21 February 2007

Age and Medicine

Back in 1997 when I made my attempt at getting into medical school, I didn't know of anyone even close to my age (45) who had started medical school. I had been in academia and was quite used to preparing myself and testing myself but I never let myself for one second, believe that getting into medical school was going to be something that I would not be able to accomplish. In short, I didn't believe that medicine was my "life's calling" or that I would ascend to some "higher plane of existance" with the practice of medicine. I thought the subject matter was interesting and that I could contribute to the profession with the tools that I already possessed.

I am a person of ideas and questions. I am always looking for a new "take" on a problem or some new aspect to an old problem. I was always curious about anything and everything that had to do with observations of the world. My Mum noticed as early on, when I was a toddler, that I could amuse myself by examining the world around me. I started out with anything that was placed in my hands and from there proceeded to catalog all of the plants in our gardens on the grounds of our farm.

She said that even before primary school, I would spend countless hours watching frog's eggs develop in the stream near the back of our house or I would sleep in the barn with my father when it was time for one of the mares to foal so that I could be awake for the birth. Our farm provided a living laboratory where I honed my powers of observation. In addition, the Encyclopedia Britannica, a gift from my father, provided a wealth of information at my fingertips that encouraged more observations.

One of my first "experiements" was the isolating Belladona, a cholinergic stimulator, from the May Apple Plants that grew wild in the fields. I ground up the plants and did the extraction following instructions from a scientist friend who lived nearby. He was totally surprised when I was able to obtain small amounts of atropine from the plants. He knew that I had succeeded when I appeared at his doorstep with dilated pupils at the age of seven. I guess I was on my way to being a chemist.

I was also intrigued when my Mum would kill and evicerate a chicken for dinner. It wasn't the meat that was of prime interest to me but the dissection of the heart and the identification of the structures in the heart. I dissected liver, made slides and examined the tissues with my small light microscope that had a mirror as a light source. I even used iodine as my primary stain for many tissues that I sectioned from the entrails of those chickens.

When I headed off to university, post secondary school at the age of 15, I didn't realize that by being as young as I was, that I was a bit different from my classmates who were all 18. To me, it was three years but to them, it was a generation. I spent most of my "downtime" hanging out with a couple of mates who were from New England. We listened to music and solved most of the world's problems from our limited perspectives. I also had a part-time job in the chemistry laboratory preparing experiments and making compounds. From atropine to nickel-complexed bioorganic substances. I had arrived.

I decided at the end of my freshman year, that I would be a research scientist. I was interested in analytical chemistry and getting to know all of the instruments in the lab. They were my friends and companions for most of the day. In the evenings, I would accompany my research advisor and his wife to the symphony (I was a great fan of Baroque music). I also played any wind instrument and wrote some short compositions. Even to this day, there is no genre of music that I do not enjoy. My music collection contains everything from classical to rap to country to jazz to new age to indie. I love to listen to everything.

When I was a junior, I had already decided that analytical biochemistry was going to be my career. The science of large biomolecules, especially proteins and their analysis, was of great interest. I had been analyzing some mushroom toxins (see, I really love those plants) and moved into working with snake venoms. These venoms were my first venture into the world of systemic pharmaceutical effects. I loved what I was working on.

I also worked in the lab of an analytical chemist who further nurtured my interests in just figuring out how things worked. He was a pioneer of computer modeling and was adept at making very complex mathematical descriptions and models of energy changes in the manner that compounds interacted with each other. I loved working with the graduate students and seeing how his ideas and theories developed. He also make me understand how mathematics was a great tool of the scientist.

My interest in medicine was awakened just before I began to study for my comprehensive exams in graduate school. My best friend in the graduate program was a Brazilian neurosurgeon who was working on his Ph.D in Biochemistry. We studied together and shared information often. In addition, we talked about medicine and the differences in practice between the United States and Brazil. Some of the best times were when he would bring his 8-year-old daughter to the lab so that she could hang out with us. She reminded me of myself at her age and what could be better than hanging around in the lab.

Right after comprehensives and defense in June, I knew that I was scheduled to take the MCAT that August. I had already filed my AMCAS application and had designated six schools (including the one where I was a graduate student). I also knew that I would be evaluated later because of the August MCAT but I didn't have a choice. It was in May that I even decided to apply to medical school so I had already missed the April MCAT. I would file everything that I could and then have my scores catch up with the rest of my application.

Well, the rest was done. I took the MCAT and the application was done. I was so busy working on my lectures for the next year, that I didn't really expect that I would get into medical school. After all, I was 45 year old but had tons of energy and an interest in everything. I recall reading one of my letters of recommendation and wondering if I was even suited for the practice of medicine. My letter writer, a cardiologist, wrote of my incredible insight into pathology and physiology of diseases. For me, these were just more things to study, explain and catalog, something that I had been doing all of my life.

My MCAT scores were released to my prospective medical schools that October. I had my first invitations to interview by the end of October and went on my first interview the first week in November. Most of the other folks who had come to interview thought I was faculty and were fairly surprised when I said that I was an applicant. One guy even laughed because he said that no medical school would "waste a seat" on someone that was as old as me. This comment was a source of humor throughout the entire process when I received the first of my six acceptances.

As I went through medical school, I noted few differences between myself and my younger colleagues. I was the third oldest person in my class. I was single so I would party with the single folks but I enjoyed the kids of my classmates because children are just neat. There are no sharp divisions between non-traditional and traditional medical students. We all have to master the same amount of material and just get the job done. Medical school is a great equalizer.

As I headed into residency, I still found little difference between myself and my younger colleagues. My gray hair (been gray since age 24 like Taylor Hicks) afforded me instant rapport with my patients but I was no more tired after a night on call than my younger colleagues. I slept little, answered every page, and always loved to operate through the night with one of my chief residents. As soon as I hit the OR, I was always wide awake and ready to work.

The long hours now make me appreciate little amenities like sitting in the hot tub or going for an early morning swim before getting to the hospital on weekends for that extra energy boost. I love the world of getting to the hospital before the sun comes up and seeing the progress of my patients. I also love reading and discovering new treatments and therapies.

If nothing else, my age allows me to appreciate this great platform from which I can observe the world. I just doing the same things that I did back when I cataloged all of those plants in our backyard.


Jacqueline said...

"no medical school would "waste a seat" on someone that was as old as me."
I can't believe that was said to you. How rude!! Well, 6 out of 6 acceptances says it all :) The nerve of some people!

Would it be rude of me to ask what your MCAT score was (yes, i'm nosey)?

For what it's worth, I look forward to your posts every week. I hope I don't sound too hokey, but your words of wisdom give me a kind of lift and support that helps keep me focused on my own journey to medical school..so thank you.


PS. I'm half Brazilian!

Drnjbmd said...

My score was in the high 30s with a score of S on the writing sample.

Dilly Bar said...

you are such an inspiration to me. thank you for writing this post