Chapter 03: Challenges in College and Medical School; Seeking a Specialty

Chapter 03: Challenges in College and Medical School; Seeking a Specialty

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Description

In this chapter, Dr. Fisch talks about selecting his college (University of Virginia at Charlottesville, BA conferred 1986) for financial reasons and explains the value of a state education. He notes that he was not a top student and had to work very hard as an undergraduate. He notes that he discovered his lack of visual/spatial ability, which made certain courses very difficult and caused him to consider a career in nursing.

Next, Dr. Fisch talks about his medical education at the University of Virginia Medical School (MD conferred in 1990), noting how he loved surgery, but his lack of visual/spatial ability made this specialty impossible for him. By working with surgeons, however, he learned to love clinical medicine and post-operative patients in particular because they were “endlessly complicated.”

Identifier

FischMJ_01_20150205_C03

Publication Date

2-5-2015

City

Houston, Texas

Topics Covered

Educational Path; Character, Values, Beliefs, Talents; Personal Background; Professional Path; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences

Transcript

Tacey Ann Rosolowski, PhD:

Interesting. Tell me more about your college experience. Why did you choose to go—let’s see. You went to University of Virginia in Charlottesville. So tell me about making that choice.

Michael Fisch, MD:

So I didn’t really want to go there at first. I had grown up—actually, again in sports—I was rooting for the University of Maryland college sports teams, so the idea of going to UVA didn’t seem like it made any sense to me. But I think I had applied and gotten into Johns Hopkins, which was way too expensive for my family, and I really liked William & Mary in Williamsburg and just thought that would be great, but that was also pretty expensive. I remember going to UVA in the summer and not liking it that much. There was a lot of construction, it was hot, and it didn’t really turn me on that much, and telling my parents that I think I liked William & Mary. They said, “That’s good. Why don’t you look at UVA one more time before you decide.” So I went back one more time, and it wasn’t, you know, jackhammers in the street, it wasn’t as hot, and decided to go there. I was lucky to be able to go there because it’s a great school, it was a tremendous value. Again, my parents, middle-class and we didn’t have tons of money, the value of in-state tuition at UVA for the quality of the education and the affordability of it was fantastic. I had a great experience. I was a resident advisor my second, I think—I want to say certainly my second—probably my second, third, and fourth year. So, anyway, that saved costs and it also gave a chance to lead and learn and work with people and trying to—you know, it’s not so much—I guess a resident advisor is not exactly a leader. It’s a certain kind of leadership role, but it’s not like project oriented as a different sort of thing. But it’s one that I enjoyed and made connections with people and learned a lot from. It was very eye-opening to be in that role and to see how various other people experience college and what problems they have and things that would be off your radar become on your radar in that sense.

Tacey Ann Rosolowski, PhD:

So were you premed?

Michael Fisch, MD:

Yes, I was premed, and, again, you know, I was not the smartest premed, but I was willing to work endlessly. (laughter) I was willing to work as hard as one needed to work to learn whatever it was we were trying to learn, and I had to learn also how to deal with things that didn’t go well. I’m having this sort of flashback of another Dr. Hong aphorism to me, or not aphorism, words of wisdom to me at one point in my career when I was involved with some disappointments or conflicts with some other groups. And I remember him looking at me and saying, “You’ve got to learn how to lose. You’ve got to learn how to lose. You can’t fight and win every battle. You’re not going to always win.” Of course, you sort of know that your whole life, but sometimes it’s hard to see that, or you need to hear that kind of advice. But my learn-how-to-lose moments in undergrad was, I think, the first semester I took organic chemistry I got a C, and I was very disappointed with that, because, trust me, I put in everything I knew how to try to learn organic chemistry. In the end, there’s a lot of visual spatial work in organic chemistry, in enantiomers and other things, and that’s my Achilles heel. That’s the lack of aesthetics and lack of visual spatial ability made that rough. Then I thought, well, that might clock me out of being in medical school. I mean, I don’t know that I will be able to go into medical school after getting a C in organic chemistry. And I remember going to my premed advisor, a guy named Dick Pearson [phonetic], I think, a very nice man, and I remember talking to him about my C and then saying, “You know, I was thinking about my career and I was wondering what I should be, and I was thinking maybe I would go into nursing,” because I wanted to go into healthcare and caring for sick people, but I was sort of ready to acquiesce that if you get a C in organic chemistry, you’d better not focus on medicine. That’s probably not going to work out for you. And I remember him looking at me and saying, “Well, is that what you want to do? You want to be a nurse?” I said, “No. I want to be a doctor.” He said, “Well, then be a doctor; i.e., don’t exit now, just stay on the course. If you want to be a doctor, this is not a disqualifying moment. Start there.” (laughs) So I think I was able to scrape a B the next semester and I had very good grades in the other classes, again, a lot of A-minuses, A’s, a few B-pluses, but a good grade-point average, and so it went. I got good enough MCAT scores and got into UVA Medical School, which I remember getting that letter. Again, this is the era when you didn’t get an email or something, but you opened up an envelope and it said what you wanted. It was a really big thrill. And the other sort of similar experience that I had in med school, the same sort of problem, my visual/spatial stuff got me in anatomy. I think I got a C one of the semesters in anatomy, and I was just devastated, because again, like organic chemistry, I was studying anatomy endlessly. This is obviously not the era where you have apps and stuff, so you have four or five sort of manuals and atlases of anatomy open with different perspectives on the anatomy. So I was just trying to figure it out in 2D, in the 2D world I had available to me. And then I was best at managing lists, so I’d try to convert it into 2D lists, but anatomy is sort of endlessly complicated if you’re just going to make lists of things. You’ve got to picture it. If you can’t picture it, it’d be like turning architecture into a rote thing. Pretty tough. You just either see it or you don’t.

Tacey Ann Rosolowski, PhD:

Mm-hmm. It’s kind of funny, because, I mean, I often ask people if they’re visual thinkers, and so many of them don’t know what I’m talking about, though they clearly are. I mean, people in radiology, surgeons, I mean, if they don’t have that ability, they can’t practice.

Michael Fisch, MD:

You can’t function, yeah.

Tacey Ann Rosolowski, PhD:

No. So it’s interesting that you had to confront it, because you were not able to work easily in that mode [unclear].

Michael Fisch, MD:

Yeah. So I got a C and I was devastated by that, but—

Tacey Ann Rosolowski, PhD:

But, again, it wasn’t a determining factor.

Michael Fisch, MD:

No. So what it told me is you’d better not want to be, say, an intervention radiologist, probably not a surgeon. And I remember thinking, “But I love surgery.” That’s the thing. I went into my clinical rotations, my very first rotation was surgery, and, man, did I love it. First of all, because I love clinical medicine, I was just ready to eat up clinical medicine at the first opportunity, so I was overjoyed to be in clinical medicine. And I loved the surgical culture. You know, the surgeons were cool, and they said funny, cool things, and they did funny, cool things, and they were great to hang around. And then I loved caring for the post-op patients, because they were wildly complicated. They had all kinds of things. You know, they had wounds and metabolic abnormalities and infectious complications and clots and things. You know, things started to happen in the post-op world that required you to tune in and be effective, and so I liked caring for the post-operative patient. Time in the OR was pretty okay as a clinical clerk, because you didn’t really have to do much, right? You’re just watching and retracting and being in the room and seeing cool things and having school experiences. The problem is if you have to do any surgeries. So then we had like a dog lab, and we had to do a splenectomy on a dog, and, man, I could not figure it out. I mean, I’d get lost. If you’re a dog, you don’t want me to be taking your spleen out, because I’m going to struggle. So I found out that—you know, and I could sort of sense. I mean, it’s no mystery to me that that was not going to be—you don’t get to be a surgeon by being a post-op care provider. I thought I could probably learn how to do whatever surgeries need to be done. Like I could learn how to take out a spleen in a dog and I can learn how to do repair a hernia, and I could do it all. Kind of like I could learn how to do organic chemistry and maybe not fail it and maybe even get from C to B, but I’ll never be A-plus. I will never be the one that you would want, so why would I want to go into a specialty where I have that sort of limitation of my potential? Go into something where I can find my own flow and not make life such a struggle. (laughs)

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Chapter 03: Challenges in College and Medical School; Seeking a Specialty

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