“Perfect numbers like perfect men are very rare” ~Descartes

Ever go into something…a book, or a movie…so excited and expecting to love it, only to leave disillusioned and confused? I felt this way today after attending a lecture on diversity in medicine and research.  Dr. Q is his name, and he is a fancy-pants onco-neurosurgeon from Hopkins who illegally immigrated to the US from Mexico in the 80’s and worked as a migrant farm worker until he somehow went to and succeeded in medical school. I say somehow because I haven’t read his book yet…….but I will.

I was shaking with excitement because I love an underdog story, and ever more when it comes to marginalized races/ethnicities. I myself am a URM….Under-Represented Minority. My grandparents and parents have a tale that could make up a trilogy. Cliff notes version: my parents (and uncles….and grandma) immigrated to the US from Peru when they were in their late teens/early 20’s and worked in the lowest paying service jobs to put food on the table. My mom had a dream…she wanted to go to school, and she wanted to be a physician. My dad was (and still is) an extraordinarily patient and supportive man. He worked as a taxi driver and in a restaurant for years to help put my mom through school (and give me a good upbringing when I came along). My grandmother also worked her ass off cleaning hotel rooms because she wanted to give my parents the best future possible. Humble beginnings.

The talk by Dr. Q was a bit all over the place.  He jumped back and forth from talking about his family, his profession, his research, the growing number of Hispanics in the US and how that will affect future generations. He implored us to embrace diversity and improve the education of minorities.  He felt very passionate about curing brain cancer, being there for his patients, and spoke about the most difficult part of his job…saying goodbye….death.

These are all things I completely agree with, respect, and inspire me. But as he spoke there was a lack of humility that tainted everything. I tried not to let it bother me. I tried to let myself become inspired and excited. But it didn’t happen. He said he teeters too much between confidence and arrogance. He likes his expensive leather chairs. He lives in a nice neighborhood with a beautiful home, 3 perfect kids and a wife.

Great, we get it. You are a huge success. You’ve been on tv and radio. You’re kind of a big deal…..you have many leather bound books and your place smells of rich mahogany. We get it.

I guess I kind of appreciate him being honest about being arrogant.

But…but…… What happened to those humble beginnings? Does he feel entitled to be less humble because of his difficult past and how much he has overcome? I don’t think that’s a good excuse.

He said he hadn’t thought about disparities in health care until after he was already a surgeon and he was asked in an interview how many Hispanics he sees. If he thinks there was a disparity. He couldn’t answer the question. So yeah, after being all caught up in his biomedical research he switched gears and published some papers showing that there IS a Hispanic and African American disparity in the neuro-oncological care given. But only after he was asked to think about it……

You would think given his minority status and his background, something like this was at the forefront of his mind. It sure is with me. I am 24….I’m not an MD (YET)….I’m not in medical school (YET). But I think about this all the time. Racial/ethnic/socioeconomic disparities bother me. They have bothered me ever since my grandmother, who didn’t speak English, encountered her own cultural barriers to health care. I was 10.

You would think a migrant farm worker-turned-surgeon would have that much more inspiration and passion for such a topic. Yes, it came later in life. But what was happening before that??

He got caught up in the numbers. That’s my hypothesis. I have no doubt Dr. Q cares fiercely about his patients and disparities. But somewhere along the way he lost his humility, and maybe lost sight of the bigger picture and got caught up with # of publications, # of patients seen, # of procedures, # of people on his team, #$, # of fancy leather chairs he can sit in.

To top it off…..he said he had completely forgotten about his roots. Where he came from. Giving back. Only recently has he started a mission to bring the fanciest “most complex and advanced brain surgeries to 3rd world countries”. Dr. Q…..why didn’t you do or even think about this sooner? You realize it doesn’t have to be fancy? How …how could you forget about your roots? How could you forget about how you lived……the people that still live there, and their continued difficulties? Yes, you have rectified it. But how could you forget all that?

The numbers.

This brings me to my med school interview that I had yesterday here in my own institution. My first interviewer was, to put it plainly, one of the most incredible people I have ever met. He was a professor emeritus, long time retired physician and we shared a vision of what the future of medicine is and what kind of physicians are needed. We talked about the difficulties physicians experience in the profession. He grew quite and looking straight into my eyes nearly into my soul he said “You will struggle. You will struggle with the numbers, the other side of medicine. The way you feel now, never lose that. Never. Its not like the good old days. It was simpler then. Now you have to see more patients, do more procedures, publish more papers, know more things.  Don’t forget why you are doing this.”

Simple. Profound.

Dr. Q is a great man and he does great things. I hope he doesn’t get caught up in the numbers again.

My mother. We have a complex and often tense relationship. But when it comes to medicine, there is no better example. I may want to rip her eyes out sometimes, but she is the type of MD I want to be like. She didn’t get caught up in the numbers. That is why she is no longer here in my hometown and in Jacksonville instead. She cares so much about her patients, and her past keeps her humble and pushing the envelope when it comes to racial/cultural disparities.

She hasn’t forgotten the feeling. Neither will I.


3 thoughts on ““Perfect numbers like perfect men are very rare” ~Descartes

  1. I think your hypothesis is a little short sighted. You’re trying to look at politics logically and that is a no-no. The reason the good doctor droned on about how awesome and arrogant he was is that he didn’t care about the disparity because he is the proof that one doesn’t exist. He only talks about the disparity because it sells books. I’m as white as white gets – and I have the exact same family story that you do. Grandparents came from Italy and Poland. Grandpops worked as a taxi driver and at the steel mill (Bethlehem Steel) so grandma could stay home to raise my dad. My dad did ok, and now I am. It’s a story that’s told a thousand times a day in every state of the US. If you work hard, you can make it. But that won’t sell books and get one on TV. Sadly we’ve devolved to a point where “it’s not fair” does, and that’s sad indeed.

    People who hide behind that political view rarely care about whether it’s true or false – in fact the dictor’s arrogance shows that he KNOWS he did it himself – but the pats on the back for being an underdog and doing something decent with yourself against impossible odds is too great to pass up.

    Look at this from a different perspective. Guy writes A Million Little Pieces. He takes an average recovery story, lies about it to make it sound a little tougher than it was, sells a bunch of books and is eventually exposed… Same idea. What he did happens a million times a year. The only difference is he wasn’t a protected class – where you can actually get away with the lie. For that, you “have to be on the right side of the issues”. That’s how politics work. You’ll see.

  2. I have to disagree on a few things here……the politics of medicine are definitely not as simple as I point out here, but do have an impact (negative and positive) on how physicians change their way of practicing and way of being all around. I’ve heard this so many times from doctors, professors, and mentors (all in the medical field) I personally know.
    Disparities exist. That is a fact. The often confounding/modifying relationship between race, culture, and socioeconomic status are VERY difficult to tease out. This makes it difficult to understand WHY disparities exist. But they exists…its a scientific and cultural fact.

    Honestly, I believe disparities in health care have more to do with your socioeconomic situation than anything else. Therefore, yes you could be the whitest person alive and still have no access to quality health care because of poorer education/lower income. And yes, a white person’s “tale of woe” is less “sexy” than a Hispanics or African American’s…Why?

    All you have to do is look at census data. Its all there. Relative to overall numbers, there are more Hispanics/AAs of lower income, lower paying jobs, less insurance, and lower education. A quick lit review will show that time and time again Hispanics/AAs have higher rate of obesity, heart disease, diabetes, certain cancers, certain dementias. They have poorer outcomes, less access to care, less likely to finish treatments, lower quality of life…..the list goes on and on and on and on. Yes, there are plenty of White people in this boat too. But there is a FAR greater percentage of minorities in this boat. Don’t even get me started on other marginalized populations…..LGBT, deaf, American Indian…..there is sooo little known about those groups, its scary.

    Because of this greater proportion, it is always amazing to see story like Dr. Qs. He did in his one life-time what many families do in 2 or 3 generations. Just because he knows the story will sell well, doesn’t mean it isn’t true or disparities don’t exist.

    The guy who wrote a Million Little Pieces is a liar…..and I Highly doubt Dr. Q is one too. So I don’t think that is a useful or appropriate analogy.

    Yeah…being first generation and your parents becoming a cop or teacher or librarian isn’t going to get you a book deal. Those are important people to have in our society……but its a little different when you don’t speak a word of English and then not only go to college but go well beyond that……Medical school, grad school, law school….whatever….pass those tough exams that are HELLA hard for people who DO speak English….and then not only get a graduate degree but begin to contribute to knowledge in a sustainable way where your work is used to benefit human kind and transcends your lifetime. THAT is rare. And when an underdog does that……….no matter what the color of your skin is……….its an awesome story.

    But i digress……

    • Couldn’t agree more that it’s tough, but he did it. Now, why was it all if those people, Doc Q, my grandparents and your grandparents moved here in the first place? Oh yeah, the opportunity. It’s all good doc.


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