Chapter 03: Medical School and a Life-Changing Experience as a Physician Volunteer Near the Cambodia-Thailand Border
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Description
Dr. Dmitrovsky begins this chapter by explaining why he chose to attend Cornell University Medical College (MD conferred in 1980). He notes that he did research studies as well as a rotation at the National Cancer Institute. Next Dr. Dmitrovsky talks about volunteering to travel to Cambodia the summer after medical school. For three months he worked with the International Rescue Committee and saw difficult cases in the Khao-I-Dang Holding Center on the Cambodia-Thailand border. He talks about the diseases and conditions he say, many of which American doctors never diagnose. He talks about his triage experience. He also tells an anecdote about being invited back to Cambodia last year to give a graduation speech and meeting a patient who had been treated at the Holding Center. He notes that his experience had a "huge effect" on him, solidifying his desire to have a career of service.
Identifier
DmitrovskyE_01_20150303_C03
Publication Date
3-3-2015
City
Houston, Texas
Interview Session
Topics Covered
The Interview Subject's Story - Professional Path; Character, Values, Beliefs, Talents; Personal Background; Professional Path; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences
Transcript
Ethan Dmitrovsky, MD:
So after graduating from Harvard with this dual experience as clinical experience and scientific experience I was open-minded to having a career in medicine, with the idea there might be an opportunity for me to also have science as an aspect of my career, although I entered medical school with the strong thought that I would become a private doctor in general medicine. That was my plan. And I went to Cornell Medical School, as I mentioned, which was renamed I guess about fifteen years ago the Weill Cornell Medical School. I think "Weillis W-E-I-L-L. I'm not sure of the spelling.
Tacey A. Rosolowski, PhD:
I think it's W-E-I-L.
Ethan Dmitrovsky, MD:
Yeah, for Sandy Weill it was the family who named it, he and his wife. So Cornell Medical School, and that's in New York City, as you know. It's on the East Side, although on York Avenue in Manhattan, although obviously, the university is in Ithaca. The medical school is in New York City, and it's across the street from Memorial Sloan Kettering Cancer Center and next door to Rockefeller University. So this idea that I had when I went to medical school of, "Wouldn't it be interesting to be a practicing doctor, but keep an open mind about two other topics?One is that maybe tackling for my career's focus cancer is a problem, because it was a daunting medical problem, obviously, and because I felt there would be great progress that would be made. It seemed the juxtaposition of having Rockefeller University on one side of Cornell, and across the street which was one of the teaching hospitals Memorial Sloan Kettering. I knew I would have clinical and potentially science experience.
Tacey A. Rosolowski, PhD:
Was anybody talk no one had articulated the phrase "physician scientistat the time. That was still on the horizon.
Ethan Dmitrovsky, MD:
No, and many people I have a story similar to tell that I'm going to tell you in a second. So I enjoyed medical school. I did do research one summer, but it wasn't as in-depth an experience as what I had in college, because it was just a brief summer experience. During another at the very end of medical school, I did a rotation at the National Cancer Institute. They had a medical student exchange program, and I really was drawn to the idea of for my fellowship, to go there. And just before I finished medical school, I volunteered to work for the International Rescue Committee. They had after the Vietnam War, you know about the terrible holocaust in Cambodia. You may recall that President Carter had encouraged physicians to volunteer to work in these camps that were caring for these really tragic clinical cases of young children with kwashiorkor, which is a protein wasting syndrome, and many of the illnesses that went untreated for the five years of the Khmer regime. So I volunteered to do that and worked along the Cambodian-Thai border, and if you ever saw the movie The Killing Fields, that was actually the camp that I worked in.
Tacey A. Rosolowski, PhD:
Really?
Ethan Dmitrovsky, MD:
Yeah, and so I cared for I was in the camp opened in the end of November, and early December, I began volunteering there.
Tacey A. Rosolowski, PhD:
How long were you there?
Ethan Dmitrovsky, MD:
So probably, I guess, about three months. I'm not sure of the exact time. My I think it was two or four months. I don't really remember. But that had a huge effect on me, because this notion of a career of service was solidified with that experience, and I had decided that whatever I did in my career, helping others who were in particular need was something that I wanted to do.
Tacey A. Rosolowski, PhD:
Tell me about some key experiences you had during that three months. It must have been so intense.
Ethan Dmitrovsky, MD:
So I have seen illnesses that most western doctors never see. So malaria, obviously, we frequently diagnosed, and there are many types of malaria. Dengue fever, which, most fortunately, has not affected is not a disease that most American doctors have diagnosed. I've diagnosed leprosy, beriberi which is a thiamine deficiency that causes cardiomyopathy that's reversible, and the few causes are reversible. And we took care of a lot of wounded, and because the Vietnamese were just three kilometers away, and there were people who had stepped on landmines and other terrible things and had suffered gunshot wounds, and so we cared for them. And indeed, I even had the experience of triage, and you know what that is. So triage is where you triage, in the military tradition for medicine, is that those with head injuries you don't care for, because they can't be helped, and that you take care of visceral injuries. So I had that experience, too.
Tacey A. Rosolowski, PhD:
So you really had to make decisions on the spot about living and dying.
Ethan Dmitrovsky, MD:
And so I was in the Cornell emergency room that we were set up to be with a few other groups, so we were in charge of the emergency services for the International Rescue Committee, and so everyone would come through the emergency room first, which gave incredible experience in terms of infectious disease, pneumonias of all stripe, many meningeal infections. And one evening, I actually diagnosed a case of cholera.
Tacey A. Rosolowski, PhD:
Wow.
Ethan Dmitrovsky, MD:
And so there's you may not know this, but there's a very famous what's called a "cholera bed,because of the the illness, you know, it's highly infectious. The patients can infect the whole camp, and so we were understandably extraordinarily concerned when we made this diagnosis, and fortunately, we were able to prevent an outbreak. So it was just a remarkable experience, and which I am grateful to have had that experience, and quite notably, I was the invited graduation speaker this past June for the camp that I worked in is called Khao-I-Dang. It's closed now, but that's what it was called K-H-A-O hyphen I hyphen Dang, D-A-N-G in a town called Aranyaprathet. Aranyaprathet is a town right across the border from Cambodia in Thailand, so there was a very large that was the largest Khmer city outside of Phnom Penh in the world at that point. I don't recall the it was, I think, over 100,000 people at some point, so very large. So I was the graduation speaker, and as we were shaking hands for the graduates coming through, one of the students actually was in the camp.
Tacey A. Rosolowski, PhD:
Oh my gosh.
Ethan Dmitrovsky, MD:
And I had talked about this experience that I had for the graduation, and he told me that he wanted to thank me for what I did. And you know, I may very well have cared for him at some point. It was just quite quite a moment. So this notion of a commitment to service and a commitment to particularly helping people with very difficult clinical problems was what I took fresh in my mind in my decision of what discipline to choose, and I chose hematology-oncology for that reason. And also, there was a tremendous sense that progress was going to be made, which turned out to be the case. It really true progress has been made. From there, I wanted to continue having experience with the care of cancer patients, so I chose for my residency that combined internal medicine residency and internship program at New York Hospital, which is the major teaching hospital for Cornell Medical School and Sloan Kettering and Memorial Sloan Kettering. So over a three-year residency, I received a lot of practical experience of caring for cancer patients and found that I enjoyed caring for cancer patients, because the ability to improve their conditions both physically and emotionally was great. And in particular, caring for people who had terminal disease, I thought that it was possible to be particularly compassionate and saw how beneficial that was to the patients and the families. So based on that experience, I decided to devote myself to oncology as a career, and then, in part because of the Alsop book that had always intrigued me, I did my fellowship at the National Cancer Institute in Bethesda.
Recommended Citation
Dmitrovsky, Ethan MD and Rosolowski, Tacey A. PhD, "Chapter 03: Medical School and a Life-Changing Experience as a Physician Volunteer Near the Cambodia-Thailand Border" (2015). Interview Chapters. 638.
https://openworks.mdanderson.org/mchv_interviewchapters/638
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