Some things I will never forget. I will always see the wires and pipes hooked up to my aunt as she lay there, heart open, and hear the hideous pumping of the heart-lung machine, as if driving air and blood through her heart might have brought life to her as well. I have tried to forget the look of her face that last morning, when the machines stopped and she did not wake up, but shiny anger has kept the darkness well away from those memories. On that day, men and women in white coats and blue gowns had tried to console me and my family, tried to convince us that all that could be done had been done, and tried to help me through my pain and frustration. I cried quietly to myself, each tear a promise to fight death myself, to stop anyone from ever having to experience that feeling of helplessness ever again. I promised myself that I would become a physician one day.
I was just a boy then with no idea of the set of reactions and physics called physiology and no concept of medical science. Wanting to learn more about medicine as I grew up, I volunteered at the Mary Immaculate Hospital Emergency Room in Jamaica, New York, and was struck by the complexity of the medical system and medicine, encompassing not just patients, physicians, pharmaceuticals, and surgeons but also nurses, technicians, clinical aides, translators, social workers, and even business managers. Moreover, as I saw the different sides of medicine, I was humbled by the fragility of human life. Once, I witnessed a little boy of barely three being rushed in with severe trauma and bleeding. Hour after hour, the entire healthcare team fought a desperate war to save him. They ultimately failed. I will never forget how gently the attending physician cleaned the blood from the boy’s blue face with a piece of sterile gauze. Everyone had tried their absolute best, but saving a life is difficult even with knowledge, technology, and experience. In the face of such complexity, my childishness dissipated into a directed curiosity.
Despite the limitations of medicine, the disciplined application of integrated scientific knowledge in medicine captivated me. As I became immersed in physics and engineering, I wondered how they applied to biology; every time I learned new biology, I considered the physical principles behind it. My research in instrumentation design and then in intervertebral disc biomechanics stimulated me with the challenge of considering both biological principles and physical constraints. I wanted to discover and invent for medicine. As I continued with interdisciplinary work in experimental electrical neuroethology, I vacillated between the possibility of a career in medicine and in science. I think engineering and physics are deeply entwined with the future of medicine.
However, I recognize that medicine is more than a science, that it is also an art. At a palliative care ward in Bethesda Hospital in Western Australia, I helped care for people with incurable conditions. Medicine could do little to heal them, and I was humbled by their appreciation of comforting words, a cup of tea, and a listener to their stories. The physician responsible for these patients seemed to derive satisfaction from spending time with them helping them feel better physically and emotionally. The patient-physician bond, a relationship of trust and empathy, was more beautiful and poetic than anything I had ever witnessed. Indeed, the power of medicine to change people’s lives and to empower them even in the face of death demonstrated to me that medicine cannot afford to have only one narrative, that of science. It is equally a human endeavor; it is compassion and kindness.
One day, I returned to the palliative care ward to see Mr. E, a patient who had spent months in a place where many came to pass peacefully and painlessly into whatever lies beyond. I had spoken to him in Spanish when I remembered the words, written letters for him to the government, and read newspapers and books to him. I had imagined that his kindness and concern might be like that of the grandfathers I had never known. On that day, he was gone, never to return; I will never the forget the emptiness of his room, vacant of his black and white photographs of Spain and his welcoming smile full of brown and broken teeth. Feelings of anger and helplessness did not accompany sadness. Instead, I also felt assured that all that could have been done had been done and felt hope that maybe one day more could be done to help people like Mr. E, like the boy in the ER, like my aunt. And, for more to be done to help them, dedicated investigators would have to first discover basic scientific principles and then translate these into medical treatments.
Having realized this, it makes perfect sense that I am fascinated with both science and medicine. I want to be a doctor who can personally care for patients and a scientist inspired by patients to seek new treatments, a true physician-scientist. I do not have to choose science or medicine but can use each other to sharpen the other. Both scientific research and medicine are indivisible aspects of one quest, the journey to health others. I seek to spend my life as an interdisciplinary clinician, a driven investigator, and a compassionate human being.