part. 00:50:59.753 --> 00:51:01.343 I don't know where they are anymore or 00:51:01.343 --> 00:51:01.523 Madeline Cusimano: anything. 00:51:01.553 --> 00:51:05.303 I think how I've mitigated these situations in the past, like. 00:51:06.608 --> 00:51:09.088 If I was in your situation with the patient was just 00:51:09.128 --> 00:51:11.078 like almost not talk at all. 00:51:11.558 --> 00:51:12.998 And that's worse 00:51:14.888 --> 00:51:15.758 Riley Behan-Bush: desire to do 00:51:15.758 --> 00:51:16.058 Dave Etler: that. 00:51:16.478 --> 00:51:18.308 You're letting your discomfort rule. 00:51:18.608 --> 00:51:18.938 Yeah. 00:51:18.968 --> 00:51:19.298 Yeah. 00:51:19.328 --> 00:51:19.928 And that is 00:51:20.888 --> 00:51:21.788 Madeline Cusimano: worse care. 00:51:21.788 --> 00:51:27.278 So it's just like, oh, almost like not saying their name at all, or just kind 00:51:27.278 --> 00:51:32.948 of talking about a situation and not including, like, there are ways that 00:51:32.948 --> 00:51:37.148 you can get around conversations where you like don't make any mistakes, but 00:51:37.148 --> 00:51:42.368 it makes communication really awkward and it's in a patient care situation. 00:51:42.368 --> 00:51:45.548 It probably makes their patient care worse and more awkward. 00:51:45.548 --> 00:51:50.678 And so I think that, you know, talking about discomfort, I did not have almost 00:51:50.708 --> 00:51:54.908 any experience with the transgender community before medical school. 00:51:55.298 --> 00:51:58.316 And so, I think the only way to get better. 00:51:59.546 --> 00:52:03.656 You know, throw yourself in there and make mistakes at times, and then 00:52:03.656 --> 00:52:06.266 apologize when you're wrong, more 00:52:06.326 --> 00:52:07.916 Aline Sandouk: direct, personal and Iraq. 00:52:07.976 --> 00:52:09.536 It's practice makes perfect. 00:52:09.536 --> 00:52:11.096 That's exactly the point. 00:52:11.126 --> 00:52:15.566 People are going to make mistakes and it's look, the world is changing really quick. 00:52:15.626 --> 00:52:18.056 It has changed and it is continuing to change. 00:52:18.056 --> 00:52:21.296 And sometimes we just don't know the right language, but like what's coming 00:52:21.296 --> 00:52:27.926 across loud and clear is you can't go wrong when you have authenticity. 00:52:27.926 --> 00:52:30.599 And when you show a, an honest desire to be better. 00:52:30.909 --> 00:52:31.209 Dave Etler: like 00:52:31.389 --> 00:52:34.359 Riley Behan-Bush: requires that when you think I don't want to go talk to this 00:52:34.359 --> 00:52:38.589 patient, because I'm afraid of using the wrong language to push past that 00:52:38.589 --> 00:52:40.959 barrier and to say, no, you know what? 00:52:40.959 --> 00:52:41.889 I've learned enough. 00:52:41.919 --> 00:52:42.819 I'm going to go in. 00:52:42.819 --> 00:52:45.099 I'm going to have compassion for myself when I make mistakes. 00:52:45.099 --> 00:52:46.539 I'm going to say I am so sorry. 00:52:47.199 --> 00:52:49.989 When you do make mistakes and you're going to learn from it. 00:52:49.989 --> 00:52:52.629 And I think that's the hard part is to push past that 00:52:52.629 --> 00:52:54.309 discomfort and to learn more. 00:53:09.447 --> 00:53:15.477 Dave Etler: I think the other discomfort that you can feel is with people that you 00:53:15.957 --> 00:53:23.337 feel like you cannot agree with, how they live their lives, people who, or, or, or 00:53:23.337 --> 00:53:28.557 circumstances that they find themselves in that you judge to be improper. 00:53:28.589 --> 00:53:31.241 as I said that the, you know, the person from the person who went to 00:53:31.241 --> 00:53:32.381 prison, who now needs healthcare. 00:53:33.251 --> 00:53:33.624 Right. 00:53:33.624 --> 00:53:38.291 or I don't know any, any number of things that you can, that you 00:53:38.291 --> 00:53:41.801 can unconsciously or consciously judge, to be antithetical to you. 00:53:42.701 --> 00:53:43.571 Way of living. 00:53:44.651 --> 00:53:49.091 I don't think it's, you know, we're, we're all in here, you know, talking 00:53:49.091 --> 00:53:53.440 about being compassionate, and thinking about the other person and 00:53:53.440 --> 00:53:57.160 all this kind of stuff, which is what you are, which is kind of the ideal. 00:53:57.160 --> 00:54:02.560 But you know, some people come to this profession with very little 00:54:02.560 --> 00:54:04.180 experience outside their own. 00:54:04.270 --> 00:54:04.600 Yeah. 00:54:04.960 --> 00:54:06.820 How they, you know, outside how they grew up 00:54:08.530 --> 00:54:11.736 Madeline Cusimano: so I think, I think this, especially in like the first couple 00:54:11.736 --> 00:54:16.986 of years of medical school, like you have an opportunity to just learn a lot. 00:54:17.346 --> 00:54:22.056 So if it's lectures about topics that are kind of uncomfortable for 00:54:22.056 --> 00:54:27.843 you, like, I mean, just take those in, and listen, I came from a more 00:54:27.843 --> 00:54:29.673 conservative religious background. 00:54:29.785 --> 00:54:34.813 and so, yeah, I think, not all of the things that I learned in medical 00:54:34.813 --> 00:54:39.013 school were in conflict with my own personal beliefs, but I did feel 00:54:39.013 --> 00:54:43.512 at times that, That, that other perspective isn't always representative 00:54:43.632 --> 00:54:45.492 represented in medical school. 00:54:45.504 --> 00:54:48.711 I'm not saying that I was like conservative politically. 00:54:48.711 --> 00:54:52.396 but I just felt like that there are a lot of things that were one sided. 00:54:52.396 --> 00:54:58.415 And again, like, like I said, I just had, almost no interaction, not. 00:54:59.615 --> 00:55:02.765 Means of actively avoiding it, but with the transgender community. 00:55:02.765 --> 00:55:05.975 So it was just really a lot of just like learning from ground zero. 00:55:06.004 --> 00:55:12.887 when, what you're asking about is like things that you cannot like, something 00:55:12.887 --> 00:55:14.837 that you completely disagree with them. 00:55:14.917 --> 00:55:19.147 I feel like as a healthcare professional, you have an obligation to. 00:55:20.707 --> 00:55:24.187 The people who are in front of you and you can separate that 00:55:24.187 --> 00:55:25.447 from your personal beliefs. 00:55:25.447 --> 00:55:33.641 But I also very strongly believe in now the ethics term is, leaving me right now. 00:55:33.671 --> 00:55:34.031 Dr. 00:55:34.031 --> 00:55:37.290 Calvin talks about it, the, therapeutic Alliance. 00:55:37.320 --> 00:55:41.751 No, it's, basically, every physician has a right to like, you know, like 00:55:42.021 --> 00:55:44.781 not to refuse care and like kick someone out of their office, but 00:55:44.781 --> 00:55:48.531 like to step away if it's something that they're not comfortable with. 00:55:48.951 --> 00:55:53.241 And I feel like if we lose that in medicine, we lose a lot of our ethics too. 00:55:53.901 --> 00:55:54.141 Matt Engelken: You don't want 00:55:54.141 --> 00:55:57.951 Dave Etler: to talk a little bit more about like, as I think there's 00:55:57.951 --> 00:56:04.131 this perception that I'm a doctor, I work for everybody who walks in with. 00:56:05.906 --> 00:56:09.146 Yeah, I think what you're saying seems to, and what you, what Dr. 00:56:09.146 --> 00:56:13.016 Caldron is apparently taught is it's not necessarily the case. 00:56:14.336 --> 00:56:16.016 Madeline Cusimano: Well, I think that there's always referral. 00:56:16.736 --> 00:56:17.156 Dave Etler: Okay. 00:56:17.636 --> 00:56:26.306 So maybe the best option in that situation is to say, Work with 00:56:26.306 --> 00:56:27.296 you, but I know somebody who can. 00:56:28.136 --> 00:56:30.056 Madeline Cusimano: Yeah, but I just, I don't know. 00:56:30.086 --> 00:56:31.196 This is, this is hard. 00:56:31.196 --> 00:56:34.586 Cause I feel like my thoughts aren't fully formed and I'm like talking 00:56:34.586 --> 00:56:37.436 about, yeah, this is complex. 00:56:37.586 --> 00:56:37.856 I, you 00:56:37.856 --> 00:56:40.556 Dave Etler: know, like people get mad at these discussions I think 00:56:40.556 --> 00:56:42.866 are, I don't think it's fair. 00:56:43.316 --> 00:56:46.016 Aline Sandouk: It's hard to have these conversations because the stakes are 00:56:46.016 --> 00:56:50.786 so high and there are so many people all across the political spectrum that 00:56:50.786 --> 00:56:53.786 are like, if you don't agree with me a hundred percent right now, without 00:56:53.786 --> 00:56:55.706 question faithfully, we're done. 00:56:56.366 --> 00:57:00.476 And they are so unforgiving and it's not even having a difference 00:57:00.476 --> 00:57:03.986 of opinions, but merely questioning is now seen as intolerance and 00:57:03.986 --> 00:57:07.076 it's fairy off-putting honestly, 00:57:07.976 --> 00:57:11.426 Matt Engelken: I think going back to where you're going with that Madeline. 00:57:12.501 --> 00:57:15.501 It's just like, I know the one thing that Dr. 00:57:15.501 --> 00:57:18.451 Kajan who, for people that don't know is our ethics professor. 00:57:18.451 --> 00:57:22.874 one thing that we focused on was like people that might be abusing 00:57:22.874 --> 00:57:25.952 their, opioids, opioid medication. 00:57:25.971 --> 00:57:29.791 how do you deal with that as a physical, as a future physician? 00:57:29.813 --> 00:57:32.543 because on one side we do want to treat them and we want to make 00:57:32.543 --> 00:57:38.333 sure that they are as healthy and as like feeling well as possible. 00:57:38.693 --> 00:57:42.983 But on the other side, like we can't contribute to the opioid epidemic. 00:57:43.013 --> 00:57:46.283 And so trying to like figure out those boundaries and it's like, do 00:57:46.283 --> 00:57:51.113 we kick away everybody that like, doesn't completely fill our needs? 00:57:51.113 --> 00:57:54.023 Or like, if somebody goes on vacation, can we give them an opioid 00:57:54.623 --> 00:57:59.213 prescription ahead of the date that they can or does that put risk into it? 00:57:59.213 --> 00:58:01.193 So there's a lot of nuance that I feel like. 00:58:02.108 --> 00:58:06.098 Can lead to issues, but I know that that was one big thing of like, you 00:58:06.098 --> 00:58:11.378 can turn away people if they're not adhering, especially if they're not 00:58:11.378 --> 00:58:14.438 adherence can cause like a bigger issue. 00:58:14.738 --> 00:58:15.578 But what if, 00:58:17.978 --> 00:58:25.028 Dave Etler: what if you accept that they are, they themselves are imperfect, 00:58:25.868 --> 00:58:30.428 struggling with something that is difficult for them to come, you know, 00:58:30.878 --> 00:58:41.288 to adhere to, and just allow yourself to have whatever small victories you can. 00:58:41.288 --> 00:58:44.018 I E that came to me. 00:58:45.848 --> 00:58:47.468 They, they came to me in the first place. 00:58:47.468 --> 00:58:49.208 That's a tiny victory right there. 00:58:49.808 --> 00:58:53.638 I'm in a system that sometimes isn't very forgiving for people who, do 00:58:53.638 --> 00:58:55.678 quote unquote the wrong thing, or 00:58:55.828 --> 00:58:57.598 Aline Sandouk: you're tie that harm reduction. 00:58:59.443 --> 00:59:01.393 Harm reduction goes both way. 00:59:01.453 --> 00:59:03.013 It goes all ways actually. 00:59:03.043 --> 00:59:07.393 And I think that's what Maddie is alluding to, or actually kind of outright set 00:59:07.393 --> 00:59:12.793 of, like you're dealing with the patient in front of you and you might hear some 00:59:12.793 --> 00:59:15.733 things or you yourself express some things that they don't like, or they 00:59:15.733 --> 00:59:20.203 might say things that you don't like, but at the end of the day, you are the perf. 00:59:20.743 --> 00:59:22.423 And I like to take what you're saying. 00:59:22.423 --> 00:59:26.113 Maybe a step further is like, I am the professional. 00:59:26.953 --> 00:59:27.913 It's not about me. 00:59:27.913 --> 00:59:28.723 It's about them, 00:59:29.653 --> 00:59:30.073 Madeline Cusimano: you know? 00:59:30.523 --> 00:59:34.603 And if you truly disagree with whatever their life choices are and what, cause 00:59:34.603 --> 00:59:38.893 I think what's part of, what's really difficult for this conversation is like 00:59:39.223 --> 00:59:43.603 every specific situation is so different and this could apply to a broad range and 00:59:43.603 --> 00:59:44.893 Aline Sandouk: we're not naming any of them. 00:59:44.893 --> 00:59:46.843 We're talking in very unspecific. 00:59:47.003 --> 00:59:48.193 Madeline Cusimano: So yeah. 00:59:48.253 --> 00:59:53.953 So if you just like strongly either morally or just like really, even 00:59:53.953 --> 00:59:57.163 for the good of their own health disagree with their life choices, like. 00:59:57.958 --> 01:00:00.928 If for whatever reason that makes it really hard for you to care for them. 01:00:00.928 --> 01:00:05.338 And you might have something personal, like your father died from lung cancer. 01:00:05.338 --> 01:00:08.488 And so you have a patient who continues to smoke or whatever, you 01:00:08.488 --> 01:00:10.037 know, like it could be anything. 01:00:10.071 --> 01:00:14.511 but I think the bottom line in most situations, it's just like 01:00:14.511 --> 01:00:18.051 you treating them as a whole human being, listening to their stories 01:00:18.051 --> 01:00:22.671 and doing the best that you can is going to make their experience within 01:00:22.671 --> 01:00:24.561 the healthcare system more positive. 01:00:24.591 --> 01:00:29.691 And therefore they might consider making the choices that you personally 01:00:29.691 --> 01:00:31.341 think are the best choices for them. 01:00:31.406 --> 01:00:33.884 and for their health in the future. 01:00:34.004 --> 01:00:34.664 So taking 01:00:34.664 --> 01:00:41.654 Dave Etler: that discomfort, examining it and figuring out what, you 01:00:41.654 --> 01:00:44.689 know, not ignoring it, not pushing people away, not, not, you know, 01:00:44.689 --> 01:00:50.899 condemning them, not pushing the situation away, but examining it and. 01:00:53.029 --> 01:00:57.169 Acting in a way that is in the best interest of the person in front of you. 01:00:57.649 --> 01:00:58.009 Madeline Cusimano: Yeah. 01:00:58.459 --> 01:01:00.529 And separating what comes from your yeah. 01:01:00.529 --> 01:01:06.989 Your personal experience versus your overall like life, perspective. 01:01:06.989 --> 01:01:11.718 and I thought of it conscientious objection is the term. 01:01:11.748 --> 01:01:13.873 I think that that should still exist. 01:01:13.873 --> 01:01:18.626 because if we, as physicians don't have autonomy, like what you should 01:01:18.626 --> 01:01:22.616 and should not refuse is a different argument than the autonomy we have 01:01:22.766 --> 01:01:27.270 as physicians for, conscientious objection to exist as a principle. 01:01:27.420 --> 01:01:29.310 But that's just my opinion. 01:01:30.270 --> 01:01:33.150 Aline Sandouk: I think that's one that comes up a lot actually. 01:01:33.180 --> 01:01:34.440 And I, I agree. 01:01:34.440 --> 01:01:35.100 I think. 01:01:36.885 --> 01:01:39.435 However we feel on the issue that comes up. 01:01:39.705 --> 01:01:43.665 I think people should absolutely have the right to step away from a situation where 01:01:43.665 --> 01:01:46.425 they don't feel aligned with their values. 01:01:46.425 --> 01:01:49.605 And I know that's probably, I don't think that's a popular opinion. 01:01:49.605 --> 01:01:52.875 I think that might even be a little controversial depending, 01:01:53.385 --> 01:01:54.345 but again, it goes both. 01:01:54.375 --> 01:01:58.425 So the problem that I have around a lot of these conversations is that people 01:01:58.425 --> 01:02:03.045 have this expectation of a courtesy that they themselves don't want to give. 01:02:03.495 --> 01:02:08.145 So they want a lot of flexibility to exercise, you know, whatever 01:02:08.145 --> 01:02:11.685 feels right to them, but not for anyone else just for them. 01:02:11.715 --> 01:02:15.795 And the problem is either everyone gets to have that right. 01:02:15.825 --> 01:02:17.085 Or no one gets to have that. 01:02:17.085 --> 01:02:17.385 Right. 01:02:18.105 --> 01:02:22.215 And I think that's what leads to a lot of discord nowadays, but 01:02:22.215 --> 01:02:23.895 that's the thing about convictions. 01:02:24.165 --> 01:02:25.815 You don't get to choose when they apply. 01:02:26.025 --> 01:02:27.495 That's why they're called convictions. 01:02:27.495 --> 01:02:28.875 They're your core beliefs. 01:02:28.905 --> 01:02:29.235 And when. 01:02:30.495 --> 01:02:32.745 Pick and choose how to apply their values. 01:02:32.775 --> 01:02:34.095 They're not really values. 01:02:34.575 --> 01:02:38.655 If your values change in order to make something maximally convenient for 01:02:38.655 --> 01:02:40.305 yourself, then I have news for you. 01:02:40.605 --> 01:02:42.885 That's not a core value of yours, but what if your 01:02:42.885 --> 01:02:47.175 Dave Etler: value is changed because you engaged with that sense 01:02:47.175 --> 01:02:48.585 of discomfort, that's different. 01:02:48.615 --> 01:02:48.825 Aline Sandouk: Yeah. 01:02:49.155 --> 01:02:51.855 You know, Hey, I had a lot of learning to do, and I thought 01:02:51.855 --> 01:02:54.705 about this and I've changed. 01:02:55.125 --> 01:02:59.595 So here's the thing I operate on the belief that fundamentally everyone 01:02:59.595 --> 01:03:00.975 thinks they're doing the right thing. 01:03:00.975 --> 01:03:05.085 What we disagree on is method and information. 01:03:05.715 --> 01:03:08.865 Sometimes we just have different information, but like, I really want to 01:03:08.865 --> 01:03:13.545 believe that deep down as contemptible, as some people might seem on the 01:03:13.545 --> 01:03:17.025 surface, they are doing what they have been raised to believe as the right. 01:03:18.030 --> 01:03:23.160 And we just have different ideas about how, I don't know if anyone 01:03:23.160 --> 01:03:25.020 else agrees with that, but I think 01:03:25.020 --> 01:03:29.130 Dave Etler: it's hard when the right thing appears to hurt other people. 01:03:29.440 --> 01:03:30.090 Of course. 01:03:30.270 --> 01:03:30.540 Yeah. 01:03:30.720 --> 01:03:38.400 And so, you know, hopefully if you're engaging with, with that thing that 01:03:38.400 --> 01:03:45.210 makes you wonder, or that, that, that moment where your brain goes, huh? 01:03:45.480 --> 01:03:45.930 Okay. 01:03:46.020 --> 01:03:47.340 I don't is that really? 01:03:48.420 --> 01:03:50.880 I'm not expressing this well on an audio podcast, 01:03:51.990 --> 01:03:53.130 Aline Sandouk: it's so complicated. 01:03:53.130 --> 01:03:57.030 Like I can, like, I've been sweating for the last 10 minutes cause 01:03:57.030 --> 01:04:00.160 I, cause we're, we're talking a little bit in circles, but because, 01:04:00.780 --> 01:04:01.050 Madeline Cusimano: well, 01:04:01.080 --> 01:04:03.820 Dave Etler: the thing, the reason we're talking in circles is because I 01:04:03.820 --> 01:04:08.830 want this discussion to be about the discomfort and what you should do with it. 01:04:09.595 --> 01:04:09.865 And we're 01:04:10.045 --> 01:04:11.245 Madeline Cusimano: not necessarily 01:04:12.085 --> 01:04:12.355 Dave Etler: right. 01:04:12.355 --> 01:04:14.206 And we're all definitely uncomfortable. 01:04:14.206 --> 01:04:18.958 and I, and I don't necessarily want it to be about the issues themselves, 01:04:19.588 --> 01:04:21.058 but it's really hard to separate 01:04:21.058 --> 01:04:21.368 Madeline Cusimano: those two. 01:04:21.448 --> 01:04:21.718 Yeah. 01:04:21.718 --> 01:04:26.188 So to go back to that, I just feel like regardless of where you fall on this 01:04:26.188 --> 01:04:33.614 spectrum of any issue, like kind of taking the time to listen, having deep 01:04:33.674 --> 01:04:40.064 conversations with a diverse thought group, which is really hard to find and 01:04:40.064 --> 01:04:44.864 really hard to do, I found like there's so many echo chambers, like in a lot 01:04:44.864 --> 01:04:46.394 of different ways, and to be clear, 01:04:46.394 --> 01:04:48.104 Dave Etler: we've been accused on this podcast. 01:04:48.104 --> 01:04:48.944 I've been in an echo 01:04:48.944 --> 01:04:49.244 Madeline Cusimano: chamber. 01:04:50.054 --> 01:04:50.644 And I, I 01:04:50.864 --> 01:04:52.944 Dave Etler: think to some, to some extent we have, I mean, the 01:04:53.024 --> 01:04:57.044 people who are on the show are the people who's happened to sign up. 01:04:57.404 --> 01:04:59.414 Sometimes people sign up in groups. 01:04:59.864 --> 01:05:00.164 Yeah. 01:05:00.233 --> 01:05:02.003 other times it's completely random. 01:05:02.423 --> 01:05:04.073 I think we're blessed today. 01:05:05.948 --> 01:05:08.858 To have what I feel like is a variety of viewpoints. 01:05:10.328 --> 01:05:11.648 Aline Sandouk: We share the same values. 01:05:11.648 --> 01:05:16.298 Like ultimately we're all agreeing that we want to do right by our patients. 01:05:16.418 --> 01:05:16.868 Right. 01:05:18.278 --> 01:05:18.818 Dave Etler: So I just 01:05:18.818 --> 01:05:21.698 Madeline Cusimano: found that helpful to enlight. 01:05:21.728 --> 01:05:25.058 This could go wrong, but like I found it helpful to go back and 01:05:25.058 --> 01:05:28.718 have these conversations and what I consider as a safe space of people 01:05:28.718 --> 01:05:32.498 who grew up in a similar background to me, which you could do that and 01:05:32.498 --> 01:05:35.888 then just never change your views or never consider other perspectives. 01:05:36.158 --> 01:05:40.193 But it's, for me, it's just like I found, that, like when I tried to say something 01:05:40.193 --> 01:05:43.853 that I didn't quite have the terminology for or whatever that I was shot down. 01:05:44.708 --> 01:05:48.398 And that, you know, my views weren't necessarily accepted. 01:05:48.462 --> 01:05:51.265 and again, they weren't even necessarily fully formed views. 01:05:51.295 --> 01:05:51.385 Okay. 01:05:51.415 --> 01:05:52.045 And you're talking, 01:05:52.115 --> 01:05:53.755 Dave Etler: so to be clear, are you talking about the people 01:05:53.755 --> 01:05:55.405 that you go back to within your, 01:05:55.430 --> 01:05:55.700 Madeline Cusimano: yeah. 01:05:55.730 --> 01:05:58.900 Or other classmates that had a similar background than me? 01:05:59.240 --> 01:05:59.360 Dave Etler: Yeah. 01:05:59.400 --> 01:06:04.070 So people, so people who grew up like you are who, you know, you're 01:06:04.070 --> 01:06:05.120 sort of aligned with already. 01:06:05.150 --> 01:06:05.510 Yeah, 01:06:05.510 --> 01:06:06.140 Madeline Cusimano: exactly. 01:06:06.140 --> 01:06:11.180 And in the conversations were to like, make just a process, like 01:06:11.330 --> 01:06:15.900 these really complicated topics that, have a lot of weight in society. 01:06:15.960 --> 01:06:16.230 And so 01:06:16.230 --> 01:06:18.180 Dave Etler: in a sense, you caused them some discomfort and 01:06:18.180 --> 01:06:19.560 they were like, mm, yeah, no. 01:06:19.920 --> 01:06:20.070 Yeah. 01:06:20.070 --> 01:06:21.720 Riley Behan-Bush: Like the discomfort at the end of the 01:06:21.720 --> 01:06:24.330 day is sometimes an opportunity. 01:06:25.080 --> 01:06:26.610 For your values to evolve. 01:06:26.640 --> 01:06:30.720 I'm not talking, you are eliminating your values and you are doing a 01:06:30.720 --> 01:06:36.600 180, but maybe your values evolve as we humans evolve over the years. 01:06:36.600 --> 01:06:41.880 I mean, I think back to my values that I probably held 10 years ago when I was 01:06:41.880 --> 01:06:47.550 in my teenage years and they're very different than the value they evolved and 01:06:47.550 --> 01:06:49.440 it wasn't just a 180 switch overnight. 01:06:49.440 --> 01:06:53.910 And so don't see that discomfort as I must now flip from black to white 01:06:53.910 --> 01:06:57.990 because there's a lot of gray and there's a lot of grade Wade through 01:06:57.990 --> 01:07:02.070 and to evolve through on your values in both directions and all directions. 01:07:02.070 --> 01:07:05.100 So having the diverse conversation surrounding yourself with 01:07:05.100 --> 01:07:09.380 knowledge, like listen to that discomfort, cause it might be. 01:07:10.200 --> 01:07:13.770 I'm uncomfortable, but I'm willing to learn and I'm willing to evolve, like, 01:07:14.250 --> 01:07:19.500 and be kind to yourself and recognize that evolution doesn't come overnight. 01:07:19.800 --> 01:07:21.720 That discomfort won't go away overnight. 01:07:21.750 --> 01:07:25.620 The values that I held 10 years ago that are different than the values I hold. 01:07:25.620 --> 01:07:27.570 Now that didn't happen overnight. 01:07:27.570 --> 01:07:33.030 That happened over years of conversations, of learning more about the certain topics. 01:07:33.030 --> 01:07:37.440 And like with each of those evolutions came more discomfort and I still feel 01:07:37.440 --> 01:07:41.400 uncomfortable, but I'm willing to accept that that discomfort likely is going 01:07:41.400 --> 01:07:43.320 to come with some degree of evolution. 01:07:43.800 --> 01:07:45.360 And I still will hold values. 01:07:45.360 --> 01:07:50.490 That mean a lot to me, so know that they can change because I think that's 01:07:50.490 --> 01:07:54.090 the problem is sometimes people see their values as static, and that can 01:07:54.090 --> 01:07:59.310 get us into maybe the world in which we have today, in which all values 01:07:59.310 --> 01:08:03.210 feel as though they can't move at all. 01:08:03.890 --> 01:08:08.070 Aline Sandouk: I just want to clarify something I said earlier, I don't 01:08:08.070 --> 01:08:10.950 mean to create the impression that values can't change what I'm saying. 01:08:11.010 --> 01:08:14.130 I think it's, I think it comes down to a question of semantics. 01:08:14.130 --> 01:08:18.150 Like for me, a core value is all people have inherent dignity or 01:08:18.150 --> 01:08:19.770 like all people deserve respect. 01:08:19.770 --> 01:08:23.250 And so if you make it much, much more specific, I think 01:08:23.250 --> 01:08:24.720 that's what people call values. 01:08:24.750 --> 01:08:29.460 But like, that's like I'm having trouble expressing myself 01:08:29.460 --> 01:08:31.110 Riley Behan-Bush: the point though, I think I hear what you're 01:08:31.110 --> 01:08:33.030 saying, which is the values may be, 01:08:33.660 --> 01:08:36.120 Aline Sandouk: what's the most fundamental belief that you can 01:08:36.120 --> 01:08:37.320 break that down to, which is 01:08:37.680 --> 01:08:39.180 Riley Behan-Bush: a different word than value when you're 01:08:39.180 --> 01:08:41.610 Madeline Cusimano: speaking out against hypocrisy. 01:08:42.120 --> 01:08:42.660 Aline Sandouk: Yes. 01:08:42.660 --> 01:08:43.740 That's the, yes. 01:08:43.770 --> 01:08:46.080 That's the biggest thing that drives me crazy. 01:08:46.080 --> 01:08:46.650 Thank you. 01:08:47.130 --> 01:08:51.060 All I, you know, I don't even care where someone sits on the political spectrum. 01:08:51.240 --> 01:08:54.240 What I'm looking for is consistency of thought, like a 01:08:54.240 --> 01:08:55.950 consistent application of that. 01:08:56.190 --> 01:08:59.940 It's impossible to find and you know, the reason I'm so steamed about it 01:08:59.940 --> 01:09:04.620 right now, I'm realizing is because the activist circles that I run in. 01:09:05.415 --> 01:09:07.215 With people that are supposed to be fighting. 01:09:07.215 --> 01:09:10.995 The same issue I care about are like paradoxically. 01:09:10.995 --> 01:09:14.535 So detrimental to populate to the population we're trying to help. 01:09:14.895 --> 01:09:19.215 And they're so blinded by their own self-righteousness that I see. 01:09:19.245 --> 01:09:23.385 They can't even be talked into seeing how they're, they're hurting people that 01:09:23.385 --> 01:09:27.195 they're supposedly out here helping and that what they're doing just boils down 01:09:27.195 --> 01:09:29.565 to virtue signaling and the highest order. 01:09:29.625 --> 01:09:31.175 I, and that's why this 01:09:31.545 --> 01:09:35.895 Dave Etler: though virtue signaling is a step towards 01:09:36.225 --> 01:09:39.555 something better or something more. 01:09:39.555 --> 01:09:40.065 I don't know. 01:09:40.065 --> 01:09:42.465 Like, I, I, if 01:09:42.465 --> 01:09:42.735 Madeline Cusimano: you're a 01:09:42.735 --> 01:09:45.945 Aline Sandouk: person that other people look to, yeah. 01:09:46.035 --> 01:09:50.355 Maybe it's a, then it can be a positive thing to be like, yes, this is my opinion. 01:09:50.355 --> 01:09:56.865 And I want people to know that I feel this way, but there are other examples. 01:09:56.985 --> 01:09:57.545 I don't know. 01:09:57.795 --> 01:10:02.850 Like, and to me, what I'm realizing it boils down to is just like, Insane trend 01:10:02.850 --> 01:10:09.300 towards narcissism and people adopting causes that are fashionable because 01:10:09.630 --> 01:10:13.410 they want to look like, and like for the cause that I work on, like, I don't 01:10:13.410 --> 01:10:15.090 even care why you're on the bandwagon. 01:10:15.120 --> 01:10:16.230 I'm just glad you're here. 01:10:16.320 --> 01:10:17.250 Let's get to work. 01:10:17.280 --> 01:10:20.640 And I hope that you stay after this becomes not cool anymore. 01:10:21.270 --> 01:10:25.200 And this is, I think that's been the driving thought behind my con. 01:10:25.470 --> 01:10:28.740 Like what I've been saying today is at the back of my mind, when I keep 01:10:28.740 --> 01:10:32.700 thinking about are people who will jump from one cause to the next to 01:10:32.700 --> 01:10:35.790 the next, without actually thinking about the people we're fighting for 01:10:36.150 --> 01:10:37.860 just cause they want to be included. 01:10:37.860 --> 01:10:39.180 And there's nothing wrong with that. 01:10:40.530 --> 01:10:43.560 Cause again, I don't care why you're at the party. 01:10:43.560 --> 01:10:44.970 I just care that you're here. 01:10:45.420 --> 01:10:46.230 Let's get to work. 01:10:46.260 --> 01:10:48.630 Like I can make anyone a good soldier for my cause. 01:10:49.410 --> 01:10:52.750 For some amount of time, but the best soldiers are the ones who 01:10:52.750 --> 01:10:57.150 were there to stay and who were there for the right reasons. 01:10:57.210 --> 01:10:58.200 I guess what I'm trying to say. 01:10:58.200 --> 01:10:58.440 All right. 01:10:58.440 --> 01:10:59.040 I'm, I'm done 01:11:01.740 --> 01:11:06.180 Matt Engelken: kind of going back a little bit, but staying on a similar topic, 01:11:06.570 --> 01:11:11.010 I think that everybody, and especially like medical students and medical 01:11:11.010 --> 01:11:17.490 professionals are afraid of being wrong and strive for perfection at all times. 01:11:17.850 --> 01:11:22.230 And like, I know I, well that's cause you get smacked when yeah. 01:11:22.230 --> 01:11:24.090 That's cause we get in trouble when we're 01:11:24.870 --> 01:11:26.970 Madeline Cusimano: all around the hand, our conversation. 01:11:28.170 --> 01:11:32.968 Matt Engelken: But, it kind of creates that tension when, if we're 01:11:32.968 --> 01:11:36.238 uncomfortable with something or if we're afraid of making a mistake, we 01:11:36.238 --> 01:11:40.618 can back away from the situation because in a lot of our minds doing nothing. 01:11:41.488 --> 01:11:44.188 Better than being wrong and not being perfect. 01:11:44.224 --> 01:11:48.364 and I know something that a lot of, I know I struggle with and I know a 01:11:48.364 --> 01:11:53.314 lot of medical adjacent people can struggle with is not in being able 01:11:53.314 --> 01:11:57.424 to, as we said earlier, embrace the discomfort and learn from it because 01:11:57.844 --> 01:12:01.564 in order to embrace discomfort, we have to risk not being perfect. 01:12:01.744 --> 01:12:03.694 And that's a really scary thought to a lot of people. 01:12:05.884 --> 01:12:07.174 Dave Etler: I'm going to give you the last word on that. 01:12:07.174 --> 01:12:12.694 That's our show because it's now hour and 18 minutes of recording. 01:12:13.384 --> 01:12:16.954 Riley Behan-Bush: Is that a few I'm running late messages to my lab, 01:12:16.984 --> 01:12:17.404 Madeline Cusimano: but that's okay. 01:12:17.974 --> 01:12:18.394 Matt Engelken: Matt 01:12:18.454 --> 01:12:19.684 Dave Etler: Madeline Riley, Elaine. 01:12:19.684 --> 01:12:22.378 Thanks for being on the show with me today and thanks for, taking the 01:12:22.378 --> 01:12:24.118 risks that you have taken today. 01:12:24.688 --> 01:12:27.748 If you're talking about to talk about this, this topic, I do appreciate it. 01:12:27.778 --> 01:12:30.028 And what kind of sputum sample would I be if I didn't? 01:12:30.028 --> 01:12:30.418 Thank you. 01:12:30.418 --> 01:12:31.828 Shortcuts for making us part of your. 01:12:32.878 --> 01:12:34.378 If you're new here and you're like, what you heard today? 01:12:34.378 --> 01:12:35.038 Follow the show. 01:12:35.038 --> 01:12:36.838 Wherever fine podcasts are available. 01:12:36.928 --> 01:12:39.328 Like Spotify, apple podcasts, Google podcasts. 01:12:39.898 --> 01:12:40.648 Sometimes YouTube. 01:12:41.098 --> 01:12:42.808 Our editors are Maddie Wellington Nicklin. 01:12:43.198 --> 01:12:43.648 Good luck. 01:12:44.038 --> 01:12:46.588 The show's made possible by a generous donation by Carver college of medicine, 01:12:46.588 --> 01:12:49.318 student government, and ongoing sport from the writing and humanities program. 01:12:49.318 --> 01:12:50.098 Our music is by Dr. 01:12:50.098 --> 01:12:50.878 Foxen Katniss fear. 01:12:50.878 --> 01:12:52.978 I'm Dave, Etler saying don't let the bastards get you down. 01:12:53.398 --> 01:12:54.958 Talk to you in one week.