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The best of times |
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| I recently had the privilege of attending the graduation of a class of newly minted physicians at the University of Connecticut. As well you might imagine, there was much pomp and ceremony, as is typical with any graduation. The late afternoon gathering of parents, spouses, children, and siblings, all present to attest to the accomplishments of their prized graduate, was followed by the filing in of the former students themselves, each in a black academic gown and mortarboard with a green tassel. The ceremony began, and as with any graduation, a series of student, faculty, and administration speakers rose to commemorate the event prior to the awarding of the degrees.
Some speakers talked of the past four years in ways both comedic and banal. Others talked about their own medical education in previous decades and how much each physician, no matter how recently graduated, has to continue to learn. The governor of Connecticut said that statistically, about 50% of the medical school graduates in front of him would stay in his state, contributing to the well-being of the populace. Then, after the degrees had been given out, there were several concluding speakers. One—a student—talked about the future from a personal perspective. Titling his presentation “There has never been a better time to be a doctor”, he talked personally about a 5-year-old cousin with acute lymphocytic leukemia, noting that today there is an 85% chance that his cousin will survive the disease. Twenty-five years ago, when he was his cousin’s age, there was but a 35% survival rate. The student continued with this theme, noting that certain types of heart disease are also much more treatable now than 25 years ago, witness Vice President Cheney. Cancer, multiple sclerosis, rheumatoid arthritis, even AIDS—the list of afflictions with better, more effective treatments grows longer. And that’s only what we know about now. As genomics and proteomics research kicks into high gear, we’ll undoubtedly have more drugs like Gleevec, the newly FDA-approved treatment for chronic myelogenous leukemia. If you are a doctor and want to make patients better off after they see you than before, I think the student was absolutely right: There has never been a better time to be a doctor. Unfortunately, the medical profession involves not only patient care but business as well, a fact also noted in the presentation. There are articles in the popular press about doctors now making less money than ever, having to job-hunt, and getting laid off from their HMO billets. And there is the ever-present question of access to medical and pharmaceutical treatment. Who pays, and how much? These are clearly major issues that will have to be confronted by these new doctors in the coming 40 or 50 years of their careers. But for now, the problems new doctors see and with which they must deal are those of the patient. Such problems notwithstanding, these students clearly believe that they can give their patients better treatments than ever. There are better medical tools, better-trained doctors, better drugs, and even better awareness of personal responsibility on the part of patients. Areas of our work such as drug discovery and pharmaceutical development and the ancillary industries of analytical instrumentation, robotics, and computer modeling will, I believe, soon make medical treatments available about which we can now only fantasize. It is a great time to be a doctor. The student speaker for whom this is the best of times is my son Jason. No parent could be prouder or more in awe of both the professional accomplishment and the future challenge. — |
