Can Med Students Save the World?

Kendra Campbell -- I am a total sucker in many ways. I can’t count the number of wounded squirrels, rabbits, mice, deer and other animals that I’ve brought home in the past. When I see an animal in need, I lose all sensibility, and immediately pick it up, bring it home, and figure out the best way to care for it.

This certainly became a problem for me when I moved to Dominica. There is an abundance of neglected, homeless and abused animals everywhere you look. Within days of moving here, I found what I thought were two homeless dogs, brought them home, cleaned them up, and gave them plenty of food and water. Then came the puppy phase. For about a year, my apartment served as a makeshift puppy shelter/rehabilitation center. I’d bring home puppies and de-worm, de-flea, de-tick, and rehydrate them. After they were overwhelmed with food and love, I’d put a collar on them and try to find them a good home. I even ended up keeping three of them for myself. (Unfortunately, one passed away.)

Eventually, however, I became somewhat overwhelmed by the shear number of animals that needed care. It was simply more than I could handle by myself, and I realized that I was barely making a dent in the problem. So, I stopped taking in the strays and just focused all my attention on my two puppies. Now, when I see a homeless or neglected animal, my heart still goes out to them, but not in the same way it did in the beginning. I think I’ve become somewhat desensitized to them. Has the harsh reality set in? Has my empathy been pounded out of me, leaving only apathy behind?

In many ways, my transformation reminds me of the one that many med students go through. In their pre-med and first two years of med school, they want to save the world. When they first start seeing patients, they have the utmost empathy for them and go out of their way to care for and help them. Then the reality of the overwhelming number of people in need sets in. Not only that, but they begin to realize that in many cases, people can’t be saved. Patients don’t listen. The healthcare system fails them. It all becomes an exercise in futility. The process reminds me of Martin Seligman's famous experiments on learned helplessness. The dogs in the experiments eventually learned that they couldn’t escape the electric shocks and hence gave up. Med students eventually learn that they can’t save the world, and in a way, they learn to give up trying to save everyone.

In a study recently published in the journal Academic Medicine, researchers found that undergraduate medical education does in fact reduce vicarious empathy in medical students. So, there is some proof that the medical education process is not always promoting empathy and compassion. Ironically, the schooling process seems to have a deleterious effect on a med student’s ability to care.

I can tell that I have yet to have all the empathy sucked out of me. The other day at the hospital, I met a 1-month old baby whose mother had left him at the hospital. The staff had been unable to contact any of the mother’s relatives, and there are no orphanages in Dominica. So, the baby will remain in the hospital until a home is found. Of course, I reflexively wanted to take the baby home with me and care for it. Seconds later, reality sunk in, and I knew that I couldn’t handle the responsibility. But there is still a part of me that wants to run back, grab the baby, and take him home with me.

We see many patients who can’t afford to have necessary surgeries performed. Every time I meet a patient in this predicament, I want to write them a check from my own bank account for the surgery. Of course, I quickly realize that I’d eventually run out of money, so I don’t.

So, while I know that I can’t help everyone in the world, I still have the instinctual response to try. And every once in a while, I am actually able to help a person or two. I don’t think it’s wrong to have those kinds of feelings. I think the problem will come the day I stop trying to save the world.