My Med Student Friends Are Zombies: On The Complicated Lives Of Doctors

Many of my med student friends are zombies. They also appear to age quicker than the rest of us, which probably has something to do with the fact that I see them after long stretches of societal oblivion. Many of my med student friends have also struck on my nerves at least once. "Arrogant, know-it-all rascal," I distinctly remember murmuring (in less restrained fashion) on one occasion when a door slammed onto my face because my flu was apparently too much of a contagious risk to be allowed inside.

But perhaps the risk really was too much to handle. It was exam time and the dread of failure—of redoubling a year—is something that is very real for all med students. The reason why they look like zombies, why they appear unshaven, shaggy and maussade is because they are in the business of saving lives. (Ironic, I know.) And with such responsibilities, come hard work and dedication. And sporadic bouts of no self-respect.

And then they eventually become doctors, start driving nice cars, buy huge houses or apartments and squeeze out that sickening feeling of envy from their entourage. They are living the life, we think. They are, but it's not a life without its complications.

When Atul Gawande, a surgeon at Brigham and Women's Hospital in Boston and a Professor of Surgery at Harvard Medical School, saw a 23-year-old young woman present with a rash on the sole of her left foot one day, he quickly assumed it was a mere case of cellulitis, a not-uncommon inflammation of some skin layers. Treatment was fairly simple: antibiotics and a follow-up. But nagging him was this horrid thought that there was something much more horrible at play. "Once a possibility has been put in your mind—especially one as horrible as necrotizing fasciitis—the possibility does not easily go away." Here was the dilemma, the complication: should he follow through with his intuition and investigate for necrotizing fasciitis, caused by bacteria which literally devour flesh and kill within days, or should he, as conventional reasoning would suggest, give her antibiotics for cellulitis?

This case is one of the many described in Gawande's 2002 book, Complications. The book smashes the perceived illustrious life of a surgeon just like a Van Gogh canvas clamours the honesty in a person's visage. It showcases the altruism world of doctors as it really is: caring for others up to one's own ability. And therein is a principal focus of the book.

From the very beginning of the book, Gawande wants to make it very clear that doctors are human beings. "A doctor with good days and bad days. A doctor with a weird laugh and a bad haircut. A doctor with three other patients to see and, inevitably, gaps in what he knows and skills he's still trying to learn." And, expectedly, Gawande does not lament this fact but instead presents readers with the same problems, insecurity, pressure that doctors have to deal with. His aim? To show us, and fellow physicians, that doctors should do their best to surpass the difficulties they are faced with but that sometimes, things will take a turn for the worst regardless.

But Gawande also shows the lethal flaws that creep in when doctors take medicine "to be both more perfect than it is and less extraordinary than it can be." In Complications, Gawande not only sensitises us, past and future patients, to the very human profession of a doctor, but also preaches to fellow doctors about the grand but limited science that is medicine.

To do both, Gawande draws upon some of his own cases. The young woman with a case of necrotizing fasciitis is one of those cases. With this story, Gawande tackles uncertainty and intuition. His end-message is that instincts need to be followed... sometimes. Sometimes because would you, the patient, rely on a doctor who does something on a limb? Sometimes because would you, the doctor, put a patient under the knife to satisfy that irascible voice in your head? This is the uncertainty which is evident everyday in Gawande's field.

For those familiar with Gawande's writing, especially his contributions at The New Yorker, where he's been a staff writer since 1998, Complications may seem a too shallow and emotionless of a book. But it is not Gawande's aim to dig into particular cases and explore the science and the human intricacies attached. Here, the stories are clearly a means to an end—a deeper end which forms the backbone of the entire book.

I'm not a doctor and after having read Complications, I am sure that I never want to become a doctor. I mean every word of this as a compliment. Doctors may only be human beings, but what brilliant beings most of them are.

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Image credits: Top: Portrait of Dr. Gachet painted by Van Gogh (from Wikimedia Commons); Bottom: Picador (from Gawande.com).